TMJ – Temperomandibular Joint Disorder

June 5, 2008

Temperomandibular Joint Disorder, the longer but more descriptive name for this condition, by definition occurs when the muscles used in chewing and the joints of the jaw fail to work harmoniously with each other. Although stress is usually a causative factor, as manifested by clenching and grinding of the teeth, other causes can include malocclusion (poor bite), accidents that damage the bones of the face of jaw, and occasionally joint diseases such as arthritis. TMJ is almost always associated with complaints of chronic muscular headaches or craniofacial pain. Other classic symptoms can include pain and tenderness of the jaw muscles, clicking and/or grinding noises during chewing, limited opening spaces or capacity of jaw movement, earache, ringing of the ears, dizziness, and occasionally facial asymmetry. Although often aggravated by emotional stress, the basic problem is oral conditions and habits. Many people are physiologically and psychologically predisposed to deal with their stress through their jaws by clenching and grinding their teeth. The diagnosis of TMJ is accomplished by both physical and radiographic means. It begins with a consultation with the patient to establish the symptoms they are experiencing. Professionals, usually dentists but occasionally other medical practitioners, can then feel and listen for joint noises, palpate the muscles which move the lower jaw for soreness and measure the range of motion of the lower jaw. Sometimes radiographs are necessary to establish the exact physical reason for the TMJ symptoms. These may be Magnetic Reasonance Imaging (MRI) or Tomography, or both. Obviously stress management can have a profound effect on some cases of TMJ. Therapy for mild cases usually consists of anti-inflammatory medications, a soft diet, limited opening, and warm compresses applied to the affected muscles. In more extreme cases, muscle relaxants can be added. Patients with symptoms that become chronic, especially in the presence of bite relationship problems, sometimes require intra-oral occlusal splints. These rigid, plastic removable appliances level the bite and eliminate irregularities, which can cause TMJ, or make the symptoms worse. After the symptoms have been relieved, permanent dental corrections may be helpful. This treatment can be accomplished by selective grinding of the biting surfaces of the teeth (called equilibration), orthodontic work, fixed dental reconstruction (crowns or bridges), or removable partial dentures. The goal of all these modalities is to restore and maintain the normal relationship between the upper and lower jaws, and thus relax the muscles, tendons, and ligaments controlling their motion. Between five and ten percent if TMJ patients have dysfunction that is of a nature that can only be relieved by surgical intervention, either surgical correction of the joint tissues themselves, or surgery to rearrange the relation of the lower jaw to the upper jaw to correct the bite relationship.