01/11/2017
TEMPOROMANDIBULAR JOINT (TMJ) DISORDERS
TMJ disorders are problems which affect the jaw joint.
The jaw joint or temporomandibular joint is located just in front of the ear, and it joins the jaw bone to the skull Problems affecting this joint are usually known as TMJ disorders and are fairly common.
What are the symptoms of temporomandibular joint (TMJ) disorders?
• Pain in and around the joint area, usually just in front of the ear or involving the cheek, ear, and/ or the temple on the same side.
• Difficulty in opening the mouth , stiffness on jaw movement, or rarely the jaw may even get locked in one position resulting in inability to open or close the mouth.
• Sometimes, the pain and restriction in jaw movement may be accompanied by clicking sounds while chewing or when opening/closing the mouth.
• Pain which appears to come from deep inside the ear, heightened sensitivity to sound, a noise in the ear or even dizziness due to the close proximity of the ear to the joint.
CAUSES
They could be due to
• Problems linked to the muscles working the joint., esp in the younger age group
• Problems inside the joint itself.
Problems with the muscles may be caused by:
• Tension of the jaw muscles.
• Overuse of the jaw muscles, such as habitually chewing gum, or biting nails.
• Rarely, other conditions make the jaw muscles overactive which result in excessive clenching of the jaw
Problems in the joint occur more in the older age group and may be caused by:
• Wear and tear to the inside of the joint due to osteoarthritis. This problem tends to affect older rather than younger people.
• Certain other types of arthritis. - rheumatoid arthritis
• Injury to the TMJ or to its cartilage disc
DIAGNOSIS
The Diagnosis is based on the individual patient’s symptoms and examination. No tests are necessary in majority of cases
MANAGEMENT
Most problems in the jaw joint can be helped with simple treatments such as painkillers and advice on how to rest the joint. There are various treatments which are often used in combination:
Resting the jaw joint
• soft food ,no chewing gum.
• avoid opening the mouth very wide
• gentle massage over the area.
• Hot fomentation
Other treatment
Stress-reducing therapies - presumably because people tend to clench their jaw when they are stressed, or because stress makes pain worse.
Use of “bite plates” at night to reduce clenching of the jaw may be helpful in some individuals
Medication
Painkillers such as paracetamol, ibuprofen with or without muscle relaxants or a small dose of a medicine called a tricyclic antidepressant can give added pain relief.
Physiotherapy
Physiotherapy treatments, such as ultrasound and gentle jaw exercises, can be helpful.
Exercises for jaw pain:
• Before you start, warm the jaw area with a hot water bottle or a heating pad, to ease muscle stiffness
• Place your fingers on the front of your chin and try to move the lower jaw forward against the resistance of your fingers. Hold this position for a few seconds, then relax. Repeat three times.
• Place your fingers under your chin and try to open your jaw against resistance. Hold this position for a few seconds, then relax. Repeat three times.
• Place your fingers on one side of your lower jaw and try to move your lower jaw sideways against the resistance of your fingers. Hold this position for a few seconds, then relax. Repeat three times. Then do the same on the other side.
• Place your fingers over the jaw joint and gently open your mouth as far as you can. Take care that your jaw opens straight and not to one side.You can repeat these exercises several times a day until the symptoms ease.
Treatment of other conditions like Arthritis is necessary.
Injection of Steroids in the joint in case of inflammation, surgical procedures on the joint via arthroscopy, kinesio taping and acupuncture are other treatment modalities.
LONG TERM OUTLOOK
With proper management, outlook is good, most symptoms improve with time, complications are rare, though symptoms do last a bit longer or recur in some individuals.
Most people do not need injections or surgery and will get better with simple treatments and time.