Temporomandibular (Jaw) Joint

TEMPOROMANDIBULAR JOINT (TMJ) DISORDERS

Overview

Temporomandibular Disorders (TMD) are a group of conditions that typically cause pain and prevent normal function of the temporomandibular joint (TMJ) or jaw joint. The TMJ is located in front of the ear, on both sides of the head. The joint is made up of the lower jawbone and the skull. A cartilage disk, which functions as a shock absorber and joint lubricant, separates these 2 bones. The TMJ and the muscles of chewing enable you to open your mouth, talk and chew.

Temporomandibular joint disorders can originate from different components of the joint:

  • The specialised muscles of chewing
  • The cartilage disc
  • The bone of the TMJ ( the jawbone and the related bony skull base )

Causes of TMJ Disorders

TMJ disorders may be caused by:

  • Prolonged stress to the TMJ – Should you habitually clench or grind your teeth, this will overload your TMJ causing pain to the joint and muscles of biting. Should this happen whilst you are sleeping, you will not be immediately aware of such habits.
  • Trauma – Any relevant history of trauma, such as a punch to the lower jaw or face, indirectly or directly, can damage your TMJ.
  • Arthritis – The TMJ can be damaged by arthritis (inflammation of the joint). Arthritis is a known degenerative process due to aging which can be particularly associated with medical conditions such as Psoriatic Arthritis, Sjogren’s Syndrome and Rheumatoid Arthritis,

However in many patients the cause of TMJ Pain may not be clear.

Symptoms

  • Noises – You may hear clicking or grinding noises on opening or closing your mouth. If this is not accompanied by pain and limitation in mouth opening (trismus), no treatment is required
  • Pain – Dull pain, on opening and closing of the mouth, can be experienced over the jaw joint area (just in front of the ear) or at the cheek or at the temple region. A clicking or grinding sound may accompany the pain. The pain is usually due to inflammation of the joint and/or the muscles of biting and may cause difficulty in biting and chewing food.
  • Restriction in mouth opening and closing – Excessive pressure, trauma, or chronic degenerative changes to the joint, can cause displacement of the cartilage disc within the joint. This obstructs the normal movement of the TMJ leading to difficulty in closing and opening your mouth.

Difficulty in eating or a sudden inability to close your mouth may be experienced. In some instances this may or may not be spontaneously resolved.

Treatment Options

TMJ pain may be treated surgically or non-surgically, depending on the type diagnosis and the causative agent.

  • Medication – Some anti-inflammation drugs and mild steroids may be helpful in reducing TMJ pain.
  • Therapies – Some TMJ symptoms can be relieved using an appropriately constructed bite guard. A bite guard is especially useful for patients who grind their teeth during sleep. There are many type of bite guards hence your Nuffield Dentist will advise of what is best for you.
  • Surgery – Surgery is an option for patients not responding to the above described non-surgical management.  TMJ Joint Surgery may range from simple washing of the joint with fluids, (arthrocentesis) to inserting a small scope into the joint for the  examination and treating the joint, (lavage and arthroscopy).

In more advanced cases, a referral to an Oral & Maxillofacial Surgeon specialising in open joint or TMJ joint replacement surgery may be required.

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