In order to let more patients have a more systematic understanding of TMJ disorder treatment, better cooperate with doctors and get the maximum treatment effect. I am putting this article here especially to help you!
What is the temporomandibular joint?
The temporomandibular joint, a small joint located in front of the ear, connects the skull to the mandible. It is this joint that allows the jaw to move and perform functions, and is the joint that moves most frequently throughout the body. The temporomandibular joint is a ball-and-socket joint with a bulbous portion called the condyle and a fossa-shaped portion called the articular fossa. Between the condyle and the articular fossa is an articular disc of cartilage that cushions the pressure and assists the condyle in opening and closing the mouth.
At the posterior part of the joint, the attachment of the disc is rich in nerves and blood vessels, making it a very sensitive area. The muscles surrounding the TMJ also stabilize the joint and help the jaw to perform functional movements such as chewing and speaking.
The teeth are also very important to the function of the TMJ because the misalignment of the teeth can create abnormal stresses that can cause misalignment of the condyles and damage to the articular disc, ligaments and muscles. Trauma can also directly cause damage to the joint and interfere with normal function.
When the factors associated with the TMJ coexist in a coordinated manner, the joint can function properly. Conversely, TMJ disorders occur when there are abnormalities in these factors, or when there is stress or trauma.
What is temporomandibular joint disorder?
TMJ disorder, which can be a relatively mild condition, can also manifest itself as a very painful and potentially disabling condition. Bad habits such as mental stress, grinding or clenching of the teeth may trigger muscle pain in the masticatory muscle groups around the joint and symptoms of TMJ. Improper intermaxillary relationships can also cause joint problems, and sometimes arthritis can be the cause of TMJ symptoms. Traumatic injuries, such as punches to the chin or mandibular body that cause misalignment of the condyles or discs, can also cause joint symptoms. In some cases of TMJ disorders, the articular disc is displaced and fails to coordinate its normal function in the ball and socket joint, and the sensitive area behind the disc acts as a cushion, resulting in pain and pain sensitivity in the joint area. In some cases, the articular disc shifts excessively anteriorly, limiting large opening movements. All of the above conditions may lead to degenerative changes in the joint tissue and the development of osteoarthrosis.
TMJ disorders can present with a wide variety of symptoms, and the presence of certain signs may indicate the risk of progression of a particular TMJ disorder. The following are some of the possible clinical manifestations of TMJ disorder.
1. Painful popping when opening and closing the mouth
2. Teeth grinding or clenching
3.Masticatory muscle pain after waking up in the morning
4. Difficulty in opening the mouth widely
5.Frequent attacks of headache or neck pain
6.Pain in the temporomandibular joint area
7.Joint “locking”
8. Muscle pain and tenderness, limited jaw movement, sometimes the pain extends halfway down the face
Does your TMJ need treatment?
When TMJ discomfort occurs, you will need a specialist in TMJ disease or an oral and maxillofacial surgeon or other dentist with experience in TMJ disease.
You will need to prepare a complete and thorough medical history, including your lifestyle and daily work stressors. Your physician will perform a physical examination of your head and neck, including an examination of the TMJ area and many tests to identify or rule out TMJ disease. These tests include X-rays, MRI (to look at soft tissue images), CT scans (to look at the bone), and arthrography (to take X-rays to look at the functional movement of the joint after a contrast agent is injected into the joint cavity). Your teeth will also be examined (and a jaw model may be taken) to evaluate whether your bite is affecting your TMJ. If necessary, you will also need to be seen by other specialists such as orthodontists, prosthetists, psychologists, neurologists or physiotherapists.
When discussing your medical history with your physician, please note the following key issues in detail.
1. the cause of the pain
2. duration and nature of the pain
3. The characteristics of the joint popping or murmur
4. whether jaw movement is affected
5.History of trauma to the head and neck
6.Stress at work or at home
7.Other related symptoms
8.History of previous or ongoing treatment
Treatment of TMJ disorder
It is important to understand that some of the symptoms of TMJ disorder can be eliminated or alleviated through your ‘self-care’ and certain lifestyle changes. Some symptoms or signs may require further treatment, including surgical treatment. Below are some treatment options for you and your physician to discuss and choose the right treatment option for you.
Self-Conditioning
In almost all cases, it is important to rest the jaw, keep the upper and lower teeth apart, and maintain a good posture. It is also important to avoid chewing excessively hard foods. As with rest, proper mouth training is also helpful. Opening and closing exercises can help patients with limited jaw movement to return to normal. Such exercises should be done with gentle force to avoid excessive stress on the joints. Hot moist packs can be used to relax the muscles. And when a joint is injured, immediate use of an ice pack can reduce swelling. Mastering mental relaxation techniques is part of your self-conditioning.
Medication
Medications are generally used as adjunctive therapy, such as NSAIDs and skeletal muscle relaxants, to reduce inflammation and painful discomfort. However, medication is a primary and sometimes the only treatment for chronic maxillofacial pain. The goal of pharmacotherapy is to achieve maximum therapeutic effect with minimal side effects. The response to medications varies greatly from patient to patient. Aspirin is effective in inflammatory diseases, but is contraindicated in patients with ulcerative disease. In addition, doses of the drug that are effective for one patient may not be effective for another patient and may even produce significant toxic side effects. It is recommended that the medication be administered under the supervision of a physician.
Physiotherapy
There are a number of physical therapy methods that can be applied to the treatment of TMJ disorders that require the assistance and guidance of a medical professional. These methods include: jaw movement training, postural training, electrical stimulation, ultrasound, infrared, laser, biofeedback and others.
Oral therapy/combination pad therapy
Your physician may recommend the use of a joint cushion or other corrective device for a period of time depending on the condition of your TMJ disorder. There are various types of pads used to adjust the position of the jaw, prevent clenching and night grinding, rest the jaw, and relax the muscles. Orthodontic or restorative treatment is used to adjust the bite, which also plays a potentially therapeutic role due to its ability to restore harmony between the teeth, muscles and joints. In the case of abnormal maxillary and mandibular relationships, surgical correction of the maxillary and mandibular positions to restore a good relationship can also be potentially helpful in resolving joint problems.