The temporomandibular joint is a hinge that connects the jaw to the temporal bone of the skull, in front of the ear. This joint allows the jaw to move up and down and side to side, allowing you to speak, chew and yawn. When problems occur with the joint and the muscles that control it, it is collectively known as temporomandibular disorders (TMD).
What causes it? There is no definitive answer as to what causes TMD. It is generally accepted that it may come from problems with the jaw muscles or parts of the joints themselves.
Joint pain may occur if.
1. the articular discs wear out or move out of their proper alignment (e.g., anterior displacement, posterior displacement).
2. the articular cartilage is affected by arthritis.
3, the joint head is subjected to prolonged stress (e.g., the bad habit of grinding or clenching the teeth frequently), impacted by trauma, etc.
4, certain connective tissue diseases.
5, mental and psychological factors.
However, in many cases, the cause of TMJ disorders is not clear.
Common temporomandibular joint symptoms include.
1. pain or pressure in the face, jaw joint area, neck and shoulders, and tissues in or around the ears when chewing, speaking, or opening the mouth.
2. “Stuck” or “locked” immobility in the open or closed mouth position.
3. Clicking in the jaw joint when opening and closing the mouth or chewing, with a “clicking” sound.
4.It is particularly hard to open the mouth.
5.Suddenly feel uncomfortable when chewing or biting, as if the upper and lower teeth are not touching together properly.
6. the face feels swollen.
7. You may also have toothache, headache, neck pain, dizziness, earache, hearing problems, upper shoulder pain and tinnitus.
The doctor will do some tests: in addition to facial pain examination, mouth opening and closing examination, bite examination, muscle examination, etc. X-rays may be taken to see the jaw, temporomandibular joint and teeth to rule out other problems. Other tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, may also be needed. MRI can show if the TMJ disc is in the proper position when the jaw moves. CT scans show details of the bone in the joint and whether there is any bone resorption.
Home relief of TMD symptoms
There are some things you can do on your own to help relieve TMD symptoms. Your doctor may recommend trying these remedies.
1. Take over-the-counter medications. Non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen, can relieve muscle pain and swelling.
2. Use moist heat or cold packs. Apply an ice pack to the side of the front of the ear area for about 10 minutes. Do a few simple jaw stretches (consult your dentist or physical therapist). When finished, take a warm washcloth or washcloth and apply it to the side of your face for about 5 minutes. Several times a day.
3. Eat soft foods. Such as yogurt, mashed potatoes, cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans and grains. Cut food into small pieces and chew. Do not eat hard, crunchy foods (such as pretzels and raw carrots), chewy foods (such as caramels and toffees) and large and thick foods that require a wide open mouth to bite.
4. Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) mouth open to a minimum and do not shout, sing, or do anything that forces you to open your mouth wide.
5. try to apply both sides of the teeth evenly, that is, do not always use one side of the teeth to chew.
6. don’t use your hands to rest your chin, don’t put the phone between your shoulder and ear. Practice good posture to reduce neck and facial pain.
7. Keep your teeth slightly apart. This will relieve the pressure on your jaw. Place your tongue between your teeth to control clenching or grinding of teeth during the day.
8. Learn relaxation techniques to help relax your jaw. If you need physical therapy or massage. Consider decompression therapy as well as biofeedback.
Treating TMD with.
1. Medications. Non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen, can relieve muscle pain and swelling. or anti-anxiety medications to relieve stress, and low-dose medications can help reduce or control pain. Muscle relaxants, anxiolytics and antidepressants are available by prescription only.
2. Fitted pads or night protective braces (night molar pads). With a pad, the upper and lower teeth are separated without contact, which reduces the effects of clenching or wear, corrects the bite, and puts the teeth in a more correct position. What is the difference between these two types of pads? Generally speaking, night molar pads are worn while sleeping. Whereas a fitted pad needs to be worn all the time for a long period of time and needs to be adjusted every once in a while. Decide what type is needed on a case-by-case basis.
3. Dental examination. Missing teeth need to be repaired and crowns, bridges are used to balance the occlusal surface of the teeth or to correct occlusal trauma problems.
Other Treatments
If the treatments listed above do not help, the doctor may recommend one or more of the following.
1. Transcutaneous electrical nerve stimulation (TENS). This treatment uses low-level electrical currents to relieve pain by relaxing joints and facial muscles.
2. Ultrasound. Deep heat applied to the joint can reduce pain or improve mobility.
3. Trigger point injection. Pain medication or anesthetic is injected into the facial muscles called “trigger points”.
4. Low-level laser therapy. This can reduce pain and inflammation and help to move the neck and open the mouth freely.
Surgical treatment
If other treatments still do not help, surgery is an option.
1. If there is no major history of TMJ, but your jaw is stuck or locked, arthrocentesis is used. This is a minor procedure in which a needle is inserted into the joint after anesthesia and special tools are used to remove damaged tissue or move the joint discs that are stuck in the joint and release the locked joint.
2. Arthroscopy is a procedure done with an arthroscope. This special tool has a lens and a light. It allows the doctor to see what is going on inside your joint. General anesthesia is needed, and then the doctor will make a small incision in front of your ear and insert the tool. It will be connected to a video screen so he can examine your joint and the surrounding area. The inflamed tissue is removed or the joint disc is realigned. This type of surgery, called minimally invasive, leaves smaller scars, fewer complications, and shorter recovery time.
3.Radio wave treatment. Radio waves stimulate the joint and can increase blood flow and reduce pain.
4.Open surgery. Depending on the cause of TMD, open surgery may be required after arthroscopy, for example, to find
Wear and tear of the bone structure of the jaw joint; tumors in or around the joint; joint scarring or filled with bone; which require general anesthesia. It takes longer to recover after open surgery and can leave larger scars that may cause problems such as nerve damage.