TMJ Management

TEMPOROMANDIBULAR JOINT (TMJ) AND ITS MANAGEMENT

The Temporomandibular (TM) Joint termed to as the jaw joint, allows all possible movements of the lower jaw.  We have two TM joints which work together as a pair, one in front of each ear. The joints connect the lower jaw bone (the mandible) to the bones of the skull on each side of the head. The muscles controlling the joints are attached to the lower jaw and allow the jaw to move in three directions: up and down, side to side, and forward and back. The synchronized, combined movement of both the joints, and its complex anatomy and biology distinguishes it from the other joints in the human body.

WHAT ARE TEMPOROMANDIBULAR JOINT DISORDERS (TMD)?
It is a complex set of conditions characterized by pain in the jaw joint, its surrounding tissues, possibility of production of “click sound” while opening of mouth causing limitation in jaw movements. These conditions can lead to various problems if not detected and treated earlier.

POSSIBLE CAUSES OF TMJ DISORDERS

Painful TMJ disorders can occur if:

  • The disk erodes or moves out of its proper alignment

  • The joint's cartilage is damaged by arthritis

  • The joint is damaged by a blow or other impact

  • In many cases, however, the cause of TMJ disorders isn't clear.

Factors that increase the risk of developing TMJ disorders include:

  • Various types of arthritis, such as rheumatoid arthritis and osteoarthritis

  • Jaw injury

  • Long-term (chronic) grinding or clenching of teeth

  • Certain connective tissue diseases that cause problems which may affect the temporomandibular join

  • Autoimmune diseases ( condition where body’s immune cells attack healthy tissue).

  • Other rare genetic or hormonal factors.

WHAT ARE THE SYMPTOMS OF TMJ DISORDERS?

  • Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide

  • Jaws that get "stuck" or "lock" in the open- or closed-mouth position

  • Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.

  • A tired feeling in your face

  • Trouble chewing or a sudden uncomfortable bite -- as if the upper and lower teeth are not fitting together properly

  • Swelling on the side of your face

HOW THE JAW JOINTS AND MUSCLES WORK?

The joints and muscles on each side of your jaw help open and close the mouth. These joints move in many different directions. They allow you to chew, talk and swallow.
The two temporomandibular joints are among the most complex joints in the body. They work together in a delicate balance with muscles, ligaments, cartilage and your jaw bones. When a problem prevents these parts from working together properly, pain may result.

WHAT ARE THE POSSIBLE TMJ TREATMENT OPTIONS?

For some patients, the disorders may disappear by themselves; for others, they may come and go, or may worsen over time. TMD disorders are often managed, rather than cured. Your general dentist may recommend treatment, or he or she may refer you to a physician or dental specialist.

There are several ways TMD may be managed. The success of the treatment often depends upon you and your dentist working together to find what works to relieve your symptoms. 

Treatment may involve a series of steps. The step-by-step plan allows you to try simple treatment before moving on to more   involved treatment. Experts generally recommend a “less is often best” approach to treating TMJ disorders.

The following self-care practices may be recommended:

  • eating softer foods or avoiding foods that cause symptoms

  • minimize extreme jaw movements, such as yawning, yelling or singing

  • avoid chewing gum

  • modifying the pain with heat or ice packs

  • practicing relaxation techniques to control jaw tension, such as meditation

  • Some sedative essential oils (such as lavender, chamomile, sweet marjoram, and clary sage) may provide temporary relief from the pain and discomfort of TMJ.

  • a night guard or bite plate to decrease clenching or grinding of teeth

  • In some cases, your dentist may recommend fixing an uneven bite by adjusting or reshaping some teeth. Orthodontic treatment may also be recommended.

When home remedies are not effective, medical treatment options may be necessary. Most of these types of treatments and remedies will not cure TMJ, but they can provide temporary and even long-term relief from the pain symptoms. These include the following:

  • Dental splint (occlusal splint or stabilization splint or bite guard), which is a dental 

  • appliance placed in the mouth that keeps the teeth in alignment and prevents tooth grinding. This resembles a mouth guard and is usually prescribed and fitted by a jaw specialist.

  • Physical therapy with jaw exercises can strengthen muscles, improve flexibility, and range of motion.

  • Biobehavioral management (biofeedback, cognitive behavioral therapy [CBT]) may help diminish pain intensity.

  • Trigger point acupuncture can sometimes be helpful.

  • In severe cases, surgery on the jaw or dental surgery may be necessary.

  • TMJ arthroscopy or arthrocentesis is a minimally invasive procedure usually done in an outpatient setting. Recovery time for this procedure is about a week.

  • Sometimes a total joint replacement is needed. This generally requires a stay in the hospital for several days, and surgery recovery time is four to six weeks.

SLEEP APNEA AND SNORING
There is a connection between TMJ disorders and sleep disorders. Out of millions having snoring problems across globe, most are adults over the age of 40. If this develops into obstructive sleep apnea, a wide range of problems from sleep disturbance to more serious health issues can result. Sleep Apnea is instigated when the soft tissue in the back of your throat relaxes while you sleep, causing interruptions in breathing. These interruptions usually last between 10 to 20 seconds each and can occur up to 100s of times a night.
Common symptoms:

  • Loud, chronic snoring and long pauses in breath

  • TMJ soreness upon awakening

  • Choking or gasping while sleeping

  • Feeling tired and sleepy thoughout the day

  • Waking up with headache, dry mouth or sore throat

  • Insomnia or constantly waking during the night

  • Forgetfulness, irritability or depression

  • Problems that can develop from untreated sleep apnea:

  • Chronic tiredness from sleep deprivation

  • Slower reflexes, poor concentration

  • High blood pressure and weight gain

  • Health issues such as diabetes and heart disease

 

As dentistry is an integral part of sleep medicine, we work together with physicians to provide effective diagnosis and treatment for sleep disorders.

If you wish to fix an appointment for dental consultancy at Sneha Dental Care (contact us); you may call the reception and fix an appointment. If you wish to know more details about dental checkups and procedures and in particular to your condition feel free to call us at: +91-9429284575 or mail us your queries on doctor.sneha21@gmail.com and we will get back to you as soon as we can.

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