Temporomandibular Disorders (TMJ)
The TMJ is a hinge and gliding joint and is the most
constantly used joint in the body. The round upper
end of the lower jaw, or the movable portion of the
joint, is called the condyle; the socket is called
the articular fossa. Between the condyle and the fossa
is a disk made of cartilage that acts as a cushion
to absorb stress and allows the condyle to move easily
when the mouth opens and closes.
What Causes TMJ Disorders?
Arthritis is one cause of TMJ symptoms. It can result
from an injury or from grinding the teeth at night.
Another common cause involves displacement or dislocation
of the disk that is located between the jawbone and
the socket.
A Displaced disk may produce clicking or popping
sounds, limit jaw movement and cause pain when opening
and closing the mouth. The disk can also develop a
hole or perforation, which can produce a grating sound
with joint movement. There are also conditions such
as trauma or rheumatoid arthritis that can cause the
parts of the TMJ to fuse, preventing jaw movement
altogether.
The Joint, the Muscles or Both are the Problem
Stress may trigger pain in the jaw muscles that is
very similar to that caused by TMJ problems. Affected
patients frequently clench or grind their teeth at
night causing painful spasms in the muscles and difficulty
in moving the jaw. Patients may also experience a
combination of muscle and joint problems. That is
why diagnosing TMJ disorders can be complex and may
require different diagnostic procedures.
Range of Possible Treatment
TMJ treatment may range from conservative dental
and medical care to complex surgery. Depending on
the diagnosis, treatment may include short-term non-steroidal
anti-inflammatory drugs for pain and muscle relaxation,
bite plate or splint therapy, physical therapy and
even stress management counseling.
Generally, if non-surgical treatment is unsuccessful
or if there is clear joint damage, surgery may be
indicated . Surgery can involve either arthroscopy
(the method similar to the orthopaedic procedures
used to inspect and treat larger joints such as the
knee) or repair of damaged tissue by a direct surgical
approach.