Temporomandibular Joint Disorders and Treatments

TemporomandibularJoint Disorders

Temporomandibular Joint Disorders contains the diseases that causes oral-facial pain which are generally collected in two main groups. Muscular disorders and diseases caused by the jaw joint.

It is shown that the symptoms of jaw joint disorders are; pain in the front of ear, at jaw joint, in facial and neck muscles and in the temples. Pain can occur suddenly or gradually. Over time, pain may be so severe like neuralgic pains.

The pain is frequently seen in the cases like, strange sounds from the jaw joint, jaw locking, sliding toward the opening of the lowerjaw on one side and the difficulties of chewing function.

Jaw pain and other ailments are usually results of fatigue because of muscular overwork and cause head-neck pains or headache. Jaw jointpains are usually the result of changes in hard and soft tissues in the jawjoint.

The pain causes are, the irritation of the tissue lining the inside of the jaw joint capsule, the displacement of disc in the joint housing and due to degeneration of the temporomandibular joint hard tissue (bone).

CAUSES OFTEMPORAMANDIBULAR JOINT DISORDERS

The criticality of the diagnose in jaw joint disorders is increased as these disorders are not depend on a single factor. Besides the disorders in the jaw joint depending on systemic diseases, sudden or persistent traumas can also be the reason of diseases. Teeth grinding and clenching, or stress-induced spasm of the muscles of the head and neck independently, neurological, and some systemic diseases, etc. causes pain in the head and neck.

The Factors that Creates the TMJ Disorders

Trauma : Having any direct trauma to the jaw joint (a sudden shot of the head and neck, jaw tobe opened beyond the normal limit, a severe power from the bottom of the jaw,etc.) is the most specific reasons that cause discomfort to begin. Dental treatments that requires open mouth for a long time or excessive opening of thejaw during general anesthesia may result jaw joint traumas.

Abnormal Activity(habits): ightening or grinding of teeth, lip biting, nail biting,chewing gum and abnormal postures of various parts of the body does not produce joint discomfort directly but plays a major role in the emergence.

Contact between upper and lower teeth (Occlusion): Although it’s assumed that occlusionis not the main factor advancing joint discomfort, important evidences were found in the clinical trials showing the relationship between TMJ problems and jaws.

Symptoms of TMJDisordes

  • Mouth pain during opening
  • The mouth squeak, clicking or click sound during opening and closing,
  • Limitation of mouth opening or lock
  • Neck pain or stiffness
  • Headache (Can be misconsidered as Migraine pain)
  • Pain during chewing
  • Facial pain
  • Teeth pain while closing
  • Frazzle at jaw during chewing
  • Pain and difficulty in opening the jaw opening frequently in the morning
  • Yawn difficulty
  • Ear pains
  • Ringing in the ears, sounds like thunder
  • Sudden change in the upper and lower teeth closing
  • Facial asymmetry in facial muscles due to hyperplasia
  • Deviation during jaw opening
  • Ear congestion and pressure
  • Displacement of the disc or the condyle and disc degenerative changes in the joint may also occur. Differences in clinical symptoms can not always be explained as the joint disc displacement. Disfunction of the muscles of mastication also has to be taken into account.

The Causes of TemporomandibularJoint Functional Disorders

  • The direct trauma of the jaw ortha jaw joint (as a result of accidentor impulse)
  • Single-sided chewing habit
  • Tooth loss
  • Teeth clenching and grinding
  • Stress, depression, etc..
  • Non-Physiological closing
  • Developmental defects of Jaw Joint (hypoplasia, etc.).
  • Degenerative joint diseases, osteoarthritis, artrozis
  • Autoimmune diseases, rheumatoidarthritis, lupus,
  • Unknown factors

Examination Methods

  • Examination of the teeth and closing system
  • Examination of masticatory muscles
  • Examination of the jaw joint

The most important thing to be done firstly is the patient education.

Diagnosis:

Some tests can also be used besides examination to diagnose disorders of the jaw joint. Conventional or digital tomography and magnetic resonance imaging are also frequently used imaging modalities. Rarely,Scintigraphy or PET scan tests may be required.

  • Treatment of symptoms
  • Treating the underlying cause
  • The elimination of predisposing factors
  • The treatment of pathological effects

Treatment options:

  • Patient education and preventive treatment
  • Splint therapy
  • Drug treatment
  • Exercises
  • Physical therapy
  • Manipulation
  • Psychiatric support
  • Advanced cases of late treatment (surgery, etc.).

During the Treatment Process;

  • Reducing the force load on the joints is very important. The patient should be rid of the stress.
  • Chewing gum and eating hard foods tiring the jaw are prohibited.
  • The jaw should be supported by hand and shouldn’t be opened excessive while yawning and sneezing.
  • Biting movement is strictly prohibited, nutrients are taken into the mouth in small pieces.
  • Do not chewing on one side, both sides should be used chewing foods.
  • In cases where a lot of painexists, pain killer, muscle relaxants and anti-inflammatory drugs can be used before contacting a dentist.

At the end of thetreatment process;

  • Early and pathological tubercle contacts are corrected.
  • Closing is checked, if necessary,patients are urged to orthodontist.
  • In case of tooth loss,prosthetic treatment is applied providing natural closing.
  • If teeth grinding or squeezing continues ,psychiatric consultation is requested.
  • A successfull treatmentis theresult of these complementary therapies.

Finally, it should be noted that: the treatment of TMJ dysfunction, requires patient compliance and a multidisciplinary approach. BesidesTMJ treatment applied by a specialist , physical therapist, psychiatrist, neurologist consultation can be necessary.

Symptoms of Jaw JointDisorders

  • Headache
  • Earache
  • Temporomandibular Joint Pain
  • Neck Pain
  • Temporomandibular Joint Sounds
  • Restricted Mouth Opening
  • Lower jaw deviation

It was shown by research that above symptoms were seen in60% of the community.

Treatment of the jawjoint disorders

The main purpose of treatment is to organise inside jaw pressure and muscle functions to ensure that it’s able to normal daily functions in the jaw joint. Information and observations obtained from patients medical examination to determine whether or not the bad habits of the patients exist.
After using orthopedic appliances (splint), conservative treatment methods and determining habits of patients and teaching control methods are sufficient in treatment process.
Scientific studies showed that more than 85% of TM Jdisorders  had been brought under controlby preventive treatment