Temporo Mandibular Joint Conditions and Treatment
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Temporo-Mandibular Joint Conditions

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 5 May 2014 - 12:31.

The point where the mandible joins the temporal bone immediately in front of the ear on each side of the head is what constitutes the temporo-mandibular joint. It is one of the most frequently used of all joints of the body and one of the most complex too.

Although accidents such as injuries to the jaw, head or neck, or diseases such as arthritis, may result in some TMJ problems, factors relating to the teeth and bite are also believed to be common causes of TMJ disorders.

Almost all the conditions affecting the temporo-mandibular joint presents with various symptoms that help in the diagnosis of the disorders.

Having covered various aspects of the Temporo-mandibular Joint, in the article “Temporo-Mandibular Joint: Enabling Jaw Movements, let us discuss briefly the treatment aspects of some of the common problems affecting the joint.

Treatment:

This depends on the nature of complaints and the extent of involvement. Several factors are taken into consideration before a definite line of action is planned for treatment. Simple complaints like pain and headache can be dealt with analgesics most commonly used being Paracetemol and Ibuprofen. Severe cases of pain may require injections for immediate relief and later followed by oral tablets.

Factors of disorders: Sometimes the muscles of mastication meant for chewing of food may be involved in the causation of a TMJ disorder. The muscles might be tired due to over use of the teeth like habitual use of chewing gum. There may be loss of nerve supply to the muscles leading to weakened action. The tendons of the muscles might get torn and chewing might become difficult and strenuous giving rise to spasm and pain.

There could be a problem with blood supply to the muscles of mastication leading to inadequate and strained action by these muscles causing spasm and pain. All these factors need to be identified and treatment sought from the respective specialist like a physician, dentist or a neurologist.

A patient may present with absolute inability to open his jaw. This could be a typical case of tetanus that has resulted in lock jaw. Such cases will always give history of injury followed by stiffness of muscles all over the body, the initial victim being the jaw. Usually such cases are treated in an infectious ward. Early treatment with ATS in large doses might cure tetanus and restore the normal functioning of the jaw.

Improper alignment of teeth, impacted tooth, infections of the gums, cavities in the teeth, decay of teeth are some of the dental problems that indirectly lead to painful temporo-mandibular joint with difficulty and/or inability to open and close the mouth the main cause being pain. Treatment for the particular problem yields excellent results.

It is a known fact that the teeth, muscles of chewing and the temporo-mandibular joints can singly or collectively be the cause for a TMJ disorder. If the problem lies with the teeth it is the dentist who will decide the type and course of treatment. The treatment may be of a routine nature or surgery depending on the extent of involvement. For example: irregular eruption of teeth requires a series of sessions for a prolonged period. However, surgery is recommended only when a precise cause of the disorder has been pinpointed and usually should not be undertaken until more conservative treatments of the disorder have been tried first.

It is important to know about some of the common methods of treating TMJ disorders as detailed below:

Elimination of spasms and pain: This can be done by applying moist heat to the face with the help of a cloth dipped in hot water and squeezing out the water and then applying it gently over the area involved. Muscle relaxants are also useful aids to relieve the spasm. Gentle massaging of the painful muscles and eating soft, non-chewy foods will help relieving the painful flares. Those with habitual clenching of teeth can use biteplates to prevent clenching and biting of the tongue. Bite guards and splints are extremely useful over time to prevent acute flares.

Counseling and relaxation training: In cases where stress plays its role in the causation of a problem in the temporo-mandibular joint counseling plays a beneficial role to reduce tension. Relaxation methods like yoga and transcendental meditation have great roles to play in eliminating tensions and worry besides giving relaxation to the mind and body.

Correcting and proper fixation of teeth together: In cases where the bite is incorrect or uneven it can be adjusted by selective grinding of the affected teeth. Orthodontic appliances like braces to correct improperly aligned teeth help reducing TMJ problems.

Surgery: If the problem of muscle spasm are of long standing duration giving rise to spells of   flares and discomfort the temporo-mandibular joint itself may become injured or arthritic. Also, the bones and soft tissues of the TMJ may slip out of normal position because of trauma such as blow to the head or any other injury. Such problems may need surgical intervention.

Besides all these steps the most important need of the hour is to maintain perfect oral hygiene, avoid smoking and drinking, avoid eating chocolates and use of chewing gum and most importantly consulting a dentist the moment you have a problem without negligence. These are some of the precautions that every one of us can take to prevent problems to the temporo-mandibular joint.

*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.