Temporomandibular Joint Syndrome

Posted on by Dr. Priyanka Soakar Navale Deccan Dental Clinic, Pune

This is the ultimate guide For Temporomandibular Joint Syndrome. In this blog, we have covered what is TMJ? Classification of TMJ, Sign & symptoms of TMJ, Diagnosis, and Treatment for TMJ.

WHAT IS TEMPOROMANDIBULAR JOINT SYNDROME (TMJ) ?

  • Temporomandibular joint and muscle disorders, also commonly known as “TMJ”, it is a conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement.
  • Temporomandibular joint (TMJ) problems affect large properties of the population at one time or another.
  • Women are more likely to significant from TMJ problems than men.
  • Temporomandibular joint problems often have significant psychological, as well as physical causes.
  • tmj

Image Source & Credit Jmarchn – Own work, CC BY-SA 3.0, Link

CAUSES OF TMJ :

  • Trauma
  • Malocclusion
  • Teeth grinding
  • Stress or anxiety
  • Arthritis or inflammatory musculoskeletal disorders
  • Orthodontic braces
  • Excessive gum chewing
  • Hormonal
  • Genetic

CLASSIFICATION OF TMJ :

  1. Developmental disorder of joint
  2. Inflammatory joint disease
  3. Traumatic disorder of TMJ
  4. Degenerative joint disease
  5. Metabolic disorder
  6. Neoplastic disorder
  7. Myofascial pain dysfunction syndrome
  8. Osteoarthritis
  9. TMJ dislocation
  10. Disc displacement with or without reduction

SIGN AND SYMPTOMS :

  • Pain or tenderness in the jaw (either at rest or when eating).
  • Aching pain in-ear or around the ear.
  • Difficulty in chewing or pain while chewing.
  • Aching facial pain
  • Locking of the jaw
  • Difficult to open or close the jaw.
  • Limited mandibular opening.
  • History of trauma or infection.
  • Earache.
  • Clicking, popping or grinding sounds of the temporomandibular joints.
  • Dull ache in face and neck
  • Headache (maybe worse in the morning)
  • Limitation in jaw opening
  • Swelling and increase temperature over muscles
  • Inflammation in the tendentious attachment of the muscles

DIAGNOSIS:

Doctor will discuss the symptoms and examine jaw:

  1. Press on the area around jaw to identify the sites of pain or discomfort
  2. Listen to feel your jaw when you open and close your mouth
  3. Observe the range of motion in your jaw
  4. A localized, constant muscles pain secondary to trauma, infection,or overuse of a muscle.

TREATMENT:

No stronge evidence exists to suggest the single best treatment for Temporomandibular joint disorders.

Treatment planning should involve balancing the patient’s wishes with potential risks and benefits of treatment.

  • STEP 1: Patient education and self-care.
  • STEP 2: behavioral modification.
  1.  identify the specific problem.
  2. Cognitive-behavioral self-regulation exercise. Physical therapy referral.
  • STEP 3 : Pharmacotherapy
  1. Analgesic.
  2. Muscle relaxants.
  3. Tricyclic Antidepressant.
  • STEP 4: Trigger point management.
  1. Injection with local anesthetic
  2. Physical therapy: vapocoolant spray or ice application and stretching.
  • STEP 5: Orthopedic appliance therapy -muscle relaxation splint
  • STEP 6: Surgical procedure:
  1. Arthrocentesis
  2. TMJ arthroscopy Modify colotomy
  3. Modify colotomy.
  4. Open joint surgery
  • RADIOLOGY : 
  1. MRI: For joint space pathology
  2. CT: For bony pathology
  • OTHERS :
  1. Occlusal adjustments and orthodontics.
  2. open surgery

BENEFITS OF LASER TREATMENT FOR TMJ :

  • Acceleration healing and reduce long-lasting pain.
  • Simple and comfortable application of infrared light.
  • No heat is omitted it will not damage cells or burns the skin or surrounding tissues.
  • No side effect.
  • Can be used in all ages
  • Help improve movement and physical function.
  • Noninvasive and nonsurgical treatment.
  • It can improve the health of your damage jaw disk as well as speed up your recovery time.
  • Laser therapy assists blood flow thus increase oxygen, glucose, and nutrient.
  • Reduce free radicals and oxidation stress.
  • Increase cell metabolism
  • And healing the nerve surrounding the jaw.
  • Dry surgical field and better visualization, less bleeding.
  • Tissue is kept sterilized, cleaned and thus less number of bacteria.
  • Decreased swelling, edema and scarring.
  • Less pain.
  • Faster healing response
  • Increased patient acceptance.
  • Minimal mechanical trauma.
  • Not harmful to eyes and skin, as protective eyewear’s are used.
  • No requirement of sutures.
  • Reduce surgical time.
  • Advantage for medically compromised patients.
  • No medication is required like antibiotics or pain killers.
  • The patient becomes free of fear and anxiety.
  • Hemostatic effect by sealing blood vessels.
  • Minimal damage to surrounding tissues.
  • No irritating sound like traditional drills.