Temporomandibular Joint Disorders

There are many people that have

Temporomandibular Joint Disorders

also known as TMJD, TMD, or TMJ syndrome, and may not even know it.  The temporomandibular joints are the two points, one on each side of the face just in front of the ears, where the temporal bone of the skull meets the lower jaw (mandible).  Ligaments, tendons and muscles that support joints are responsible for the movement of the jaw.

The temporomandibular joint is one of the most complex parts of the body:  It opens and closes like a hinge and slides forward, backward and sideways, and is under great pressure during chewing.  The temporomandibular joint contains a specialized piece of cartilage, called the disc, which prevents friction between the lower jaw and skull.

The temporomandibular joint disorders include problems related to joints and muscles that surround it.  Often, the cause of temporomandibular joint disorder is a combination of muscle tension and anatomic problems within the joints. Sometimes it also involves a psychological component.  These disorders are more common in women aged 20 to 50 years of age.

Symptoms include headache, tenderness of the masticatory muscles and clicking or locking of the joint.  Sometimes the pain seems to manifest itself in the vicinity of the joint rather than in it.  The temporomandibular joint disorders can lead to recurring headaches that do not respond to standard therapy.

Almost always the dentist based the diagnosis of temporomandibular joint disorder in the patient’s medical history and physical examination.  The test involves pressing on one side of the face or place your finger into the patient’s ear and gently press forward as it opens and closes the jaws.  In addition, the dentist also gently palpate the masticatory muscles to detect pain or tenderness, and see if the jaw slips to bite.

Internal view of the temporomandibular joint

Special techniques such as X-rays can help diagnose.  When the dentist believes the disc is in the opposite to its normal position (a condition called internal displacement), makes an X-ray dye injected into the joint (arthrography).  In special cases it is a computed tomography (CT) or magnetic resonance imaging (MRI) to find out why no response to treatment, but exploration is expensive. Additional tests are of little use.  Dentists often use electromyography to analyze muscle activity and monitor treatment and, less frequently, to establish the diagnosis.

Approximately 80 % of people get better without treatment after 6 months.  The temporomandibular joint disorders requiring treatment, the most common to least, are pain and muscle tension, internal displacement, arthritis, injuries or trauma, excessive or reduced joint mobility and developmental abnormalities.

In most cases, muscle overload and muscle spasm causes pain around the jaw, usually as a result of psychological stress, which leads to clenching or grinding teeth (bruxism) requiring a mouth guard for grinding teeth is the main treatment.