Temporomandibular Joint Dysfunction
(TMJD · Jaw Pain)
In this condition factsheet:
Diagnosing Temporomandibular Joint Dysfunction
If you experience any of the above symptoms, you should speak to your doctor or, better yet, to your dentist. Dentists commonly diagnose and prescribe treatment for TMJ problems. In order to make the diagnosis, he or she will take your medical history and perform a physical examination of your jaw and face. The dentist may push on the side of your face or place a finger by your ear and gently press forward while you open and close your jaw. Also, in order to detect pain or tenderness, your dentist may gently feel the muscles you use to chew. He or she will also check to see whether your jaw slides when you bite, and can tell if you're grinding your teeth by looking for excessive wear on the biting surfaces of your teeth.
Special X-ray techniques may be used to help make the diagnosis. If your dentist suspects that the disc lies in front of its normal position (a condition called internal derangement), he or she may order an X-ray in which a dye is injected into your joint (an arthrogram). Computed tomography (CT) or magnetic resonance imaging (MRI) may be used in rare cases to find out why a person isn't responding to treatment.
Laboratory tests for TMJ problems aren't often done, as they're rarely useful. Dentists occasionally use electromyography, which analyzes muscle activity, to monitor treatment and occasionally to make a diagnosis.
Treating and Preventing Temporomandibular Joint Dysfunction
Many people with temporomandibular joint problems (TMJ ) recover without any treatment. Your doctor will determine the best treatment based on several factors, including your age, your medical history, and your preferences.
TMJ disorders that may require treatment are those that include:
- arthritis
- damage to the inside of the joint
- developmental or congenital abnormalities
- injury
- muscle pain and tightness
- reduced or excessive mobility of the joint
If the TMJ disorder is caused by inflammation within the joint, physical therapy and medications such as acetylsalicylic acid* (ASA), other nonsteroidal anti-inflammatory drugs (NSAIDs), or muscle relaxants work quite well. Other medications, such as certain antidepressants (e.g., nortriptyline, amitriptyline), may also work for some patients. If a person is experiencing severe pain and inflammation, the doctor or dentist may recommend that a corticosteroid or a local anesthetic medication be injected into the joint to reduce discomfort. Acupuncture, acupressure, massage, and hypnosis are other techniques used by some dentists to decrease pain and to relax muscles.
A soft diet may be recommended to reduce the strain on the TMJ caused by biting and chewing.
If you're aware that you clench or grind your teeth, you can take steps to break the habit. Splint therapy is the most popular and least invasive treatment. A thin plastic night guard is specially made to fit over either your upper or lower set of teeth and is then adjusted to provide you with an even bite. Most night guards are worn at night to reduce grinding, although they can also be used during the day. They can also prevent damage to your teeth. In addition, biofeedback or relaxation therapy, physical therapy, stress management, other behaviour modification techniques, and therapeutic jaw exercises can help.
If you have abnormalities in the alignment of your teeth that are causing TMJ problems, your dentist may correct this by balancing biting surfaces, replacing missing teeth, or replacing uneven or defective fillings or crowns.
Misalignment of the TMJ is usually treated with a plastic bite plate or splint that helps promote better alignment of your jawbones. This corrective device is also worn over your teeth and will help to re-establish proper alignment. As with the night guard used to prevent grinding, you should bring this device with you when you visit your dentist, as it may need to be adjusted occasionally.
Your dentist may also recommend changes in your chewing habits such as limiting gum chewing or avoiding sticky or firm foods like caramels, non-tender meats, raw carrots, and celery. You may also be asked to try to limit opening your mouth wide when you yawn.
If your symptoms continue despite treatment, you may be referred to a specialist in oral and maxillofacial surgery to repair or to remove the disc that separates the adjacent bony surfaces of the TMJ or to realign the bones.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Temporomandibular-Joint-Dysfunction
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