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PROCEDURE : SURGICAL

What are Temporomandibular Joint (TMJ) Disorders?

  • TMJ disorders refer to a group of conditions that affect the jaw joint and surrounding muscles and ligaments.
    • These conditions can lead to pain, discomfort, and functional issues with jaw movement.

What are the Common Symptoms of TMJ Disorders?

  • Symptoms of TMJ disorders can vary widely and may include:
  • Decreased mouth opening
    • Jaw pain or tenderness.
    • Clicking or popping sounds when opening or closing the mouth.
    • Difficulty chewing or a change in the way the teeth fit together.
Before
After

What Causes TMJ Disorders?

  • The exact cause of TMJ disorders is often difficult to pinpoint, but possible causes include:
  • Intra Articular causes:
    • Inflammatory conditions:

Inflammatory conditions within the joint are often caused by direct trauma, such as a blow to the chin or jaw, indirect trauma, such as a whiplash injury, heavy chewing, grinding (bruxism), clenching of the jaw or loss of dental height due to worn down or missing teeth.

  • Disc derangement

Internal derangement describes conditions where there are structural changes within the joint. This can be caused by direct trauma, such as a blow to the jaw or falling on the chin, indirect trauma, such as a whiplash injury, long term clenching or grinding, heavy or hard chewing or prolonged periods of mouth opening, such as a dental procedure or a general anaesthetic.

  • Hyper mobility of the jaw
  • Long term hyper mobility can cause the articular disc to elongate and degenerate. The disc can then fail to reduce on closing, causing the TMJ to become stuck in an open position (Open Lock). This can often occur after opening the mouth to an extreme position, such as when singing or yawning or after a prolonged dental procedure.
  • Arthritis in the jaw joint.
  • Extra Articular causes:
  • Muscle spasm : Muscle Spasm can cause significant pain and limitation of movement of the jaw
  • Cervical postural disorders. : With prolonged cervical protraction as occurs with poor posture or stress-related posture the mandibular condyle is pushed back against the retrodiscal tissue, eventually causing swelling, pain and gradual degeneration of the disc.
  • Temporal tendinopathy Temporal tendinopathy is caused by excessive contraction of the temporalis muscle usually as a result of bruxism. 
  • Fractures: Fractures of the mandible often occur at the mandibular symphysis or the condylar neck. Commonly there will be a fracture of the mandibular symphysis combined with a fracture/dislocation of one or both condyles. The mechanism of injury can be a blow to the jaw or a fall onto the chin. Treatment can usually begin within a week or two of surgery to begin early mobilisation of the TMJ and to restore function.
Dr. Aakansha

How is TMJ Dysfunction Diagnosed?

  • Diagnosis typically involves:
    • A physical examination of the jaw and oral cavity; palpation of the TMJ  for any swelling, stiffness and range of motion..
    • Assessment of movement of the jaw noting any deviation or deflection of the jaw  and assessment of bite.
    • History of sleep bruxism  often given by the patient,s partner that they grind their teeth in sleep or signs of excessive wearing of teeth.
    • Imaging tests such as dental X-rays, CT scans, or MRI to assess the jaw joint and surrounding structures.

What Non-Surgical Treatments are Available for TMJ Disorders?

  • Non-surgical treatments can include:
    • Medications such as pain relievers, muscle relaxants, or anti-inflammatory drugs.
    • Physical therapy and exercises to strengthen the jaw muscles.
    • Use of mouth guards or splints to prevent teeth grinding.

When is Surgery Necessary for TMJ Disorders?

  • Surgery may be recommended when:
    • Non-invasive treatments fail to provide relief.
    • There is a structural issue in the jaw joint that needs correction.
    • Types of surgery include arthroscopy, arthrocentesis, and open-joint surgery.

Can TMJ Disorders be Prevented?

  • While not all cases can be prevented, steps to reduce risk include:
    • Avoiding habits like teeth grinding or chewing on hard objects.
    • Practicing good posture.
    • Managing stress through relaxation techniques.
    • Treatment of misaligned teeth/ disturbed occlusion

What Lifestyle Changes Can Help Manage TMJ Disorders?

  • Lifestyle adjustments that can alleviate symptoms include:
    • Eating soft foods to avoid overworking the jaw.
    • Performing regular jaw stretches and massages.
    • Applying heat or cold to reduce pain and swelling.

What Should You Ask Your Doctor About TMJ Disorders?

  • Some important questions include:
    • What is the likely cause of my TMJ symptoms?
    • What treatment options are best for my specific case?
    • Are there any lifestyle changes I should consider to manage my symptoms?

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