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Facts about temporomandibular joint disorders
Temporomandibular joint disorders are a variety of conditions that cause pain in the temporomandibular joint (TMJ). Your TMJ is the hinge joint on each side of your head where your lower jawbone (mandible) joins the temporal bone of your skull.
The bony surfaces of the TMJ are covered with cartilage and separated by a small disk, which prevents them from rubbing against each other. The muscles that enable you to open and close your mouth stabilise thisjoint.
The potential causes of tenderness and pain in your TMJ are many. They Include wear and tear, arthritic inflammation, injury, stress, some dental appliances, and clenching or grinding your teeth. The pain associated with TMJ disorders (also referred to asTMDs) can vary from minor to severe. The condition may be temporary or chronic.
A variety of approaches can provide relief, and you can take actions to counter the factors that may lead to TMJ pain.
Signs and symptoms
Signs and symptoms of TMJ disorders may include:
•Inability to chew certain foods, oreatingonlyasoftdiet
•Facial pain •Tendernessofyourjaw •Aching pain in and around your ear
•A clicking sound or grating sensation when opening your mouth orchewing
•Locking of the joint, making it difficult to open or close your mouth
•Headache
•Uncomfortablebite
•An uneven bite, because one or more teeth are making prematurecontact
You may feel the pain or tenderness, even when you are not moving your jaw. But in most cases, the pain or tenderness worsens when you move your jaw or chew.
A dull discomfort in your jaws and muscles on awakening in the morning or that gets progressively worse throughout the day may be the result of excessive grinding (bruxism) and jaw
clenching. This condition is sometimes associated with aTMJ disorder.
Jaw clicking is common and does not always signal a problem. If there is no pain or limitation of movement associated with your jaw clicking, you probably do not have aTMJ disorder.
Causes
Tenderness and pain originating in the TMJ can stem from a variety of causes. Like other joints, the TMJ is susceptible to osteoarthritis, rheumatoid arthritis and other forms of
inflammation.
Normally, the TMJ allows the jaw to open and close smoothly. The lower jaw has rounded ends called condyles that glide in and out of the joint socket when you talk, chew or yawn. There is also a disk between each condyle and the bone to absorb shock and keep the movement smooth.
If movement of your left and right TMJs are not coordinated, pain and other symptoms can develop. The disk that separates your lower jaw from your skull can slip out of position or a condyle can become dislocated, either of which can cause pain or the inability to open your mouth or jaw fully. An improperly aligned bite can contribute to dislocation. Pain in the TMJ can
also result from degeneration of or trauma to the joint, such as by a blow to your jaw.
Chronic tension and anxiety may cause you to grind your teeth (bruxism), often at night, or to maintain clenched jaws. This overuse of yourTMJ and supporting muscles may cause pain.
Risk factors
Stress can be a factor in temporomandibular joint disorders. Chronic tension and anxiety may cause you to keep your jaws clenched, overusing the muscles attached to the temporal
bone that stabilise the temporomandibular joint, leading to aTMJ disorder.
Stress can cause you to vigorously grind your teeth even when you are not eating. Vigorous and excessive grinding overuses the muscles of the temporomandibular joint region, which can cause pain. Many people are unaware they grind their teeth while they are sleeping. Women are more likely to develop TMJ disorders titan arc men.
When to seek medical advice
If you have persistent pain or tenderness in your temporomandibular joint, if you have facial pain and experience clicking or grating when you
chew or move your jaw, or if you cannot open or close your jaw completely, seek medical attention. Your doctor, dentist, TMJ specialist, or oral and maxillofacial surgeon can discuss possible causes and treatments withyou.
TYeatment
Many treatments are available for TMJ disorders, though not all have proved beneficial. Most health care practitioners recommend beginning with the most conservative and noninvasive treatment.
Aside from asking you to avoid overusing your jaw, your doctor or dentist may suggest one or more of the following treatments: •Anti-inflammatory medications. To reduce inflammation and lessen pain, your physician or dentist may advise taking aspirin or another nonsteroidal anti-inflammatory drug such as ibuprofen. For severe pain and inflammation, corticosteroid drugs injected into the joint may provide relief.
•Heat or cold. Appling warm, moist heat or ice to the side of your face may make you feel better.
•Corrective dental treatment. Your dentist may improve your bite by balancing the biting surfaces of your teeth, replacing missing teeth, or replacing neededfillings or crowns.
•Biteplate. If your TMJ is misaligned, your dentist may recommend a plastic biteplate (splint), worn over your teeth, to help align your upper and lower jaws.
•Night guard appliance. If you grind your teeth in your sleep, a night guard appliance, which is a soft or firm device inserted over your teeth, can help prevent grinding and excessive wear.
•Arthrocentesis. This procedure involves insertion of a needle so that fluid can be removed to clear out the joint.
•Surgery. If the above approaches don't work, surgery to repair or remove the disk between your mandible and temporal bone may help, but the need for such surgery is rare.
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