TMJ disorders are known as temporomandibular joint and muscle disorders. TMJ comes in two types: articular and nonarticular. Articular TMJ affects the inside of the joint and non-articular TMJ occurs outside of the joint. The jaw bone and skull are connected by the TMJ.
More than 10 million Americans are affected by TMJ disorders. Women between 18 and 44 have a higher risk of TMJ disorders.
TMJ Disorder Causes
The cause of a TMJ disorder is unknown in most cases. Health problems contributing to TMJ disorder development include:
- Chewing gum on a excessive basis
- Jaw problems at birth
- Joint erosion
- Tooth grinding or clenching
- Jaw/Tooth Trauma
The factors mentioned below are related to TMJ development. Note that they are not proven causes of TMJ disorders.
- Bad posture straining neck and face muscles
- Bad bite
- Dental braces
- Poor nutrition
TMJ Disorder Symptoms
TMJ disorder symptoms involve many TMJ parts: bones, connective tissue, ligaments, muscles, nerves, teeth, and tendons. Symptoms may be experienced on one or both face sides. Some TMJ symptoms are similar to those of trigeminal neuralgia. Here are the symptoms:
- Blurry vision
- Painful tongue base
- Shoulder pain
- Strange jaw noises
- Stuffy ears
- Trouble opening or closing mouth
- Trouble biting or chewing
There is no universal test that provides a correct diagnosis of TMJ disorders. The identification of TMJ disorders can be challenging as the precise causes and symptoms are unclear. Doctors will collect info about patient symptoms, obtain a full health history, and check affected areas.
Doctors will recommend diagnostic imaging, such as X-rays, CT scans, and MRIs.
Visits to various doctors such as: otolaryngologist, periodontist, etc. will be necessary to receive TMJ treatment. TMJ disorders can be identified when headaches, otitis, sinusitis, and facial pain are no longer considered.
TMJ Disorder Treatment
Treatment choices are determined by the essence of the TMJ disorder.
The following OTC or prescription medications may be help in treating TMJ.
- Nonsteroidal anti-inflammatory drugs – ibuprofen, naproxen, aspirin, acetaminophen.
- Muscle relaxants – metaxalone, cyclobenzaprine
- Antidepressants – nortriptyline, amitriptyline, desipramine, imipramine
- Benzodiazepine – diazepam, clonazepam, alprazolam
- Insomnia medications – doxepin
- Opiates- Vicodin, Lortab, Percocet
- Nerve pain medicines – gabapentin, topiramate, levetiracetam, pregabalin
- Steroid shots- beclomethasone
Patients living in states where marijuana has been legalized may be given a marijuana prescription for intense TMJ pain. Botox shots may be helpful in jaw muscle relaxation.
Jaw specialists may prescribe and fit oral appliances. Oral appliances come in four types. A description of each oral appliance is mentioned below.
- Stabilization splint- It covers upper teeth and prevents grinding. Sore jaw muscles are relaxed by this splint.
- Modified Hawley splint- This splint only touches the six lower front teeth, preventing clenching.
- Nociceptive Trigeminal Inhibition Tension Suppression System (NTI-TSS)- This appliance fits onto the upper front teeth.
- Repositioning splint- This splint is utilized for moving the mandible towards the front or back. It repositions the mandible to allow permanent bite changes.
The achievement of TMJ disorder symptom prevention is possible if you follow the recommendations below.
- Stay away from hard foods
- Apply gel packs to relieve swelling
- Gently exercise your jaws through stretching. Jaw exercises can be learned from a physical therapist.
- Avoid large movement of jaws.
- Some essential oils for sleep may temporarily relieve pain associated with TMJ disorders.
- Learn stress management techniques from cognitive behavioral therapy
- Use safety protection to prevent jaw injury
Surgery is the best option for severe cases of TMJ disorders.
Arthrocentesis involves joint lavage with a saline solution. This procedure is performed under a local anesthetic. A sedative may be given sometimes. Arthrocentesis appears to be effective for people with severe TMJ closed lock. Patients can return to work within 1-2 days after arthrocentesis.
Surgeons make a small cut around the ear to insert an arthroscope. General anesthesia is used for arthroscopies. Arthroscopies are normally done at a hospital on an outpatient basis. The typical recovery time for arthroscopies is around seven days.
Most arthroplasties are intended to treat displaced discs. Arthroplasties may also be performed to remove adhesions, bone spurs, ankylosis, or tumors. Recovery time for arthroplasties ranges from 2-6 weeks. For this procedure, general anesthesia is used. Arthroplasty types include graft (i.e. temporalis muscle and rib), temporary silicone implants, and discectomy. Other arthroplasty types include condylotomy and total joint reconstruction, which are discussed below in greater depth.
The primary reason for performing condylectomy is to permit painless and unlimited mandibular motion range.
Total Joint Reconstruction
Total Joint Reconstruction would used be a last resort after the aforementioned surgical procedures have been unsuccessful. Recovery from Total Joint Reconstruction surgery lasts 4-6 weeks. Ideally, the rib bone would be used for making a new TMJ.
The King of Prussia & Periodontics Dental Implants practice has three dentists: Dr. Marissa Crandall Cruz, Dr. Mana Nejadi, and Dr. Rimple Sandhu. All three dentists perform cosmetic periodontal surgery, implant dentistry, periodontics and treatments for tmj disorder in King of Prussia, PA.