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TMJ Disorders

The TMJ- Temporomandibular joint is a small joint that is situated in front of the ear, at the point where the skull & lower jaw meet. This joint permits the mandible (lower jaw) to move & function. TMJ disorders are quite common and the symptoms are:

  • - Earaches
    - Headaches
    - Limited ability to open the mouth
    - Grating or clicking sounds in that joint
    - Pain when opening & closing their mouth

What Causes TMJ Disorders?

It is very important to determine the actual cause of the TMJ problem, as the cause will guide the treatment. These are the possible causes:

- Arthritis - This can be the result of an injury/grinding the teeth at night.

- Dislocation/displacement of the disk that is situated between the socket & jawbone. A displaced disk might produce clicking/popping sounds and limit jaw movement. The person may also feel pain when opening & closing the mouth.

- The disk may develop a hole/perforation and the grating sound may be produced with joint movement. Certain conditions such as rheumatoid arthritis or trauma can cause parts of the Temporomandibular joint to fuse, and prevent jaw movement altogether. 

The Joint, the Muscles or Both are the Problem

Anatomy of the TMJ

Anatomy of the TMJ

The TMJ is essentially a hinge & gliding joint. It is also one of the most constantly-used joint in the human body. The condyle is the rounded upper-end of the lower jaw which is the movable portion of this joint and the articular fossa is the socket. Between these 2 is a cartilage disk that acts as the cushion and absorb stresses. It also allows the condyle to move very easily whenever the mouth opens & closes.

Stress might trigger pain in the muscles in the jaw & is very similar to the ones that are caused by Temporomandibular joint problems. The affected patients tend to grind or clench their teeth very frequently at night which causes painful spasms in these muscles & difficulty in jaw movement. Patients might also experience a mix of muscle & joint problems. This is why TMJ disorder diagnosing can be complex and different diagnostic procedures may have to be used. 

The Role of the Oral and Maxillofacial Surgeon

When any Temporomandibular joint symptoms are noticed, it is important to consult an oral & maxillofacial surgeon. This surgeon specializes in the areas of the mouth, teeth & jaws, and is in a very good position to accurately diagnose the problem. The surgeon may order imaging studies of these joints & may appropriately refer you to other dental/medical specialists/physical therapist.

Range of Possible Treatment

Temporomandibular joint treatment can range from conservative dental & medical care to very complex surgery. Based on the diagnosis, the treatment can include certain short-term anti-inflammatory, non-steroidal drugs for pain & muscle relaxation, splint/bite plate therapy & stress management counseling.

Generally, if the non-surgical treatment is not successful or in case there is clear joint damage, surgery might be required. Surgery could be the repair of the damaged tissue via a direct surgical approach or arthroscopy. Once these disorders have been correctly diagnosed, the appropriate treatment can then be provided.

© 2005-2012 American Association of Oral and Maxillofacial Surgeons (AAOMS). All rights reserved.

Reprinted with permission from American Association of Oral and Maxillofacial Surgeons.