Temporomandibular Joint Disorders (TMD, TMJ) / Jaw Joint Disorders
Your temporomandibular joint is a hinge that connects your jaw to the temporal bones of your skull, which are in front of each ear. It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn.
Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD). But you may hear it wrongly called TMJ, after the joint.
What Causes TMD?
We don’t know what causes TMD. Dentists in Mysuru believe symptoms arise from problems with the muscles of your jaw or with the parts of the joint itself.
Injury to your jaw, the joint, or the muscles of your head and neck -- like from a heavy blow or whiplash -- can lead to TMD. Other causes include:
- Grinding or clenching your teeth, which puts a lot of pressure on the joint.
- Movement of the soft cushion or disc between the ball and socket of the joint.
- Arthritis in the joint.
- Stress, which can cause you to tighten facial and jaw muscles or clench the teeth.
What Are the Symptoms?
TMD often causes severe pain and discomfort. It can be temporary or last many years. It might affect one or both sides of your face. More women than men have it, and it’s most common among people between the ages of 20 and 40.
Common symptoms include:
- Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide.
- Problems when you try to open your mouth wide.
- Jaws that get "stuck" or "lock" in the open- or closed-mouth position.
- Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.
- A tired feeling in your face.
- Trouble chewing or a sudden uncomfortable bite -- as if the upper and lower teeth are not fitting together properly.
- Swelling on the side of your face.
You may also have toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).
TMJ PAIN
The joint is placed under multiple stresses. It is used when chewing and talking. Throughout the day and night, it can also be used for un-natural purposes, what are called parafunctional habits. The classic example is the seamstress who holds pins with her teeth or the carpenter with nails. Other examples are chewing pens, pencils, fingernails, gum or tobacco. Even more insidious is clenching and grinding of teeth that are subconscious and may be brought on or worsened by stress.
Pain in the area of the TMJ is classified under the broader category of TMD (temporomandibular disorders) which encompasses TMJ (joint) problems plus musculoskeletal disorders such as myofascial pain dysfunction syndrome (MFPDS), migraines, sinus disease, temporal arteritis and anything else that could cause pain in the area of the temples, ear and jaw joint.
A thorough exam including special x-rays and sometimes CT or MRI of the joint are necessary to distinguish the cause of TMD pain. Patients are often seen by more than one dental specialist in Mysuru and visits to the oral surgeon can be to simply “rule out” joint problems.
Some of the problems under TMD can be dealt with by conservative, non-invasive methods in other words without surgery, such as Botox injections in the temporomandibular region.
How Is TMD Diagnosed?
Many other conditions cause similar symptoms -- like tooth decay, sinus problems, arthritis, or gum disease. To figure out what’s causing yours, the dentist in Mysore will ask about your health history and conduct a physical exam at best hospital in TMJ disorder in Mysuru.
TMJ disorder specialist in Mysore checks your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. He’ll also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Plus he’ll test your bite and check for problems with your facial muscles.
Your dentist may take full face X-rays so he can view your jaws, temporomandibular joints, and teeth to rule out other problems. Best facial surgeons in Mysuru may need to do other tests, like magnetic resonance imaging (MRI) or computer tomography (CT). The MRI can show if the TMJ disc is in the proper position as your jaw moves. A CT scan shows the bony detail of the joint.
You may get referred to an oral maxillofacial surgeon in Mysuru (also called an oral and maxillofacial surgeon) for further care and treatment. This doctor at dental hospitals in Mysore specializes in surgery in and around the entire face, mouth, and jaw area. You may also see an orthodontist to ensure your teeth, muscles, and joints work like they should.
Home Treatments for TMD
There are things you can do on your own to help relieve TMD symptoms. Your facial surgeons in Mysuru may suggest you try some of these remedies together.
Take over-the-counter medications. Non-steroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen, can relieve muscle pain and swelling.
Use moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple jaw stretches (if your dentist or physical therapist OKs them). When you’re done, hold a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.
Eat soft foods. Add yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans, and grains to your menu. Cut foods into small pieces so you chew less. Skip hard, crunchy foods (like pretzels and raw carrots), chewy foods (like caramels and taffy), and thick or large bites that require you to open wide.
Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) to a minimum and don’t yell, sing, or do anything that forces you to open wide.
Don't rest your chin on your hand. Don’t hold the phone between your shoulder and ear. Practice good posture to reduce neck and facial pain.
Keep your teeth slightly apart as often as you can. This will relieve pressure on your jaw. Put your tongue between your teeth to control clenching or grinding during the day.
Learn relaxation techniques to help loosen up your jaw. Ask your dentist if you need physical therapy or massage. Consider stress reduction therapy as well as biofeedback.
Traditional Treatments
Talk to your dentist about these tried-and-true treatments for TMD:
Medications. Your dentist in mysore can prescribe higher doses of NSAIDs if you need them for pain and swelling. He might suggest a muscle relaxer to relax your jaw if you grind or clench your teeth. Or an anti-anxiety medication to relieve stress, which may bring on TMD. In low doses they can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.
A splint or night guard. These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position. What’s the difference between them? You wear night guards while you sleep. You use a splint all the time. Your dentist will tell you which type you need.
Dental work. Your dentist at smile designing hospitals in Mysore can replace missing teeth and use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem.
Other Treatments
If the treatments listed above don’t help, your dentist at smile designing clinics in Mysore may suggest one or more of the following:
Transcutaneous electrical nerve stimulation (TENS). This therapy uses low-level electrical currents to provide pain relief by relaxing your jaw joint and facial muscles. It can be done at the dentist's office or at home.
Ultrasound. Deep heat applied to the joint can relieve soreness or improve mobility.
Trigger-point injections. Pain medication or anaesthesia is injected into tender facial muscles called "trigger points" to give relief.
Radio wave therapy. Radio waves stimulate the joint, which increases bloodflow and eases pain.
Low-level laser therapy. This lowers pain and inflammation and helps you move your neck more freely and open your mouth wider.
Surgery for TMD
If other treatments can’t help you, TMD surgery in Mysore is an option. Once it’s done, it can’t be undone, so get a second or even third opinion from other dentists.
There are three types of surgery for TMD. The type you need depends on the problem.
Arthrocentesis is used if you have no major history of TMJ but your jaws are locked. It’s a minor procedure that your dentist can do in his office. He’ll give you general anaesthesia, then insert needles into the joint and wash it out. He may use a special tool to get rid of damaged tissue or dislodge a disc stuck in the joint, or to unstick the joint itself.
Arthroscopy is surgery done with an arthroscope. This special tool has a lens and a light on it. It lets your doctor see inside your joint. You’ll get general anaesthesia, then the doctor will make a small cut in front of your ear and insert the tool. It’ll be hooked up to a video screen, so he can examine your joint and the area around it. He may remove inflamed tissue or realign the disc or joint. This type of surgery, known as minimally invasive, leaves a smaller scar, has fewer complications, and requires a shorter recovery time than a major operation.
Open-joint surgery. Depending on the cause of the TMD, arthroscopy may not be possible. You may need this type of surgery if:
- The bony structures in your jaw joint are wearing down.
- You have tumour’s in or around the joint.
- Your joint is scarred or full of bone chips.
You’ll get general anaesthesia, then the doctor will open up the entire area around the joint so he can get a full view and better access. You’ll need longer to heal after open-joint surgery, and there is a greater chance of scarring and nerve injury.
DO YOU HAVE A TMJ DISORDER?
- Are you aware of grinding or clenching your teeth?
- Do you wake up with sore, stiff muscles around your jaws?
- Do you have frequent headaches or neck aches?
- Does the pain get worse when you clench your teeth?
- Does stress make your clenching and pain worse?
- Does your jaw click, pop, grate, catch, or lock when you open your mouth?
- Is it difficult or painful to open your mouth, eat, or yawn?
- Have you ever injured your neck, head, or jaws?
- Have you had problems (such as arthritis) with other joints?
- Do you have teeth that no longer touch when you bite?
- Do your teeth meet differently from time to time?
- Is it hard to use your front teeth to bite or tear food?
- Are your teeth sensitive, loose, broken or worn?
Consult Dr. Ravi kumar MP for best treatment of TMJ disorder in Mysuru.