•What is temporomandibular joint?
•What are the most common causes of temporomandibular joint problems?
• How do temporomandibular joint problems manifest themselves?
• What should lead you to the maxillofacial surgeon?
• What is the treatment for temporomandibular joint problems?
• When is surgical treatment needed?
What is temporomandibular joint?
It is the joint that connects the lower jaw, on the right and left, to the head (skull) and is located just in front of the ear. Between the two articular surfaces there is a disc (meniscus) that protects them. To understand how it works, simply place your fingertip in front of your ear, open and close your jaw, and feel the movement between the lower jaw and the rest of the skull.
What are the most common causes of temporomandibular joint problems?
They are often caused either by problems of the disc (meniscus) and ligaments of the joint or by problems with the masticatory muscles.
The above problems are related either to dental occlusion (i.e., the way the teeth close) or dysfunction and increased tone of the masticatory muscles (of psychogenic or neurogenic etiology) or bad habits such as teeth grinding. Less frequently, temporomandibular joint problems are caused by systemic diseases (rheumatoid arthritis, osteoarthritis, etc.) or local pathology (fractures, tumors, etc.).
How do temporomandibular joint problems manifest themselves?
In a healthy joint, chewing and speaking functions are performed without problems. In a pathological joint, pain, noise during movement of the lower jaw, and restriction in opening the mouth may occur. The pain may be mild or acute and may occur on its own, during jaw movement, or when palpating the jaw. The pain is either localized or extends to the muscles and tissues of the surrounding neck and throat area. Very often, when opening and closing the mouth and during chewing, noises (clicks) are heard, which are usually due to the asynchronous movement of the pathological meniscus without indicating a more serious pathology and without fear of dislocation. The restriction in opening the mouth is often quite severe and makes it difficult for the patient to even eat.
What is the treatment for temporomandibular joint problems?
Treatment will depend on the correct identification of the cause of the problem.
In cases where the problems are due to dental occlusion, the initial treatment is conservative, such as rest, restriction of movement, and special exercises. If the symptoms persist, the maxillofacial surgeon will refer the patient to other specialists who are responsible for the appropriate treatments, such as the use of dental splints, orthodontic treatment, or dental restoration.
If neurogenic or psychogenic causes (stress, family, professional, or personal problems) are identified, the initial treatment is again conservative (rest, restriction of movement, special exercises) along with an effort to reduce stress. If the symptoms are more severe and persistent, appropriate long-term treatment with muscle relaxants, muscle paralysers (Botox), sedatives and antidepressants is recommended, with very good results.
When is surgical treatment needed?
Surgical repair of the damaged disc (meniscus) or other more complex arthroplasty procedures are rarely chosen nowadays. According to recent international literature, open surgery has not yielded the expected results, with a high recurrence rate, and is therefore now used as a last resort. Instead, arthroscopy of the temporomandibular joint is preferred, a diagnostic and therapeutic method that is minimally invasive, performed under local or general anesthesia, and does not require hospitalization (one-day surgery).
Although small, the temporomandibular joint often causes problems with significant consequences. It causes pain, makes chewing difficult, limits mouth opening, produces an annoying noise (clicking), and can cause headaches and neck pain. An oral and maxillofacial surgeon has the knowledge and experience to diagnose the problem and its cause and recommend the appropriate treatment.
The information provided here is not intended as a substitute for professional medical advice, diagnosis, or treatment, but is provided for your general information only. If you have any problems or concerns, always contact your oral and maxillofacial surgeon.