TMJ solutions

On either side of the head, there are joints that connect the jaw to the rest of the skull. Due to the complex structure of the joints and the special role they both play in movement, the transmandibular joints (TMJ’s) are considered the most complex joints in the human body. Therefore, every small damage to the joint (for example, an injury/blow), exaggerated movements of the jaw or excessive stressful activity of the joint may cause an entire series of side effects, such as pain, discomfort when opening and closing the mouth, clicking noises, and even extreme cases of inability to function. In addition, the TMJ can contract various inflammations just like any other joint in the body (such as rheumatoid arthritis).

Research shows that 50%-70% of the population has at least one symptom of a functional disorder related to mastication; however, only 7% of individuals exhibiting symptoms of a functional disorder related to mastication require active treatment.

A specific cause has not yet been pinpointed as the reason for the disease, and therefore, modern medicine tends to believe that this is a multifactorial phenomenon, caused by structural disorders, trauma, destructive habits such as chewing gum, grinding the teeth, strong locking of jaws while sleeping, occlusal disorders (missing teeth, unstable closure, unbalanced extensive oral rehabilitation), inflammations and in rare cases, tumors. Disorders related to the joint’s function also demonstrate a correlation to the individual’s mental state, as in cases of depression/anxiety/stress. The connection between the mental state and the functional disorder is apparently caused by the chronic character of the pain, but can create a cyclic chain reaction that continually worsens the condition. As a rule, it has been found that women of childbearing age suffer more than men or elderly people.

Early diagnosis of a mastication disorder will save the patient physical and mental suffering, but on the other hand, we must be careful not to generate unnecessary panic. Most of the symptoms that are inadvertently identified by the dentist do not need to be treated, because the body’s mastication mechanism has already adapted to them. Treatment is provided only in cases when the disorder is acute and hinders proper functioning. Most of the time, the treatment will be solely symptomatic (treating the complaint and not the cause).

The methods of treatment are, naturally, dependent on the dentist’s diagnosis. Usually, the accepted treatment approach is a multi-stage treatment that begins conservatively and symptomatically. Pain in the temple or cheek when opening the jaw can hint to muscular tension, and therefore, the treatment will aim to relax these muscles. The simplest and most effective method is to use hot compresses to apply damp heat to the sore area. In more serious cases, it is possible to add medicinal treatment that mainly influences muscle relaxation.

If the dentist diagnoses phenomena of clenching or grinding the teeth (actions defined as para-functional), which are most of the time actions performed unconsciously and sometimes while sleeping, treatment using an occlusal splint may be considered. This is a plastic mouth guard that rests between the teeth and prevents the jaws from coming into contact or clenching. The splint allows the mastication muscles to remain in a relaxed state, and over time, the pain that results from the muscular tension will pass. In cases of tooth grinding, the splint will also prevent the damage caused to the teeth. If the undesirable grinding action continues, the plastic will be eroded, but tooth enamel will not be damaged.

In more severe cases, the appropriate radiographs must be taken, and if organic damage to the osseous elements of the joint or to the cartilaginous disc is identified, an oral and maxillofacial surgeon must be consulted.

The need for surgical intervention is fairly rare and doesn’t always bring about the desired improvement. The mastication mechanism often achieves a new balance on its own and the osseous parts of the joint undergo structural changes and gradually adapt to the new situation.

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