TMJ (temporomandibular joint) disorders, sometimes referred to as temporomandibular disorders (TMD), are a family of problems related to your complex jaw joint and muscles. If you have had symptoms such as pain or a "clicking" sound, you'll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms can occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. TMJ stands for temporomandibular joint and is the name for each joint that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.
No one treatment can resolve TMJ disorders completely and treatment often takes time to be effective.
TMJ disorders develop for many reasons. You might clench or grind your teeth, which tightens your jaw muscles and stresses your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, a grating noise when you open your mouth, or trouble opening your mouth wide.
The more you answered "yes" to any combination of these questions, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you to understand how they are treated.
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There are various treatment options that can improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, your doctor will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care combined with professional care.
The initial goals are to relieve muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Steroids can be placed directly into the joints to reduce pain and inflammation.
Self-care treatments can be effective as well and include:
Stress management techniques such as biofeedback or physical therapy may be recommended, as well as a temporary, clear plastic appliance known as a bite splint. A splint fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard splint helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning splint moves your jaw forward, relieves pressure on parts of your jaw and aids in disk repositioning. It may be worn initially 24 hours/day to help your jaw heal. An orthotic stabilization appliance may be worn 24 hours/day or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.
If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontic treatment, with or without jaw reconstruction, or restorative dental work. Surgical options such as arthroscopy and open joint surgery are sometimes needed, but are reserved for severe cases. TMJ surgery is not considered unless the jaw cannot open, is dislocated and nonreducible, has severe degeneration, or the patient has undergone more conservative treatment unsuccessfully.