TEMPOROMANDIBULAR JOINT DISORDER

Overview

Temporomandibular Disorder (TMD) is a group of conditions that cause pain and loss of normal function to the temporomandibular joint (TMJ) or jaw joint. The temporormandibular joint is located in front of the ear, on both sides of the head. The joint is made up of the lower jawbone and the skull. A cartilage disk, which functions as a shock absorber and joint lubricant, separates these 2 bones. The TMJ and the muscles of chewing enable you to open your mouth, talk and chew. 

Temporomandibular joint disorder can originate from the different components of the joint, namely,

• The muscles (of chewing)
• The cartilage disk
• The bone of the joint ( the jawbone and skull bone )

Causes of Temporomandibular Joint Disorder
Temporormandibular joint disorder can be caused by:

• Prolonged stress to the Jaw joint - Habitual clenching or grinding of your teeth overloads the joint causing pain in the joint and muscles. You may not be aware of these habits if they occur during sleep.
• Trauma - A recent trauma or a history of trauma, such as a blow to the lower jaw or face, directly or indirectly, can injure the TMJ.
• Arthritis - The jaw joint may be damaged by arthritis (inflammation of the joint). Arthritis may be a degenerative process due to aging or it may be associated with medical conditions such as Rheumatoid Arthritis, Psoriatic Arthritis.

In many cases the cause of TMD may not be clear.

Symptoms

• Noises - You may hear clicking or grating noises on opening or closing your mouth. If this is not accompanied by pain and limitation in mouth opening, no treatment is required
• Pain - Dull pain, on opening and closing of the mouth, can be experienced over the jaw joint area (just in front of the ear) or at the cheek or at the temple region. A clicking or grating sound may accompany the pain. The pain is usually due to inflammation of the joint and/or the muscles and may cause difficulty in chewing and biting food.
• Restriction in mouth opening and closing - Trauma, excessive pressure or degenerative changes to the joint, can cause displacement of the cartilage disk in the joint. This causes obstruction to the normal movement of the joint leading to difficulty in opening and closing your mouth.

You may experience difficulty in eating and a sudden inability to close your mouth, which may or may not be spontaneously resolved.

Treatment Options
Temporomandibular joint disorder may be treated surgically or non-surgically, depending on the diagnosis and the cause.

• Medications - Some anti-inflammation drugs can be helpful in reducing the pain associated with TMD.
• Therapies - Some TMD symptoms can be relieved with the use of a bite guard. A bite guard is especially useful for patients who grind their teeth during sleep.
• Surgery - Surgery may be the best option for patients who do not respond well to non-surgical treatment.  Surgery may range from simple washing of the joint with fluids, (arthrocentesis) to inserting a small scope into the joint to examine and treat the joint, (arthroscopy).

In more severe cases, an open joint surgery may be required.