Temporomandibular joint disorder, or TMJ, is a common acute or chronic affliction involving inflammation in the temporomandibular joint which affixes the jaw to the rest of the skull. TMJ can vary from a minor annoyance to a debilitating and painful condition. Some of the common symptoms of TMJ include difficulty or discomfort with chewing, clicking or popping noises associated with opening or closing the mouth, and tenderness or pain in the jaw. Some patients experience further symptoms like headache, aching in the face, earache, migraine, neck or shoulder pain, tinnitus, or hearing loss. Dizziness is sometimes another result of TMJ.
What causes TMJ? TMJ can occur in patients who exhibit bruxism (grinding the teeth, usually at night), trauma, misalignment of the teeth, and degenerative joint disease. Other causes can include improper eating, nail biting, and jaw thrusting. Patients with insufficient overbite can also develop TMJ.
How do you treat TMJ? TMJ treatments vary depending on the cause of TMJ, but many elements are the same. For example, if bruxism is one of the reasons you have TMJ, part of your TMJ treatment will need to include treatment for bruxism. Breaking the habit of grinding your teeth will be necessary for lasting recovery. If poorly applied dental treatments have altered the occlusal surfaces of the teeth, they may need to be restored so that you can chew correctly again.
Regardless of the cause of your TMJ, you should avoid overly crunchy or chewy foods until your TMJ gets better. You also won’t want to open your mouth too widely to eat something, for example a large hamburger. Cut the food up and eat it instead, or take out some of the ingredients so the sandwich is flatter if you have to. Also avoid chewing gum or grinding your teeth from stress as best you can. If your life is particularly stressful, you will want to proactively manage your stress as best you can using biofeedback, therapy, or other methods.
Ice is a great treatment for TMJ since it reduces inflammation and swelling in your joint. You will usually want to follow up on the ice with heat to restore blood circulation. Ice should be applied first though in case of an injury to your joint.
A lot of people use over the counter anti-inflammatory drugs to reduce inflammation and pain such as ibuprofen. Others go for prescription medications like steroids or muscle relaxants. For some patients injections of cortisone into the joint can assist with the pain.
Even though you don’t want to over-use your jaw or chew improperly with TMJ, it is equally bad to immobilize your jaw. Your goal is to increase your range of motion, not decrease it, and lack of use can lead to further complications. It is important to do some physical therapy, for example slowly and carefully opening and closing the jaw, massaging the joints, or even using electrodes. All these measures may improve your condition or eliminate it with time.
Many TMJ cases can be cured through these simple methods. It is usually advised to try these techniques first before pursuing more drastic courses of action. If none of these methods resolve your TMJ, your dentist will probably fit you with a splint or mouth guard. The splint will assist you in repositioning your jaw to improve your bite. In many cases this will result in a gradual adjustment which will reduce TMJ pain.
Sometimes a splint won’t help, or won’t cure your entire problem, since it’s not always a problem in the joint itself which causes TMJ. Sometimes it’s the occlusal surfaces of your teeth which aren’t fitting together properly, which keeps you from biting down correctly. If this is the case, you may undergo occlusal equilibration to reshape your teeth. Once this is completed, oftentimes your TMJ will be completely and immediately cured.
Surgery is typically the last resort for TMJ treatment, and will only be attempted once all other options have been exhausted. Surgery for TMJ is often irreversible, and may or may not cure TMJ. It’s also the most expensive treatment option. There are a couple of different TMJ surgeries available including arthrocentesis, arthoscopy, and open joint surgery. You will be sedated with general anesthesia during TMJ surgery.
Arthrocentesis is used when the mandibular joint needs to be cleansed. Sterile fluid is injected into the joint using needles, and then the surgeon uses a scalpel to remove obstructions and correct the positioning of the disc. Arthroscopy is also a fairly non-invasive procedure. First an incision is made to allow the insertion of an endoscope. Then the endoscope transmits images of the joint area so that the surgeon can use the visual information to help repair the area. If more invasive surgery is required, you may have to undergo open joint surgery. This can be necessary if there is a tumor in your joint or severely damaged bones.
What do you do if none of these mainstream methods of TMJ treatment solve your problem? You might try alternative treatment for TMJ. Some options include transcutaneous electrical nerve stimulation (TENS), ultrasound, or radio wave therapy. These methods can be used to promote proper blood flow in the affected region, but rarely will resolve TMJ on their own. Another treatment method which helps some TMJ sufferers is Botox. You probably know Botox only as the popular cosmetic surgery injection which reduces wrinkles and age lines by relaxing the underlying muscles. Through the same faculty though, Botox can help the muscles in your jaw and mandibular joint area to relax as well. This can reduce grinding and other TMJ aggravators. It may be necessary to get routine Botox injections, or perhaps a couple of treatments will manage to cure your condition if it is not that severe.
TMJ is best treated early, since muscle and joint problems tend to compound with time if you ignore them. If you catch some early signs and symptoms of TMJ, then try the simple at-home treatments suggested like NSAIDs, heat and cold, and relaxation of the jaw. If your symptoms don’t abate, see your dentist for suggested treatments.