Oral and Maxillofacial Surgery

Temporomandibular Joint (TMJ) Dysfunctions

What is the Jaw Joint (Temporomandibular joint)?

The mandible, also known as the lower jawbone, connects to the skull through the temporomandibular joints (TMJ) on either side of the face. These joints are unique in that they are bilateral, meaning that they are present on both sides of the body, and function as a single unit, with both joints working together to move the lower jaw. The TMJs are horseshoe-shaped bones that connect the mandible to the skull, allowing for movement such as talking, chewing, and yawning.

What are TMJ Disfunctions?

Temporomandibular joint disorders (TMD) are a group of conditions that affect the jaw muscles, temporomandibular joints, and nerves and can cause chronic facial pain. Any problem that disrupts the normal function of the muscles, bones, and joints in the jaw can lead to TMD. Stress is a major contributor to TMD symptoms, as it can cause teeth grinding and jaw clenching, which can aggravate the condition. Missing teeth can also contribute to TMD as it can cause imbalances in the jaw, leading to asymmetrical movement. Hard foods, such as raw carrots, nuts, and gum chewing can also strain the jaw joint. Trauma to the jaw, joint, or muscles in the head and neck area, such as a car accident can also lead to TMD.
Although TMD is not a life-threatening condition, it can significantly impact a person’s oral and general health. After being diagnosed with TMD, some patients may ask if the condition is serious, and it is important to communicate that while it may not be life-threatening, it can still have a significant negative impact on their overall well-being.

What are the symptoms of Temporomandibular Disorders?

Jaw disorder, also known as temporomandibular joint disorder, is characterized by pain or tenderness in one or both jaw joints and the surrounding muscles. Other symptoms include pain or discomfort in and around the ear, difficulty chewing, general facial pain, and clicking or popping sounds when opening and closing the mouth. In some cases, the joint may become locked, making it difficult to open or close the mouth. TMD symptoms usually occur symmetrically in both jaw joints, but it can also affect one joint.

If left untreated, TMD can lead to ongoing pain and inflammation, and can negatively impact the quality of life, causing problems with bite and even leading to tooth wear and fatigue. Conventional x-rays may be used to evaluate the bony structures of the jaw joints, but they do not provide information about the cartilage and soft tissues. In some cases, your physician may request advanced imaging such as MRI to get a more detailed view of the joint.

How are Temporomandibular Joint Disorders Treated?

Occlusal splints, also known as bite plates, are a common treatment option for individuals with moderate symptoms of temporomandibular joint disorder (TMD). These custom-made splints are transparent and can be worn on the upper or lower jaw, depending on the patient’s condition. They can be easily attached and removed by the patient and have been shown to reduce joint pain with minimal risk of long-term side effects.

Your doctor will determine the specific usage for your splint, including the recommended number of hours per day to wear it. Typically, splints are worn during sleep and removed in the morning. It is important to use the splint for a minimum of 6 months in order to achieve permanent results and break the habit of teeth grinding if present.

Another treatment option for TMD is botulinum toxin injection, which can be used in combination with an occlusal splint, or for patients who cannot use an occlusal splint. Botox can help alleviate symptoms such as teeth grinding and jaw clenching by reducing muscle tension and pain in the head and neck area. The injection is administered to the specific muscle group responsible for clenching, such as the bilateral masseter muscles or temporal muscles. The effects usually take 1-3 days to start, but may take up to two weeks, and can last for 3-6 months. The procedure typically takes 5-10 minutes, with minimal discomfort during the injection.
The best course of treatment, whether it be a splint, botulinum toxin injection, or a combination of the two, will be determined during your examination with your doctor.