By: Sabrina Ye | Edited By Lexi Chen
A common misconception concerning temporomandibular joints (TMJ) and temporomandibular joint disorders (TMD) is that many believe both are the same. However, that is incorrect because TMJ is the joint whereas TMDs are the disorders associated with the joining of muscle and joints. The TMJ is a crucial part of the composition of one’s jaw as it allows one to talk, eat, yawn, and use one’s mouth.. The TMJ is the connector of one’s mandible (one’s lower jaw) to one’s temporal bone (the side of one’s head), hence its name. The joints are designed to be flexible to allow for the gliding movements of the jaw. The smooth movement occurs due to condyles, which are the round ends of the mandible, and the articular discs which are soft plates made up of fibrocartilage that rest between the condyle and temporal bone. The condyles glide along the socket of the temporal bone while the disc acts a buffer to absorb any pressures that impact the jaw. The muscles surrounding the TMJ are in control of the positioning and movement of the joint. This cohesive unit that needs to work together to allow for the functioning of the sliding of one’s jaw along with the different tissues that make up the joint, sets the TMJ apart from the other joints in the human body. The TMJs can be felt by placing one’s fingers in front of one’s ear and opening one’s mouth.
TMDs occur in approximately 10 million people in America. Around 12% of the global population suffer from this disorder. Researchers are still in the midst of conducting studies in their search for answers concerning the causes of TMDs and its effective treatments. For the most part, TMDs are temporary, and usually disappear on their own with no treatment. People with TMDs have varying responses over time. Some people experience a worsening in symptoms while others have symptoms that fade after a while. Within TMDs, there are three categories that are grouped according to the location and the type of symptom that appears. The first type is called myofascial pain disorder. This happens when there is pain in the jaw-controlling muscles surrounding the TMJ. The most probable cause is bruxism, otherwise known as the clenching and grinding of teeth. The second type is internal derangement of the joint. This happens when there is a dislocation or displacement of the articular disc, condyle or jaw joint. The last category is called degenerative joint disorder. This happens when the joint is overused and becomes inflamed. Sometimes, rheumatoid arthritis or osteoarthritis may be the cause.
SYMPTOMS:
The symptoms vary depending on a person.
Pain in chewing muscle/jaw joint
Pain in face/jaw/neck
Stiffness in jaw
Limited movement of jaw
Change in the bite of your teeth
Painful clicking/popping/grating when opening/closing mouth
CAUSES:
Not much is known about TMDs, thus its causes are still hypothetical. Some speculations point to genetics, while others believe that injuries to the jaw may have some effect. However, such speculations are not consistent as some people who have bruxism develop TMDs while others do not. This also applies to people who experience the dislocation of a jaw; some have TMDs after while others don’t. Some people experience symptoms of TMD with no apparent cause. The majority of people who experience pain in the jaw have a mild form of TMD while only a few live with chronic, debilitating pain throughout their whole lives. Scientists have found that TMDs are much more common in women, although there is no discernible cause, theories point to hormones being a factor. However, there are a few risk factors that increase a person’s chance of developing a TMJ disorder. Arthritis, the erosion of the TMJ, and grinding of the teeth all raise the additional problems that contribute to TMDs. Furthermore, stress is a defining risk factor. Due to stress, there is muscle tension which leads to habits of grinding one’s teeth. The grinding leads to tired jaw muscles which then spasm and cause pain.
TREATMENT/WHAT YOU CAN DO?
Diagnosing TMDs becomes harder due to the uncertainty concerning the origin of the disorder, thus healthcare workers have to rule out possible medical problems whose symptoms coincide with TMDs before arriving at this diagnosis. Doctors take into account one’s medical and dental history, examine areas causing problems, and in some cases, conduct imaging tests like x-rays, CT scan, or an MRI. As more studies need to be conducted in order to determine the necessary treatments and the safety of certain procedures, conservative treatments that can be reversed are recommended. In most cases, it will go away on its own through self - care practices. Conservative treatments are noninvasive procedures that do not involve surgery and cause no irreversible changes to the positioning of one’s jaw and teeth. Some effective home remedies include consuming soft foods and avoiding hard and chewy foods. Ice packs can be used to quell the swelling and pain. Relaxation techniques and the reduction of stress is important as it will lessen the grinding and clenching of the teeth. However, if one is experiencing large quantities of pain, doctors recommend a short stint of pain medication like ibuprofen and anti-inflammatory drugs (NSAIDS). In some cases, physical therapy may be needed to maintain jaw movement. In rare cases, alternative methods like surgery or botox may be needed. These are the absolute last resort as in many cases, the side effects and the result cause even more pain than prior. Other treatment methods include having an oral appliance applied, such as a stabilization splint or a bite guard to balance one’s bite. Splints, also known as bite plates, are the most commonly used. Similarly night guards are used when sleeping. Both appliances are pieces of plastic that mold to one’s teeth and reduce the negative effects of grinding one’s teeth while also correcting the positioning of one’s teeth.
Arthrocentesis is a minimally invasive procedure which removes excess fluid or debris from the joint. However, if pain is unbearable, botox, surgery, or implants are used. Implants are conducted to replace jaw joints with artificial ones. The possible repercussions are astronomical and can cause many more problems than just a TMD. Surgery to drastically change and alter the TMJ is unreliable at best as the area that doctors are working in is quite sensitive and complex. Botox is a drug that is made from the same bacteria that causes food poisoning but can be used to solve health problems if given in small doses. Results for the effectiveness of botox are inconclusive and require more research to figure out how botox affects the muscles and nerves.
The National Institute of Dental and Craniofacial Research (NIDCR) is a federal research effort concerning the TMJ and muscle disorders surrounding it. They are currently tracking healthy people over long durations of time to determine risk factors that may have some effect on the development of the disorders. Early results show that a combination of clinical, psychological, sensory, genetic and nervous systems may increase risk of chronic TMDs. They are also identifying the pain of the TMJ as this disorder’s most defining feature. The outlook for TMDs, for the most part, is bright. Most can be treated successfully using home remedies. However, in some cases, lifestyle changes may not have much effect. In these cases, arthritis may be a part of the problem. Since arthritis causes inflammation, the joint is slowly worn down through the passage of time. In most cases, pain in the jaw does not signify a serious problem
WORKS CITED PAGE:
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