Temporomandibular Joint Diseases

JAW JOINT DISEASES

Although symptoms of jaw joint disorders are seen in approximately 50-75% of the population, the number of patients who apply to a doctor with this complaint is much less. The biggest problem patients experience in this regard is not knowing which doctor they should apply to with this complaint.

It is usually noticed during an ENT specialist examination due to discomfort or when a dentist they visit for another reason examines the issue carefully.

TMJ (JAW JOINT) It is the only joint located in the front of the head that connects the lower jaw to the skull base. The joint consists of a protrusion of the lower jaw, a hollow area in the front area of ​​the ear canal, a cartilage disc that prevents them from rubbing, and various muscles attached to this area. There are one on the right and one on the left.

Thanks to the joint, opening & closing, forward & back and right & left sliding movements can be made.

TRAUMA

It is one of the leading joint disorders. Due to traumas to the head & neck region, tearing, swelling, inflammation and bleeding may occur in the joint disc ligaments. Although the pain may ease in 1-2 days, there will be limited movement.

Causes of trauma may include direct blows to the jaw, accidents, as well as uncontrolled stretching, forcing the mouth open for a long time during dental treatments, etc.

BRUXISM

Bruxism causes excessive load on the joints. It causes wear on the tooth surfaces, decrease in the bite height between the jaws, and increase in muscle volume.

MAGGING MUSCLE DISORDERS

Myofascial Pain: It is the most common among masticatory muscle disorders. There is contraction in a group of muscles, but there is no shortening as in myospasm. Headache is usually felt and is not sensitive to touch. Application of ice, cold spray or local anesthesia relieves the pain to a great extent.

Myositis: It is the primary inflammation that occurs in the muscles due to infection or trauma. It is characterized by constant pain in one or more masticatory muscles. This pain is usually accompanied by swelling, redness and fever in the skin of the muscle area. The typical feature is limited mouth opening due to pain and swelling.

Myospasm: Known as cramp, myospasm is a painful but very rare condition that occurs as a result of sudden, involuntary and continuous contraction of one or more muscles. It is characterized by local pain and severe limitation in mouth opening. It can be distinguished by its sudden onset during rest.

TREATMENT

1-Behavioral treatment: The most important part of the treatment of jaw joint disorders is informing the patients. The success of the treatment depends on the patients' motivation, cooperation and compliance with what is said. Information can start with the definition of the disease, and explanatory visuals can be used. It should not be forgotten that this disease is not aggressive like cancer. A soft diet should be recommended, gum should not be chewed, and large bites that will overload the joint should be avoided.

2- Splint treatment: Splints can be used successfully for the following purposes;
• Changing chewing forces,
• Protecting teeth from abrasion,
• Reducing bruxism and parafunctions and distributing excessive forces caused by these,
• Providing neuromuscular coordination,
• Treating muscle-related pain,
• Treating joint-related pain,
• Improving the function of the TMJ,
• Increasing the vertical dimension,
• Stabilizing moving teeth
There are 3 types of splints in terms of stiffness;
- Soft
- Hard
- Soft + hard
The degree of stiffness and thickness is decided by the physician.

3- Physical Therapy: The aim of this treatment is to relieve skeletal-muscular pain and activate tissue healing to ensure normal lower jaw function. For this purpose, thermal therapies that include hot and cold applications, acupuncture, low-dose laser therapy, ultrasound, rotation, coordination, physical therapy methods such as stretching exercises are used.

4- Drug Treatment: Drug treatments give good results when used together with other treatments. Painkillers, muscle relaxants, antidepressants are used for this purpose.

5- Intra-articular Injection: Intra-articular injection treatment is a method used especially in patients who cannot get results with other methods.