What is TMJ Syndrome?Answer: Temporomandibular joint syndrome (TMJ) is a painful condition involving the joint that opens and closes the mouth. The temporomandibular joints are small joints in front of each ear that attach the lower jaw ( mandible) to the skull. The disorder may affect the jaw joint or the muscles surrounding it.Causes
The exact cause of TMJ syndrome is often unclear. Possible causes includeExcess tension in the jaw musclesFaulty alignment between the upper and lower teeth and jawsDisturbed movement of the jaw jointDisplaced or abnormal position of the jaw joint or cartilage disc inside the jaw jointArthritis or similar inflammatory process in the jointExcess or limited motion of the jointInjury of the jaw and faceRisk factorsFactors that increase your chance of getting TMJ syndrome include:Sex: female more affected than menAge: 30-50 years oldClenching or grinding of teeth especially at night while sleepingPoorly fitting denturesFibromyalgia, disease affecting the muscle fibersStressArthritisSymptomsPain in the temporomandibular joint,and jaw, or facePain may be worse with chewing, yawning, or opening the mouthClicking, popping, or grating sounds with movement of the jawA sensation of the jaw “catching” or “locking “ briefly, while attempting to open or close the mouth, or while chewingDifficulty opening the mouth completelyA bite that feels “ off ” uncomfortable, or as though it is freguently changingSwelling in the affected side of the face or mouthPainful muscle spasm in the area of the temporomandibular jointHeadacheEaracheNeck, back , and/or shoulder painDiagnosisThe doctor will ask about your symptoms and medical history, and perform a physical exam. The physical exam may include:Range of motion tests, mandibular movementListening for sounds in the temporomandibular jointsVisual inspection of your teeth, temporomandibular joints, and muscles of your face and headPalpation of the joints and the muscles of the face and headOther tests may include:-X-rays- plain x-rays or panoramic dental x-rays of the jaw joint, they show the teeth.-Arthrography-jaw movements videotaped with x-rays after dye is injected into the joint-MRI Scan-a test that uses magnetic waves to create detailed images of the jointTreatmentLifestyle Measures- resting the jaw with a soft diet, restricting its movement through smaller bites, and applying warm packs may offer considerable relief. Cognitive behavior therapy can help some patients learn to avoid clenching and grinding their teeth.Medications- the most commonly used medicines includeacetaminophennonsteroidal anti-inflammatory drugsMuscle relaxantsLow-dose antidepressantsIn some cases, the jaw joint may be injected with pain relieving medicine such as cortisone or lidocaine. When pain or clicking are major symptoms, injections of botulinum toxin (Botox) may offer temporary relief that responds to retreatment.Physical Therapy - gentle massage or stretching exercises, and transcutaneous electrical nerve stimulation (TENS) may reduce pain and help muscles relax in some patients.Stress Reduction - counseling to learn stress management and relaxation techniques, including biofeedback and cognitive behavioral therapy may help some patients with TMJ.Dental Procedures - a splint or mouth guard, usually worn at night, can be made to relax your jaw muscles and prevent clenching and grinding of your teeth. Correction of bite abnormalities by a dentist or orthodontist is sometimes recommended.Surgical Procedures - surgical correction is a last resort if other treatments have not succeeded and the pain persists. These procedures include arthroscopy, arthrocentesis, removal of the disc, eminectomy and partial /total joint replacement.RecommendationThere are no guidelines to prevent TMJ syndrome. This is because, these are so many factors that can precipitate this condition. However early diagnosis and treatment can prevent the condition from becoming worse, conservative therapy such as medication and splint therapy can alleviate many of the milder symptoms. People who grind their teeth should ask their dentist if a night guard would help them. With severe jaw pain when opening wide or eating, try to limit jaw movements and learn to relax your jaw, muscle relaxants prescribed by your dentist may help. For stress induce TMJ conditions learn relaxation techniques and effective ways to cope with stress.TMJ syndrome is still a poorly understood condition and different practitioners treat it differently. The important thing is not the treatment, but that the condition improves and the patient can live pain free. Severe TMJ syndrome can be very debilitating and many patients have multiple major surgeries in order to relieve the pain, therefore early diagnosis is the key.