Temporomandibular Disorders (TMJ/TMD)

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Temporomandibular disorders (sometimes known as TMJ & TMD) describe a range of issues affecting the jaw. Problems can range from issues with the jaw, the joint or the surrounding facial muscles which you use for moving your jaw and chewing. Your lower jaw is linked to the temporal bone in your skull by the temporormandibular joint which acts like a hinge. Normally, these joints are highly flexible and allow your jaw to make the range of motions it needs for talking, yawning or chewing.

Causes of TMJ

Although the causes of TMJ are not currently known, studies have shown that there are a number of contributing problems in the jaw muscles or within the joint itself which can trigger TMJ. Injury or damage to the jaw or the joint can often trigger TMJ such as patients experiencing whiplash or a severe blow to the area. If you clench or grind your teeth (also known as bruxism) this will put a lot of strain on your temporormandibular joint and can often trigger TMJ. Rheumatoid arthritis and osteoarthritis which occur in your temporomandibular joint can also be a potential trigger for TMJ. Interestingly, research indicates stress can also be a potential trigger for TMJ as it may sometimes cause sufferers to tighten the muscles in their faces or jaws.

Symptoms of TMJ

What symptoms you experience largely depends on how severe the toothaches and headaches. Some patients also suffer from swelling on the side of the face or facial muscles which feel 'tired'. Women are more likely to experience TMJ than men and it tends to occur most between the ages of 20 and 40 years.

Treatment for TMJ

TMJ can be treated in a variety of ways, depending on its severity. In less severe cases home care may be sufficient but invasive surgery is also an option. It is usually recommended that TMJ patients start off with the least invasive therapies saving surgery until all other options are exhausted. Many sufferers use a cold compress or a warm towel on their face and temples for a few minutes a couple of times per day. Patients are often advised to exclude hard foods which require a lot of work by the jaw from their diets as this can put unnecessary strain on the jaw. For TMJ caused by teeth grinding, a mouth guard can be used to protect the teeth, especially when the patient is asleep. There is a range of advice on how to keep a good posture and how to avoid making movements which tax the muscles in your neck or jaw. A number of medicines are available to manage the swelling and minimise pain in your muscles. Whilst over-the-counter medications like ibuprofen are usually enough for most patients, you may be prescribed a stronger painkiller in more serious cases. If your TMJ is occurring due to an issue with your bite then a range of corrective treatments such as dental bridges,crowns or Orthodontics may be advised. If all else fails however, surgery may be the only remaining option.

There are three main types of surgery for treating Temporomandibular disorders and which option is selected will solely depend on the type of TMJ problem you are experiencing. Almost all TMJ treatments are carried out under a general anaesthetic, meaning you will be unconscious throughout. This is done to facilitate access to the area and to minimise discomfort during the procedure. Arthorocentesis is a relatively minor surgery which is usually performed when the jaw's movement is restricted. Needles are placed into the affected  joint and used to clean it with sterile liquids. Sometimes a stuck disc will need to be corrected by removing tissue with a blunt surgical instrument. Arthoscopy uses a tiny camera to allow greater access to the affected joint and also lets your surgeon investigate the damage to the area. Your surgeon will either adjust your disc or extract any affected tissue depending on the cause of the TMJ. Open joint surgery exposes the entire area but is usually only carried out in severe cases such as tumours in the joint, scarring on the bone or a deterioration in the bone.

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