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The
temporomandibular joint (TMJ) is a small joint located in
front of the ear where the skull and lower jaw meet, which
allows the lower jaw (mandible) to move and function.
TMJ
disorders have a variety of symptoms. Patients may complain
of earaches, headaches and limited ability to open the mouth.
They may also complain of clicking or grating sounds in the
joint and feel pain when opening and closing the mouth. What
must be determined, of course, is the cause.
WHAT
CAUSES TMJ DISORDERS?
Arthritis
is one cause of TMJ symptoms. It can result from an injury
or from grinding of the teeth at night. Another common cause
involves displacement or dislocation of the disc that is
located between the jawbone and the socket. A displaced
disc may produce clicking or popping sounds, limit jaw movement,
and cause pain during opening and closing of the mouth.
There are also conditions such as trauma or rheumatoid arthritis
that can cause the parts of the TMJ to fuse, preventing
jaw movement altogether.
SOMETIMES
THE JOINT ITSELF IS THE PROBLEM
Stress
may trigger pain in the jaw muscles that is very similar
to that caused by TMJ problems. Such patients frequently
clench or grind their teeth at night causing painful spasms
in the muscles and difficulty in jaw movement. Patients
may also have a combination of muscle and joint problems.
That is why diagnosing TMJ disorders can be complex and
may require different diagnostic procedures.
Determining
the cause of a TMJ problem is important, because it is the
cause that guides the treatment.
THE
ROLE OF THE ORAL AND MAXILLOFACIAL SURGEON
When
symptoms of TMJ trouble appear, an oral and maxillofacial
surgeon should be consulted. A specialist in the areas of
the mouth, teeth and jaws, the oral and maxillofacial surgeon
is in a good position to correctly diagnose the problem.
Special imaging studies of the joints may be ordered and
appropriate referral to other dental or medical specialists
or a physical therapist may be made.
RANGE
OF POSSIBLE TREATMENT
The
oral and maxillofacial surgeon's treatment may range from
conservative dental and medical care to complex surgery.
Depending on the diagnosis, treatment may include short-term
medications for pain and muscle relaxation, bite plate or
splint therapy, and even stress management counseling.
Generally,
if non-surgical treatment is unsuccessful or if there is
clear joint damage, surgery may be indicated. Surgery can
involve either arthroscopy (the method identical to the
orthopedic procedures used to inspect and treat larger joints
such as the knee) or repair of damaged tissue by a direct
surgical approach.
Once
TMJ disorders are correctly diagnosed, appropriate treatment
can be provided.
Portions of the above information provided as a courtesy
by:
American
Association of Oral and Maxillofacial Surgeons
9700 W. Bryn Mawr Avenue
Rosemont, Illinois 60018-5701
847/678-6200 Fax: 847/678-6286
Website: www.aaoms.org
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