The Jaw

Normal Jaw Closed

 

Normal Jaw Open

 

Nerves of the Temporomandibular Region

TMJ syndrome is a term often used to describe a disorder of the temporomandibular joints (jaw joints) and/ or the muscles that control the joints and balance the head on the spinal column. It is a collection of symptoms that occur when the jaw joints and /or surrounding muscles do not work together properly. The problem can extend around the head and down the neck and back.

What Causes This Syndrome?

• Whiplash injuries like in car accident can cause the muscle of the neck to be jarred and pulled violently, often resulting in ligament tears, stretching of hard and soft tissues to their limits and articular disc tearing.
• Clenching and bruxism
  Clenching is the abnormal habit of keeping the teeth together during the day or night. Bruxism is the grinding of teeth usually during sleep. Both can lead to muscle spasms. Constant grinding can increase the pressure on the TMJ. Bruxism can put pressure on the articular disc, squeezing out synovial fluid and depriving it of lubrication
• Loss of teeth ,change to the bite and loss of support to the muscles of mastication
• Crooked bite or malocclusion- the abnormal contact of opposing teeth can lead to muscle spasms and TMJ disorder
• Systemic diseases like osteoarthritis, rheumatoid arthritis, psoriatic arthritis and systemic lupus erythematosus and electrolyte imbalances can produce inflammation and muscle cramping in the TMJ.
• Articular disc displacement. The jaw joint, in addition to being a ball and socket joint, glides forward and backward. When functioning correctly, the articular disc lies between the condyle head of the mandible and the roof of the joint. It normally follows the condylar head in its forward and backward movement.

If the ligaments that hold the disc to the condylar head are injured, the disc can slip out of place and can no longer serve as a normal cushion between the lower and upper parts of the jaw. Usually the disc is pulled forward. Mild displacements can cause a clicking or popping sound in the joint and can be sometimes painful. Permanent damage may result from the displacements.

Symptoms of TMJ disorders

• Headache
• Tooth pain caused by excessive pressure and biting on teeth
• Numbness or tingling of fingers
• Dizziness
• Neck, shoulder or back pain
• Pain behind eyes
• Earaches or ringing in ears
• Pain around the jaw joints
• Clicking or popping of the articular disc
• Crepitus(grinding sound)of the articular disc
• Locking of the mouth or Limited mouth opening

Treatment

• Attempt to break the cycle of muscle spasms Eat only Soft diet to minimise chewing and rest the jaw Try to chew on both side of the jaw Stop any habits like chewing gums and pen biting
• Rest the jaw muscles by becoming aware of clenching Keep your lips gently together and keep your back teeth apart
• Taking anti-inflammatory medications like Nurofen to relief muscle pain
• Relaxation and stress management
• Physiotherapy: gentle movements, exercises and massage can be effective in reducing pain and stiffness and increase strength and mobility.
• Behavioural modification therapy can be helpful in identifying sources of stress and learning to relax.
• Adjustment of the bite to relieve excessive pressure on teeth
• Replacing lost teeth to improve the contacts between the teeth and improve muscle functions
• Orthodontics to align the teeth and balance the load on the teeth and improve muscle functions
• Occlusal splints also known as bite plates may be sometimes useful to take pressure off the jaw joints and teeth. Usually they are worn at night and can act as nightguard