Temporomandibular Joint Disorder

The temporomandibular joint connects the mandible (lower jawbone) to the part of the skull known as the temporal bone. The joint allows the lower jaw to move in all directions so that the teeth can be used to bite off and chew food efficiently.

In temporomandibular joint disorder, the joint, the muscles and the ligaments that control the joint do not work together properly, causing pain. The condition is three times more likely to occur in women.

Temporomandibular joint disorder is most commonly caused by spasm of the chewing muscles, often as a result of clenching the jaw or grinding the teeth. Clenching the jaw and grinding the teeth may be increased by stress.
A poor bite (malocclusion) places stress on the muscles and may also be the cause of temporomandibular joint disorder, as may an injury to the head, jaw or neck that causes displacement of the joint. In some cases, arthritis is a cause.

What Are The Symptoms?

You may notice one or more of the following symptoms:
• headaches
• tenderness in the jaw muscles
• aching pain in the face
• severe pain near the ears.
In some cases, pain is caused by chewing or by opening the mouth too widely when yawning. There may be difficulty in opening the mouth, locking of the jaw, and clicking noises from the joint as the mouth is opened or closed.

What Might Be Done?

• Your dentist may take X-rays of your mouth and jaws.
• He may also arrange for you to see a specialist for treatment and investigations such as CT or MRI.
• Treatment is aimed at eliminating muscle spasm and tension and relieving pain.
• There are several self-help measures that you can adopt, including applying a warm, wet towel to the face, massaging the facial muscles, eating only soft foods and using a device that fits over the teeth at night to prevent you from clenching or grinding your teeth. #
• Taking analgesics, such as aspirin and paracetamol, may also help relieve pain.
• Your doctor may prescribe muscle-relaxant
  drugs if tension of the muscles used for chewing is severe.
• If stress is a major factor, relaxation techniques may help.
• If your bite needs to be adjusted, your dentist may recommend wearing a fixed or removable orthodontic appliance for a period of time.

What Is The Outlook?

In approximately 3 out of 4 people with temporomandibular joint disorder, symptoms improve within three months of treatment. However, if symptoms do not improve, further treatment may be required. In a few cases surgery to the joint may be necessary.