Himachal Dental


Treatment of Temporomandibular Joint Disorder ( TMD )

Posted in Oral Surgery by UK Dental Tourism on September 24, 2010

TMD, also commonly known as TMJD, is short for temporomandibular disorder and is a condition that affects the jaw, muscles in the neck and head and the TMJ joints next to each ear. The TMJ joint is responsible for coordinating movements that lead to eating, drinking and talking so any complaint in the area can have a significant impact on the life of the patient.

The main symptom of TMJ is unfortunately pain. This usually occurs when the patient is chewing or yawning, or any other extended movement of the TM joint. There may also be a painful ringing or tinnitus in the ear. Other major symptoms include swelling around the joint, a change in the bite and profile and trouble swallowing.In TMJ disorders, the joint can be affected by injury, arthritis, general wear and tear or degenerative joint disease. The disk of cartilage that cushions the joint can also become damaged or displaced, leading to a loss of flexibility or range of motion for the joint. Patients often experience pain, difficulty opening and closing their jaw or even hear a “clicking” or “popping” sound when using the joint.

One of the major problems when diagnosing TMJ is that a lot of these symptoms can be caused by manifold other conditions, some of which are far more likely to occur. This means that TMJ is often far down the list of diagnoses. Your dentist, if suspects TMJ, will conduct something called a clench test. This involves clenching the jaw to assess whether there is a structural disorder that could be TMd.

In most cases, treatment of TMJ will involve some level of orthodontics. In some severe cases, there may be a need for surgery but most bite misalignments can be cured with orthodontic treatment. During treatment, it may be necessary to wear a mouth guard to protect the lower teeth.

Symptoms can be treated with anti-inflammatory medications, bite splints or physical therapy techniques. But for patients with lasting TMJ pain, a consultation with an oral maxillofacial surgeon or a TMJ/oro-facial pain specialist can bring them more options to ease their condition.

The most minimally invasive technique for TMJ surgery is arthrocentesis, a short procedure usually performed under IV sedation or general anesthesia. Surgeons inject the joint with local anesthetic and fluid to flush out inflamed fluids.
Arthrocentesis is effective when inflammation is limited to or focused most within the joint.

When treatment requires open surgery, or arthroplasty, surgeons have several options, including disk repositioning, discectomy and joint replacement. Because these surgeries involve more risk, including damage to the ear canal or nearby nerves, they are only used after other treatment options have been considered.

Disk repositioning: Disk repositioning is used when the cartilage disk has slipped out of place inside the joint. Once out of place, the slipped disk can cause the often noted “popping” noise inside the joint, pinch a nerve surrounding the joint or stretch or inflame the surrounding ligaments. In disk repositioning, the surgeon makes an incision, moves the displaced disk back to its original position and stitches it in place, repairing surrounding ligaments if needed. Repositioned disks can sometimes slip back or degenerate.

Discectomy: A discectomy is a full removal of the disk in the TMJ joint. Disks that are constantly out of position or pop back and forth inside the joint are good candidates for this surgery.

Articular eminance recontouring: For some patients, the articular eminence (the “socket” part of the TMJ’s ball and socket joint) can be too deep. In this treatment, the surgeon shortens and smooths the articular eminence to prevent excessive forces on the joint, improve range of motion and reduce pain.

TMJ replacement: Newer techniques and materials have made prosthetic replacement of the TMJ a feasible option for patients with end-stage TMJ degeneration. The replacements have a socket component made of dense polymer and a jaw joint head made of a mixed alloy material that is attached to the remaining jaw bone. Prostheses are recommended to be replaced every decade.

There are various other treatments your dentist will be able to explain upon diagnosis of TMJ. If your jaw joints hurt or are swollen, then contact a dentist and ask for a test for TMJ.

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