Temporomandibular joint (TJM Disorders)
The temporomandibular joint (TMJ) is a sliding hinge that connects your jawbone to your skull. There are two joints, one on each side of your jaw. The parts of the bone in the joint are covered with cartilage and are separated by a small shock-absorbing disk within the sliding hinge which allows the jaw to open smoothly.
Temporomandibular joint disorders (TMD) — can cause pain if the joints are damaged or the muscles in the area are sore.
The joints may be damaged when:
- the disc is worn out or pushed out of its normal position
- the cartilage is worn out or damaged by an impact
- you clench or grind your teeth so there is too much pressure on the joints
- your joints undergo premature degenerative changes
The muscles may be sore when:
- you clench or grind your teeth so the muscles are overused and go into spasm.
In some cases, however, the cause of TMJ disorders isn’t clear.
Signs and symptoms
- pain or tenderness of your jaw or joints.
- pain when chewing
- generalised facial pain
- “locking” of the joint, making it difficult to open or close your mouth
- clicking sound or crepitus (rough grating sounds) when opening and closing mouth
At the first consultation appointment, we will look at the range of motion of your jaw, discuss symptoms, and feel around for sore spots that elicit pain.
We may also need more information like:
- Dental X-rays to examine your teeth and jaw
- CT scans and/or MRI to provide detailed images of the joint.
We may prescribe medication to relieve pain such as:
- Pain killers
- Muscle relaxants to relieve pain caused by muscle spasms.
You may also need to wear a mouth guard (occlusal appliance) inserted in between the upper and lower jaw to provide a cushion between the upper and lower teeth and reduce pressure on the joint.
Botulinum Toxin injections into the muscles used to chewing may also be necessary to help relieve muscle spasm and pain.
If the pain does not resolve with more-conservative treatments and it appears to be caused by a structural problem in the joint, we may suggest a joint washout (arthrocentesis) to remove the inflammatory mediators, a scope or open-joint surgery (arthrotomy) to repair the joint.