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Temporomandibular Disorders (TMD) -- TMJ

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The temporomandibular joint or TMJ is a joint that acts as a sliding hinge as it connects the jawbone and the skull together. Disorders involving the temporomandibular joint can cause pain and discomfort in the jaw joint itself as well as the muscles that are responsible for jaw movement. The exact cause for a temporomandibular joint disorder can sometimes be difficult to diagnose exactly, because pain can occur in response to a variety of different problems such as jaw injury or arthritis. Some people create temporomandibular joint problems by grinding or clenching their teeth chronically, while others habitually engage in these behaviors without ever developing a temporomandibular joint problem.

Causes, Risk Factors and Complications of TMJ

The temporomandibular joint has two actions, a sliding motion and a hinging action. The bone parts that interact within the joint have cartilage covering and there is a small shock-absorbing disk meant to separate them while keeping these movements smooth. When temporomandibular joint pain appears, it may occur because the disk is eroding or moving out from proper alignment, because the cartilage in the joint has become damaged due to arthritis, or because the joint has become damaged as a result of a blow or another impacting injury. In many of the cases of temporomandibular joint disorder, however, the exact cause is not completely clear.

When there is a cause behind the temporomandibular joint pain and discomfort, such as a breakdown of the cartilage or erosion of the disk, the problem itself is only going to get worse with time if treatment is lacking. Patients who are suffering pain or discomfort due to temporomandibular joint disorders need to seek professional medical assistance to find a potential cause and the treatment options available to remedy the problem.

Signs, Symptoms and Tests of TMJ

The signs and symptoms that are associated with temporomandibular joint disorders can include tenderness or pain in the jaw, aching pain around and inside the ear, difficulty chewing or a feeling of discomfort while chewing and joint locking which can make it difficult to close or open the mouth. Some people who have temporomandibular joint disorders experience a grating or clicking sensation when chewing or opening and closing the mouth. If there is no limitation of movement or pain present, then the temporomandibular joint disorder may not require immediate treatment.

A patient with a temporomandibular joint disorder may visit either a doctor or a dentist, who will perform a basic physical examination. The examination may involve listening to and feeling the jaw when the mouth opens and closes, observing the jaws range of motion and pressing on different areas of the jaw in order to identify sites where there is discomfort or pain. The physician may also utilize CT scanning or X-ray in order to get a detailed look at the mouth and the jaw and any potential issues involving the bone or cartilage. MRI may also help to reveal problems with the disk in the joint and the surrounding tissues.

Treatment, Drugs and Prevention of TMJ

Some temporomandibular joint disorder symptoms may resolve themselves without treatment, but persistent symptoms will require treatment. Physicians may recommend prescription medications including pain relievers, muscle relaxants, sedatives and tricyclic antidepressants. Therapies that physicians use for temporomandibular joint disorders include bite guards or oral splints, counseling, physical therapy, ultrasound, arthrocentesis, corticosteroid injections and surgical procedures. Although there are surgical options for treating TMJ disorders, physicians try to avoid them unless absolutely necessary because they are still in the developmental phase and therefore are controversial and experimental