Information About Temporomandibular Joint (Jaw Joint)
The temporomandibular joint is an important joint that connects the lower jaw to the skull. This joint includes various components such as the jaw bones, the disk in the cartilage structure of the joint, and the chewing muscles, all of which affect jaw joint diseases. Jaw joint diseases are common in a wide segment of society, especially affecting women more. Generally, these disorders are frequently encountered in individuals aged 20-40 years.
The treatment of diseases related to the jaw joint and jaw muscles is carried out by physicians specialized in Oral, Dental and Maxillofacial Surgery. The temporomandibular joint (TMJ), is one of the most mobile joints located between the mandibular fossa, which is just in front of the external auditory canal and under the temporal bone, and the condyle of the mandible. This complex structure consists of the jaw bone, muscles, cartilage structures and ligaments that restrict excessive opening of the jaw. The movement of the jaw joint, through the contraction and relaxation of the jaw muscles, allows for mouth opening and closing, speaking, chewing, and yawning.
Causes of Jaw Joint Disorders
- Teeth grinding, clenching, lip biting, nail biting, and prolonged gum chewing habits
- Excessive fatigue and strengthening of the jaw muscles (due to bruxism)
- Dental treatments that cause prolonged mouth opening
- Excessive opening and straining of the jaw during general anesthesia
- Unilateral chewing habits
- Chewing with only certain areas due to the absence of lower and upper jaw teeth
- Incompatibility between lower and upper teeth (Dental Malocclusions)
- Structural incompatibility between the lower and upper jaw relationships (Skeletal disorders)
- Improperly applied dental fillings and porcelain prostheses
- Impacts, injuries, and accidents affecting the joint area
- Resting the jaw on the hand, putting pressure on the jaw
- Pressure on the lower jaw joint due to sleeping on a pillow of mismatched height
- Certain systemic diseases
- Psychological disorders
Symptoms of Jaw Joint Disorders
- Pain felt in the jaw area or cheeks in the mornings, along with teeth grinding and clenching
- Pressure and pain radiating from the jaw joint to the ear, neck, teeth, and even to the nose and eyes
- Restriction in jaw movements (inability to fully open the jaw, grating, locking, clicking sounds, deviation to one side)
- Painful and difficult opening of the mouth during yawning or eating
- Difficulty biting and/or tearing food with the front teeth while eating
- Constant or intermittent differences in teeth closure (space remaining between upper and lower jaw)
- Pain, fatigue, and swelling in the face
- Tooth sensitivity, wear, breakage, or looseness
Examination Methods
- Detailed history taking from the patient regarding joint complaints
- Examination of teeth and occlusion system
- Examination of chewing muscles
- Examination of the jaw joint
In diagnosing jaw joint disorders, alongside the examination, some auxiliary tests may also be conducted. Additionally, traditional or computerized tomography and magnetic resonance imaging methods may also be utilized. The most critical point during the examination phase is to identify the underlying cause of the jaw joint disorder. Most treatments applied to the joint, aside from surgical interventions, are symptomatic (targeting symptoms).
Treatment of TMJ
- Treatment of symptoms
- Treatment of the underlying cause
- Elimination of predisposing factors
- Treatment of pathological effects
Treatment Options
- Patient education and preventive treatment
- Splint therapy
- Medication therapy
- BOTOX applications to chewing muscles
- Exercises
- Physical therapy
- Manipulation
- Psychiatric support
- Advanced treatment methods in complex cases (surgery, etc.)
The primary aim of treatment is to regulate the pressure within the jaw joint and to ensure normal jaw functions. In disorders of the jaw joint, the treatment process may include corrections of the areas causing the disorder (necessary dental treatments), application of dental splints to eliminate excessive forces on the jaw joint, and intra-articular injections known as arthrocentesis in cases related to the disk. The use of orthopedic appliances (splints) is also among the current treatment methods. During this process, it is essential for the patient to adhere to the precautions and recommendations they receive.
Things to Consider During the Treatment Process
- Take good care of your teeth; pay attention to oral and dental health.
- Be mindful of your jaw position.
- Prefer soft foods.
- Avoid chewing gum.
- Be cautious not to bite hard foods with your front teeth.
- Be careful not to open your mouth beyond a certain limit; support your jaw (for example, while yawning).
- Regularly perform the jaw exercises recommended by your physician.
- Follow prescribed medical treatment for pain.
- Take your medications regularly.
- If applicable, use your splint meticulously.
