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Treatment of temporomandibular joint disorders

Diseases related to the jaw joint and jaw muscles and their treatment are one of the branches of dentistry. The jaw joint is located where the lower and upper jaw meet and is a complex structure made up of the jawbone and muscles. Thanks to the contraction and relaxation of the jaw muscles and the simultaneous movement of the moving parts of the jaw joint, the mouth opens and closes, and a person can speak, chew something, and yawn. Since the jaw muscles and joints work together, they affect each other. For example, teeth grinding caused by stress and poor posture weakens the muscles, causing the lower and upper jaw to move closer together. When the jaws approach each other, pressure occurs in the jaw joint and this pressure wears down the lower teeth. Jaw joint disorders affect the system that consists of certain head and neck muscles, ligaments (tough connective tissue that holds bones together), teeth, cheeks, lips, and salivary glands. Complaints about the jaw joint may occur not only in the joint area but also in the areas of the jaws, eyes, ears, nose and throat.
Causes of Jaw Joint Disorders
  • Teeth clenching or grinding, lip biting, nail biting, gum chewing habits
  • Injuries and accidents,
  • Poor posture
  • Excessive fatigue of the jaw muscles,
  • Long-term dental treatments,
  • As a result of excessive opening of the jaw during general anesthesia,
  • Some systemic diseases,
  • Psychological disorders,
  • Incompatibility and crowding between teeth.
Symptoms of Jaw Joint Disorders
  • Teeth grinding and the pain associated with it
  • Spreading pain to the head, neck and teeth areas
  • Complaints such as tinnitus, dizziness and fatigue
  • Impaired jaw movement (inability to fully open the jaw, clicking of the jaw when opening the mouth, grinding)
  • Painful and difficult opening of the mouth during yawning and/or eating
  • Difficulty in biting and/or taking a bite with the front teeth while eating
  • Permanent or occasional differences in the closure of the teeth (distance between the upper jaw and the lower jaw when the teeth are closed, the lower and upper teeth not matching each other thus preventing a regular closure)
  • Pain and feeling of tiredness, swelling of face
  • Ear pain, ringing or hearing problems
  • Dizziness, fainting,
  • Teeth becoming sensitive,loose or broken
  • In some cases, patients also need help from otolaryngologists, neurologists, physical therapists and psychiatrists.
Examination and Assessment
Clinical examination of the jaw joint takes approximately 30-35 minutes. Doctor examination is important for exact and accurate determination of the cause of jaw disease. A person’s medical history provides information about their health in general. The type and severity of symptoms also give important clues to the doctor. During the examination, the doctor checks the pain, muscle tension and sensitivity in the muscle and jaw joint with the palpation (touch) technique. In addition, they put their little finger in the patient’s ear and feels how the jaw joint works. They can detect the clicking sound in the joint with a stethoscope. They can measure how much the mouth opens with a ruler. Some diagnostic tests may be requested after the examination.It is understood whether there is joint damage, fracture, tumor by tomographic or direct x-rays. Magnetic resonance (MRI) also provides detailed information about soft tissue and shows disc and fiber damage. In addition, the doctor may request a dental plaster. In dental plaster, the teeth are modeled and a model is made from plaster. This model is passed to a mechanical movement stimulator. This device assists demonstration of the lower jaw movement, whether the teeth can come together, damage to joints and surrounding muscles due to biting.All these examinations and tests reveal the condition about the causes and magnitude of the disease, and the physician determines the best treatment method afterwards.
Jaw Joint Disorder Treatment Applications
Main aim of the treatment is to regulate the pressure in the jaw joint and to achieve normal jaw functions. In the treatment of jaw joint disorders, various methods can be applied with the recommendation of the doctor. For the treatment of jaw joint disorders, correction of regional factors causing discomfort (necessary dental treatments) is ensured, dental plaque application is performed to eliminate excessive forces on the jaw joint, intra-articular injections called arthrocentesis are applied for disc-related disorders. Orthopedic appliance (splint) use is also among the available treatment methods. It has been proven by scientific research that diseases can be taken under control by educating the patient. At this point, it is very important for the patient to take certain precautions, follow the recommendations and protect themselves.We can list the issues that the patient should comply with during the treatment as follows:
  • They should protect their teeth well, take care of their oral and dental health,
  • Pay attention to good chin position,
  • Prefer soft foods,
  • Perform the jaw exercises recommended by the doctor,
  • Follow medical treatment for pain and take medications regularly.