The temporomandibular joint (TMJ) is a small joint located in front of the ear where the skull and lower jaw meet. It permits the lower jaw (mandible) to move and function. TMJ disorders are not uncommon and have a variety of symptoms. Patients may complain of earaches, headaches, and limited ability to open their mouth. They may also complain of clicking or grating sounds in the joint or feel pain when opening and closing their mouth.
As specialists in all areas of the mouth, teeth and jaws, the doctors at Advanced Oral Surgery are in a good position to correctly diagnose your problem.
Special imaging studies of the joints may be ordered and appropriate referral to other dental or medical specialists or a physical therapist may be made. TMJ treatment may range from conservative dental and medical care to complex surgery. Depending on the diagnosis, treatment may include short-term non-steroidal anti-inflammatory drugs (NSAIDs) for pain and muscle relaxation, bite plate or splint therapy, and even stress management counseling.
Generally, if non-surgical treatment is unsuccessful or if there is clear joint damage, surgery may be indicated. Conservative surgery can include arthroscentesis and arthroscopy. These are procedures that wash out the joint, removing inflammatory products and lubricating the joint so as to function more easily and smoothly (this method is similar to orthopedic procedures used to inspect and treat larger joints such as the knee). Another method may include repair of damaged tissue by a direct surgical approach.
Determining the cause of a TMJ problem is important, because it is the cause that guides the treatment. Arthritis is one cause of TMJ symptoms. TMJ disorder can result from an injury or from grinding the teeth at night. Another common cause involves displacement or dislocation of the disk that is located between the jawbone and its socket in the skull. A displaced disk may produce clicking or popping sounds, limit jaw movement and cause pain when opening and closing the mouth. The disk can also develop a hole or perforation, which can produce a grating sound with joint movement. There are also conditions such as trauma or rheumatoid arthritis that can cause the parts of the TMJ to fuse, preventing jaw movement altogether.