WHAT DO YOU UNDERSTAND BY TMJ?
TMJ stands for TEMPOROMANDIBULAR JOINT.As the name suggests TMJ is that joint of your body which connects your lower jaw(also called as MANDIBLE) to the temple region of your skull(temporal bone).In more simpler terms, you can also call it as JAW JOINT. Anatomically, this joint is situated in front of your ears. This joint helps your lower jaw to move forward and sideways as in talking, chewing or yawning.
WHAT IS TEMPOROMANDIBULAR JOINT (TMJ) SYNDROME?
Temporomandibular joint syndrome may also be referred as temporomandibular joint disorder. Temporomandibular joint (TMJ) syndrome may be defined as the disorder of muscles and nerves of the jaw joint occurring as a result of injury to the muscles and nerves of the jaw joint or due to the injury caused to the parts of TMJ itself.
WHAT CAUSES TMJ SYNDROME?
Temporomandibular joint (TMJ) syndrome is a disorder characterized by localized pain occurring as a result of injury or damage to the jaw joint.
The factors that lead to TMJ syndrome are still not very clear. There are end number of factors that may result in stiffness and malfunctioning of the muscles of the jaw. But it is still not yet scientifically proven whether these factors ultimately lead to TMJ disorder or these factors are the outcome of disorder of the JAW JOINT.
Factors causing injury to TMJ-(i) trauma to teeth or jaw due to accidents
- Poorly aligned teeth (malocclusion)
- Jaw deviation
- Bruxism (teeth grinding) which puts lot of pressure on the jaw joint
- Incorrect body posture
- Inflammation of jaw joint (arthritis)
- Habit of frequent gum chewing
- Orthodontic treatment(correction of malocclusion using braces)
We at Zental and tmjhelpline.com, are known to provide almost all solutions for TMJD problems, and TMJ treatments, as a package of TMJ in India. TMJ India the destination and one stop solution is Zental Dental at our TMJ division Sanora.
SIGNS AND SYMPTOMS OF TMJ SYNDROME
Patient suffering from TMJ syndrome commonly experiences following signs and symptoms:
- MAIN SYMPTOM:Tenderness or pain especially in the area of jaw joint (Which is situated right in front of the ears).Pain might even radiate to other parts of face like cheek, mouth, eyes, forehead, ear, neck, shoulder etc.
- Pain experienced in TMJ syndrome sometimes mimic pain experienced during toothache.
- jaw clicking or popping,
- pain in and around your ears,
- Tinnitus(popping or ringing noisein ears) or feeling of fullness in the ears.
- Headaches or even migraine, resulting due to nerve inflammation.
- Soreness or stiffness in the muscles(especially in muscles of mastication) of the jaws thereby causing difficulty or discomfort while chewing food.
- Aching pain in the side of head(temple region)
- LOCK JAW causing difficulty in opening and closing of mouth.
- Jaw dislocation(especially after wide mouth opening a in yawning)
- Blurring of vision
- SPASM(sudden and painful tightening of muscles)of jaw muscles
- Numbness or tingling sensation in chin area.
- Pain beneath the tongue.
- Tenderness or swelling in the side of forehead(temple region).
- Giddiness(lightheadedness) or VERTIGO (loss of balance).
- (xvii) Eustachian tube(ear tube) problems.
RISK FACTORS ASSOCIATED WITH TMJ SYNDROME
Various risk factors are associated with TMJ syndrome like-
- Improper body posture particularly of neck and upper back cause much strain on their respective muscles, which may later contribute to TMJ syndrome.
- Stress or anxiety could also put facial and masticatory muscles under undue tension thereby resulting in jaw clenching and further may later progress to cause TMJ syndrome.
- Commonly seen in women between 18-44 years of age.
- Patients suffering with long term (chronic) inflammatory condition of the jaw joint like arthritis are at increased risk.
- People with poor alignment of teeth (malocclusion) and deformity or deviation of jawsare also at increased risk of developing TMJ syndrome.
- People who are more susceptible to pain and exhibit exaggerated stress response due to hereditary inheritance, are more prone to development of TMJ syndrome.
DIAGNOSIS OF TMJ SYNDROME
Whenever a patient of TMJ doctor consults a doctor, following steps are carried out to confirm the diagnosis-
- Complete medical and dental history of the patient.
- Thorough physical and oral examination of the patient
- MRI to rule out any probability of damage to the cartilage of jaw joint or any other existing medical condition.
- To confirm the diagnosis patient is referred to an oral and maxillofacial surgeon or ENT specialist/otolaryngologist or a dentist specialized in jaw disorders.
With the recent advancements in the field of dentistry, many advanced and sophisticated technologies have been launched to accurately diagnose this condition of TMJ syndrome like JT-3D, TekSCAN, BioJVA, BioEMG and many more.We feel proud to be equipped with almost all of them, which makes ZENTAL DENTAL CLINIC and SANORA BODY PAIN RELIEF CENTRE as the technologically most advanced super specializedTMJ clinic in India.
DIFFERENTIAL DIAGNOSIS OF TMJ SYNDROME
Conditions which may mimic facial and neck pains of TMJ syndrome includes-
- TRIGEMINAL NEURALGIA- Trigeminal nerve is a cranial nerve which supplies TMJ. Facial pains may also be the outcome of irritation of this cranial nerve which may be mistaken for TMJ syndrome.
- Swelling of lymph nodes of the neck.
- Giant cell arteritis.
- Diseases of the salivary gland.
- Soreness of throat may also cause facial pain at times.
- Poor fitting of the dentures may also cause facial pain.
TREATMENT FOR TMJ SYNDROME
(A) HOME REMIDIES TO RELIEVE THE SYMPTOMS OF TMJ SYNDROME: many symptoms of TMJ disorder respond quite well to the self-care and home remedies , which includes-
- Ice pack application to the joint
- Drugs to reduce the inflammation in jaw joint like NSAIDs(Non-steroidal anti-inflammatory drugs)
- Relaxing the jaw muscles by gently messaging and stretching them
- Stress management by doing exercise, yoga and meditation
- Giving up the habit of excessive chewing gum.
(B) WHEN HOME REMEDIES PROVES TO BE OF NO BENEFITE, DEFINITE TREATMENT OF TMJ SYNDROME IS REQUIRED.
These treatments may not completely cure the disorder but is highly effective in providing temporary and evenlong term relief. However the pahse 2 treatment that we provide with Crowns and Orthodontics, invariably leads to complete cure. We have track record of over 1000 cured cases for over 14 years.These treatments include-
- BOTOX(botulinium type A) INJECTIONS-Though it is not an FDA approved treatment procedure for TMJ disorder, it can be used to relax the facial musculature.
- Muscle relaxation using TENS
- ORTHOTIC/JIG/SPLINTS/MOUTH GUARD-It is an oral appliance which the patient needs to wear for most of the time to break the habit of bruxism and prevent further tooth grinding.
- Medicines for relieving the pain and muscle strain
- In severe cases-SURGERY.
- Gentle massaging and stretching of the muscles of neck and jaw, as recommended by a doctor or physiotherapist, with the aim of strengthening the muscle, enhance its flexibility and range of motion.
- Dental splint (occlusal splint or stabilization splint or bite guard), which is a dental appliance placed in the mouth that keeps the teeth in alignment and prevents tooth grinding. This resembles a mouth guard and is usually prescribed and fitted by a jaw specialist.
- Marijuana may also be prescribed in certain cases of severe TMJ pain ,in states where it is legal
- Pain management in patients with TMJ disorder may also be done by means of Biobehavioral management ( cognitive behavioral therapy [CBT], Biofeedback)
- Trigger point acupuncture may be of some relief in some patients.
- TMJ arthroscopy or arthrocentesis: it is a surgical procedure requiring minimal surgery. Greatest advantage being the rapid recovery of the patient in a week’s time.
- Total joint replacement is needed in some severe cases where all other treatment procedures have failed. DISADVANTAGE: hospitalization for several days and long recovery time of four to six weeks.
The following medicines are commonly prescribed to TMJ disorder patients:
- Pain management with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), and other pain relievers, including aspirin (Ecotrin) and acetaminophen (Tylenol).
- Medicines for relaxing the muscles(Muscle relaxants):cyclobenzaprine (Flexeril),metaxalone (Skelaxin)
- Medications for reducing the inflammation: celecoxib (Celebrex),nabumetone (Relafen), meloxicam (Mobic)
- Steroid injections to reduce inflammation in severe cases: beclomethasone (Qvar)
- Stress management drugs likeTricyclic antidepressants: imipramine (Norfranil, Tipramine, Tofranil), nortriptyline (Pamelor), amitriptyline (Elavil, Endep), and desipramine (Norpramin)
- Benzodiazapines: alprazolam (Xanax),diazepam (Valium), clonazepam (Klonopin)
- Medications for relaxed sleep: doxepin (Silenor)
- Medicines for managing nerve pain: levetiracetam (Keppra), pregabalin (Lyrica), gabapentin (Neurontin), topiramate (Topamax)
- Opiate medications for pain management: oxycodone and acetaminophen (Percocet) , hydrocodone and acetaminophen (Vicodinb, Lortab),
We at Zental Dental Clinic and Sanora take pride in curing TMJD and TMJ problems both with an Orthotic and without it.
WHOM TO SEE IF YOU ARE SUFFERING FROM TMJ DISORDER
If you are experiencing any signs and symptoms of TMJ syndrome you may first consult a general physician. After basic examinations and tests, your doctor may refer you to an ENT specialist (otolaryngologist) or oral and maxillofacial surgeon or a dentist specialized in jaw disorders(prosthodontist or prosthetic dentist) to confirm the diagnosis and carry out further treatments. In severe cases of pain you may also consult a doctor specialized in pain management.
PROGNOSIS FOR TMJ SYNDROME
Most of the symptoms of TMJ syndrome are easily manageable with self-care or home care remedies. The prognosis is generally good if the root cause for the TMJ disorder is accurately diagnosed and adequately treated.
COMPLICATIONS OF LONG-TERM TMJ SYNDROME
An untreated TMJ syndrome may result in chronic pain in the face and neck region and frequent headaches or even migraines. In severe chronic cases you may have to undergo a long term treatment protocol.
PREVENTION OF TMJ SYNDROME
Symptoms of TMJ syndrome are often intermittent (or episodic). It can be prevented to a great extent by doing some simple changes in our lifestyle like-
- Avoid chewing very hard food items as it can put excessive pressure on the jaw joint and injure them over a period of time. Soft food items must be preferred.
- Avoid excessive usage of chewing gum
- maintaining a good body posture to avoid any undue pressure on jaw joint
- Following stress management techniques by means of exercises, yoga, meditation
- Wearing orthotic/jig/dental splint appliances to correct the jaw position and avoid further injury to the jaw joint.
- Avoiding the chances of any trauma to the teeth or jaws by using appropriate safety equipment during working, exercising or playing sports.