What causes TMJ disorders? What are the common symptoms? How is TMD diagnosed? Explore the home treatments, traditional treatments, and surgical options for managing TMJ disorders.

Understanding Temporomandibular Joint Disorders (TMJ & TMD)

The temporomandibular joint (TMJ) is a hinge that connects the jaw to the temporal bones of the skull, located in front of each ear. This joint allows for essential movements like talking, chewing, and yawning. Problems with this joint and the surrounding muscles are known as temporomandibular disorders (TMD).

Causes of TMJ Disorders

The exact cause of TMD is not fully understood, but dentists believe the symptoms arise from issues with the jaw muscles or the components of the joint itself. Some of the common causes include:

• Injury to the jaw, joint, or muscles of the head and neck, such as from a heavy blow or whiplash
• Grinding or clenching of the teeth, which puts significant pressure on the joint
• Displacement or movement of the soft cushion or disc between the ball and socket of the joint
• Arthritis in the joint
• Stress, which can lead to tightening of facial and jaw muscles or tooth clenching

Symptoms of TMJ Disorders

TMD often causes severe pain and discomfort, and the symptoms can be temporary or last for many years. The disorder may affect one or both sides of the face. Some of the common symptoms include:

• Pain or tenderness in the face, jaw joint area, neck, shoulders, and around the ear when chewing, speaking, or opening the mouth wide
• Difficulty opening the mouth wide
• Jaws that get “stuck” or “lock” in the open- or closed-mouth position
• Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth or chewing
• A tired feeling in the face
• Trouble chewing or a sudden uncomfortable bite, as if the upper and lower teeth are not fitting together properly
• Swelling on the side of the face
• Other related symptoms like toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus)

Diagnosing TMJ Disorders

To determine the cause of the TMD symptoms, the dentist will take a comprehensive health history and perform a physical examination. They will check the jaw joints for pain or tenderness and listen for any clicking, popping, or grating sounds when the jaw is moved. The dentist will also assess the proper functioning of the jaw and whether it locks when opening or closing the mouth. Additionally, they may order imaging tests like X-rays, MRI, or CT scans to rule out other underlying issues.

Home Remedies for TMJ Disorders

There are several self-care measures that can help provide relief from TMD symptoms. These include:

• Taking over-the-counter anti-inflammatory medications like naproxen or ibuprofen to reduce pain and swelling
• Applying moist heat or cold packs to the affected area
• Performing gentle jaw stretches (if approved by the dentist or physical therapist)
• Eating soft, easy-to-chew foods and avoiding hard, crunchy, or chewy foods
• Minimizing extreme jaw movements like yawning, chewing gum, or singing
• Maintaining good posture to reduce neck and facial strain
• Keeping the teeth slightly apart to relieve pressure on the jaw

Traditional Treatments for TMJ Disorders

If the home remedies do not provide sufficient relief, the dentist may recommend more traditional treatment options, such as:

• Physical therapy to stretch and strengthen the jaw muscles
• Bite splints or mouth guards to prevent teeth grinding and clenching
• Prescription medications, including muscle relaxants or anti-anxiety drugs
• Injections of corticosteroids or Botox to reduce muscle tension and pain

Surgical Options for Severe TMJ Disorders

In cases where the TMD symptoms are severe and do not respond to conservative treatments, the dentist may refer the patient to an oral surgeon for potential surgical intervention. Some of the surgical options for TMJ disorders include:

• Arthrocentesis: a minimally invasive procedure to flush out the joint and reduce inflammation
• Arthroscopy: a more advanced surgical procedure to repair or remove damaged joint parts
• Open-joint surgery: a complex procedure to restructure or replace the joint components

The decision to undergo surgery for TMJ disorders is made on a case-by-case basis, taking into account the severity of the symptoms, the individual’s response to conservative treatments, and the potential risks and benefits of the surgical intervention.

Seeking Specialized Care for TMJ Disorders

If you are experiencing persistent or severe TMD symptoms, it is recommended to seek evaluation and treatment from a dental professional, such as a general dentist, oral surgeon, or orthodontist. They can thoroughly assess your condition, provide an accurate diagnosis, and develop a customized treatment plan to manage your TMJ disorder and alleviate your symptoms.

Temporomandibular Joint Disorders (TMJ & TMD): Overview

Written by WebMD Editorial Contributors

Medically Reviewed by Evan Frisbee, DMD on October 31, 2021

• What Causes TMD?
• What Are the Symptoms?
• How Is TMD Diagnosed?
• Home Treatments for TMD
• Traditional Treatments
• Other Treatments
• Surgery for TMD
• More

Your temporomandibular joint is a hinge that connects your jaw to the temporal bones of your skull, which are in front of each ear. It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn.

Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD). But you may hear it wrongly called TMJ, after the joint.

We don’t know what causes TMD. Dentists believe symptoms arise from problems with the muscles of your jaw or with the parts of the joint itself.

Injury to your jaw, the joint, or the muscles of your head and neck — like from a heavy blow or whiplash — can lead to TMD. Other causes include:

• Grinding or clenching your teeth, which puts a lot of pressure on the joint
• Movement of the soft cushion or disc between the ball and socket of the joint
• Arthritis in the joint
• Stress, which can cause you to tighten facial and jaw muscles or clench the teeth

TMD often causes severe pain and discomfort. It can be temporary or last many years. It might affect one or both sides of your face. More women than men have it, and it’s most common among people between the ages of 20 and 40.

Common symptoms include:

• Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
• Problems when you try to open your mouth wide
• Jaws that get “stuck” or “lock” in the open- or closed-mouth position
• Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.
• A tired feeling in your face
• Trouble chewing or a sudden uncomfortable bite — as if the upper and lower teeth are not fitting together properly. Learn more about the pros and cons of teeth alignment surgery.
• Swelling on the side of your face

You may also have toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).

Many other conditions cause similar symptoms — like tooth decay, sinus problems, arthritis, or gum disease. To figure out what’s causing yours, the dentist will ask about your health history and conduct a physical exam.

They’ll check your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. They’ll also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Plus they’ll test your bite and check for problems with your facial muscles.

Your dentist may take full face X-rays so they can view your jaws, temporomandibular joints, and teeth to rule out other problems. They may need to do other tests, like Magnetic resonance imaging (MRI) or computer tomography (CT). The MRI can show if the TMJ disc is in the proper position as your jaw moves. A CT scan shows the bony detail of the joint.

You may get referred to an oral surgeon (also called an oral and maxillofacial surgeon) for further care and treatment. This doctor specializes in surgery in and around the entire face, mouth, and jaw area. You may also see an orthodontist to ensure your teeth, muscles, and joints work like they should.

There are things you can do on your own to help relieve TMD symptoms. Your doctor may suggest you try some of these remedies together.

Take over-the-counter medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen, can relieve muscle pain and swelling.

Use moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple jaw stretches (if your dentist or physical therapist OKs them). When you’re done, hold a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.

Eat soft foods. Add yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans, and grains to your menu. Cut foods into small pieces so you chew less. Skip hard, crunchy foods (like pretzels and raw carrots), chewy foods (like caramels and taffy), and thick or large bites that require you to open wide.

Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) to a minimum and don’t yell, sing, or do anything that forces you to open wide.

Don’t rest your chin on your hand. Don’t hold the phone between your shoulder and ear. Practice good posture to reduce neck and facial pain.

Keep your teeth slightly apart as often as you can. This will relieve pressure on your jaw. Put your tongue between your teeth to control clenching or grinding during the day.

Learn relaxation techniques to help loosen up your jaw. Ask your dentist if you need physical therapy or massage. Consider stress reduction therapy as well as biofeedback.

Talk to your dentist about these tried-and-true treatments for TMD:

Medications. Your dentist can prescribe higher doses of NSAIDs if you need them for pain and swelling. They might suggest a muscle relaxer to relax your jaw if you grind or clench your teeth. Or an anti-anxiety medication to relieve stress, which may bring on TMD. In low doses they can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.

A splint or night guard. These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position. What’s the difference between them? You wear night guards while you sleep. You use a splint all the time. Your dentist will tell you which type you need.

Dental work. Your dentist can replace missing teeth and use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem. Learn more about what causes an overbite, as well as when an overbite is considered normal.

If the treatments listed above don’t help, your dentist may suggest one or more of the following:

Transcutaneous electrical nerve stimulation (TENS). This therapy uses low-level electrical currents to provide pain relief by relaxing your jaw joint and facial muscles. It can be done at the dentist’s office or at home.

Ultrasound. Deep heat applied to the joint can relieve soreness or improve mobility.

Trigger-point injections. Pain medication or anesthesia is injected into tender facial muscles called “trigger points” to give relief.

Radio wave therapy. Radio waves stimulate the joint, which increases blood flow and eases pain.

Low-level laser therapy. This lowers pain and inflammation and helps you move your neck more freely and open your mouth wider.

If other treatments can’t help you, surgery is an option. Once it’s done, it can’t be undone, so get a second or even third opinion from other dentists.

There are three types of surgery for TMD. The type you need depends on the problem.

Arthrocentesis is used if you have no major history of TMJ but your jaws are locked. It’s a minor procedure that your dentist can do in their office. They’ll give you general anesthesia, then insert needles into the joint and wash it out. They may use a special tool to get rid of damaged tissue or dislodge a disc stuck in the joint, or to unstick the joint itself.

Arthroscopyis surgery done with an arthroscope. This special tool has a lens and a light on it. It lets your doctor see inside your joint. You’ll get general anesthesia, then the doctor will make a small cut in front of your ear and insert the tool. It’ll be hooked up to a video screen, so they can examine your joint and the area around it. They may remove inflamed tissue or realign the disc or joint. This type of surgery, known as minimally invasive, leaves a smaller scar, has fewer complications, and requires a shorter recovery time than a major operation.

Open-joint surgery. Depending on the cause of the TMD, arthroscopy may not be possible. You may need this type of surgery if:

• The bony structures in your jaw joint are wearing down
• You have tumors in or around the joint
• Your joint is scarred or full of bone chips

You’ll get general anesthesia, then the doctor will open up the entire area around the joint so they can get a full view and better access. You’ll need longer to heal after open-joint surgery, and there is a greater chance of scarring and nerve injury.

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TMJ (Temporomandibular Joint) Disorders: Symptoms and More

The temporomandibular joint (TMJ) is the joint that connects your mandible (lower jaw) to your skull. The joint can be found on both sides of your head in front of your ears. It allows your jaw to open and close, letting you to speak and eat.

The abbreviation “TMJ” has also been used to refer to a group of health conditions related to your jaw. However, this is becoming more commonly abbreviated as “TMD” or “TMJD” to distinguish the temporomandibular joint itself from TMJ disorders.

These disorders can cause:

• tenderness at the joint
• facial pain
• difficulty moving the joint

According to the National Institute of Dental and Craniofacial Research, as many as 10 million Americans suffer from TMJ disorders. They are more common among women than men.

These disorders are treatable, but they have many different possible causes. This can make diagnosis difficult.

Keep reading to learn more about TMJ disorders. You should discuss any concerns with your doctor.

The symptoms of TMJ disorders depend on the severity and cause of your condition. The most common symptom of TMJ disorders is pain in the jaw and surrounding muscles.

According to 2021 research, other symptoms typically associated with these disorders include:

• pain that can be felt in the face or neck
• stiffness in the muscles of the jaw
• limited movement of the jaw
• locking of the jaw
• clicking or popping sound from the TMJ site
• dental issues, such as the wearing down of teeth
• tinnitus (ringing in the ear)
• vertigo
• headaches
• shift in the jaw, changing the way that the upper and lower teeth align (called malocclusion)

Symptoms may show up on just one side of the face or both.

Because TMJ disorders can have a variety of causes, there are also a variety of ways to treat them.

Physicians will typically advise starting with home treatments first. This is because many of the more complicated treatments still need more studies to prove their efficiency.

Home treatments

In a lot of cases, the symptoms of TMJ disorders can be treated with self-care practices at home. To ease the symptoms of TMJ at home, you can:

• Eat soft foods.
• Use ice to reduce swelling.
• Reduce jaw movements.
• Avoid chewing gum and tough foods (like beef jerky).
• Take measures to reduce stress.
• Use jaw-stretching exercises to help improve jaw movement.

Medication

If you find that your TMJ is not eased by using home treatments, some medications — both over-the-counter and prescribed by a doctor — may provide more relief.

Some of these medications include:

• nonsteroidal anti-inflammatory drugs (NSAIDs)
• corticosteroids
• muscle relaxers
• antidepressants
• local anesthetics

Your doctor will help you decide which medication is best for you, based on your personal condition and health history.

Therapies

Occasionally, your doctor may recommend physical therapy. Depending on the area that needs attention, your therapy could include:

• heat therapy
• cooling therapy
• acupuncture
• tissue mobilization
• resistance exercises
• stretches

If you and your doctor believe your TMJ disorder may be caused by stress, talk therapy or stress management exercises are additional options.

Surgery or other procedures

If your symptoms don’t improve with the methods listed above, your doctor may decide that your condition requires serious treatment.

Botox injections are one such treatment. Typically, these injections are done for painful trigger points or chronic teeth grinding. The evidence behind this treatment is still lacking, however.

In very rare cases, your doctor may recommend surgery to treat your condition. Procedures can include:

• corrective dental treatment to improve your bite and align your teeth
• arthrocentesis, which removes fluid and debris from the joint
• surgery to replace the joint

Procedures used to treat this condition may, in some cases, make your symptoms worse. Talk with your doctor about the potential risks of these procedures.

In many cases, it’s not known what causes TMJ disorders. Trauma to the jaw or joint may play a role. There are also other health conditions that may contribute to the development of TMJ disorders.

These include:

• arthritis
• erosion (wearing away) of the joint
• habitual grinding or clenching of the teeth
• structural jaw issues present at birth
• growth disorders

Risk factors

While there are some factors that are often associated with the development of TMJ disorders, they haven’t been proven to be a direct cause.

Some of these include:

• female hormones (it’s theorized that estrogen may play a role in the development of TMJ)
• poor posture that strains the muscles of the neck and face
• prolonged stress
• joint hypermobility

TMJ disorders can be difficult to diagnose. There are no standard tests to diagnose most of the disorders that fall under that title. A doctor may refer you to a dentist, or an ear, nose, and throat (ENT) specialist to diagnose your condition.

A healthcare professional may examine your to see if there is swelling or tenderness. They may also use several different imaging tests.

These can include:

• X-rays. X-rays of the jaw and teeth usually involve you biting down on a small mouthpiece as your dentist moves an imaging machine around your head. These X-rays will allow your dentist to see the bones in and around your jaw, as well as your teeth placement.
• CT scan. A CT scan of the jaw allows your doctor to see the bones and joint tissues in a more advanced way than a regular X-ray.
• MRI. An MRI of the jaw will reveal if there are problems with the structure of the jaw. An MRI, or magnetic resonance imaging scan, uses a magnetic field to show detailed images of organs and tissues.

You may not be able to prevent TMJ disorder from developing, but you might be able to reduce symptoms by lowering your stress levels, employing physical therapy and exercises, and working with a dentist or doctor if you often grind your teeth at night.

Possible solutions for teeth grinding include wearing a mouth guard at night and occasionally taking muscle relaxants.

Can TMJ disorder be cured?

TMJ can be caused by a variety of issues, such as trauma to the jaw or persistent stress, so curing the symptoms is directly connected to curing, or easing, the condition that caused them.

However, many individuals find that their TMJ symptoms improve or even go away on their own within weeks or months if home remedies are employed.

Are TMJ disorders serious?

While many people find their TMJ symptoms go away on their own after addressing the root cause, other individuals may deal with more serious symptoms that can affect their quality of life.

Even when someone is dealing with a more serious case of TMJ disorder, it’s recommended to avoid aggressive treatments such as surgery whenever possible, because there is still not enough evidence to show that these irreversible methods work.

There are a wide variety of treatments available for TMJ disorders. If one doesn’t work for you right away, work with your doctor to find one that does.

What will happen if TMJ disorder is not treated?

TMJ isn’t life threatening, but if it’s not treated, it can cause pretty persistent discomfort and tension in and around your jaw. It’s also possible that the affected joints could become inflamed, and there may even be damage to your teeth.

You don’t have to deal with the pain and discomfort of TMJ alone. Talk with your doctor or dentist about your symptoms.

The outlook for TMJ disorders depends on the cause of the condition. TMJ disorders can be successfully treated in many people with at-home remedies, such as changing posture or reducing stress.

If your condition is caused by a chronic (long-term) disease such as arthritis, lifestyle changes may not be enough. Arthritis can wear down the joint over time and increase pain. There are, however, many treatments to help with the symptoms of arthritis itself.

Most cases of TMJ disorder warrant changes in lifestyle habits, possibly combined with medications to ease pain and discomfort. Aggressive treatments are rarely needed.

Talk with your doctor about your options to determine what treatment is right for you.

Temporomandibular joint dysfunction (TMJ): symptoms and treatment

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What is Temporomandibular Joint Dysfunction (TMJ)?
Temporomandibular joint dysfunction means that the joint that connects the upper and lower jaws does not function properly. This joint is one of the most complex joints in the human body, it is responsible for the movement of the lower jaw forward, backward and from side to side. Any disease that prevents this complex system of muscles, ligaments, cartilage, and bones from working properly is called temporomandibular joint dysfunction. Often with TMJ dysfunction, there is a feeling that the jaw clicks, clicks, or even “jams” for a moment. It is often impossible to determine the exact cause of this disorder.

What are the symptoms of TMJ dysfunction?
TMJ dysfunction disorders have many signs and symptoms. It is often difficult to accurately determine the presence of TMJ dysfunction, since one or more of its symptoms may be a manifestation of another disease. Your dentist can make an accurate diagnosis by reviewing your medical and dental records, performing a clinical examination, and taking the necessary x-rays.

The most common symptoms of TMJ dysfunction include:

• Headache (often migraine-like), pain in the ears, and pain and pressure behind the eyes.
• Clacking or clicking sound when you open or close your mouth.
• Pain when you yawn, open your mouth wide or chew
• If the jaws “stuck”, they do not open or “pop out”
• Jaw muscle weakness
• Suddenly the upper and lower jaws begin to close differently

How is TMJ dysfunction treated?
Although there is no single treatment for TMJ dysfunction, there are various treatments that can significantly reduce your symptoms. Your dentist will be able to recommend one or more of the following methods for you.

• Try to relieve muscle spasm and pain by applying hot compresses or taking medications such as muscle relaxants, aspirin or other over-the-counter pain relievers, or anti-inflammatory medications.
• Reduce the adverse effects of squeezing and grinding by wearing an apparatus sometimes referred to as a bite block or splint. Made to fit your mouth, this appliance covers your upper teeth and prevents them from rubbing against your lower teeth.
• Learn relaxation techniques to control jaw muscle tension. Your dentist may suggest that you go to a training session or a consultation where you can learn how to manage stress.

If the joints of the jaw are out of order and other treatments fail, a jaw joint surgery can be recommended.

This article is intended to increase knowledge and understanding of general oral health issues. The article does not replace the professional medical advice of a specialist, and cannot be used to make a decision on making a diagnosis and prescribing treatment. Always seek the advice of a dentist or other qualified professional for all questions regarding your health condition and treatment.

Temporomandibular joint dysfunction (TMJ)

The temporomandibular joint is a paired organ that connects the lower jaw to the base of the skull. As you know, the lower jaw is the only movable bone that is capable of performing complex movements of the jaw in space. The most simple and understandable movements are opening and closing the mouth (up / down). But, we also know how to move the jaw to the right to the left, back and forth and an infinite number of combinations, when the movements occur simultaneously in all directions of the three-dimensional coordinate system. The movement vector is set by four pairs of the main masticatory muscles: masteterial (right and left), temporal (right and left), medial pterygoid and lateral pterygoid muscles of the right and left sides. Thanks to them, we open and close our mouths, bite and chew food, swallow, make sounds when talking, play musical instruments, bite our nails, bite walnuts, open beer bottles, kiss and much more. The jaw joint provides the possibility of such movements, while maintaining a strong and stable connection between the lower jaw (M/N) and the fixed bones of the entire skull.

Anatomy of the jaw joint

Describing the detailed anatomy of a joint in the format of a popular presentation is not so easy. We will try to do this without going into details, but by addressing important defining questions.

The articular part of the lower jaw is called the condyle. The condyle articulates with the articular fossa. The surfaces of these formations are incongruent and the sliding of the condyle along the surface of the fossa would be impossible if it were not for the intraarticular disc, which is a cartilaginous lining. Its upper surface is adapted to the shape of the fossa, while the lower surface is adapted to the shape of the condyle. This property eliminates incongruity.

When opening the mouth, the condyle (pos. 4), and with it the entire lower jaw, performs two types of movement:

• translational movement from the fossa (pos.1) to the top of the hillock (pos.2)
• rotational movement (counterclockwise).

Simultaneously with the movement of the condyle, the articular disc also moves (pos. 3). And this is one of the easiest movements to describe. Many movements are much more complex and intricate.

In order for the joint to work in a normal mode, it is necessary to coordinate the work of all masticatory muscles, ligaments firmly attached to the condyle and the ligamentous apparatus holding the intraarticular disc.

What does TMJ dysfunction mean?

Any discoordination of the work of the elements of the joint is called dysfunction. The more pronounced violations of the interaction, the rougher the symptoms of arthritis or arthrosis coming in response to dysfunction.

The initial signs may be slight pain and appearing noises, clicks, crackling and crunching with various movements of the lower jaw.

As problems worsen, the abnormal sounds increase and the free and smooth movement of the mandible is disturbed. The opening of the mouth may occur unevenly, with a shift to the side or in a zigzag pattern. Pain can increase in intensity and capture or radiate to neighboring areas. Sometimes people report general headaches.

In difficult cases, mouth opening is drastically reduced and patients cannot chew food.

Causes of dysfunction of the jaw joint

The causes of joint dysfunction in the global sense are overloads. These may be short-term exposures or the result of chronic fatigue accumulated over a long period of time.

Short term stress is sometimes referred to as acute injury. For example, hit. As a result of injury, ruptures and sprains of the ligaments occur, after which some muscles will be in hypertonicity, and the ligamentous apparatus will be unable to hold the elements in the correct ratio in relation to each other.

Many patients suffer from bruxism, which is clearly a chronic injury to the TMJ. Hypertonicity of the masticatory muscles and keeping the jaws in the position of closed teeth leads to overloading of the joint elements, impaired blood circulation, and compression of the intraarticular disc.

Can teeth cause dysfunction? Yes, the condition of the teeth and the nature of the bite also affect the condition and functioning of the jaw joint. So the bruxism described by us in a few years will lead to pathological abrasion of the teeth. Reducing the height of the teeth will lead to a change in the intermaxillary distance (the height of the lower third of the face decreases), and this leads to an increase in the load on the articular surfaces.

Do braces and orthodontic treatment prevent jaw disease?

Braces can prevent TMJ problems (be preventive), it really is. So the task of orthodontic treatment is the formation of such a type of bite, when any movement in the joint will be protected by correct, functional occlusion. This means that with any chewing movements of the lower jaw, the teeth must be guiding and determining for the trajectory of the glide of the articular process. The joint is limited from complete freedom of movement, which prevents overloading of its structures.

Let’s take a simple example of the sagittal movements of the lower jaw. In the case of sliding the dentition back and forth (imitating the final part of biting off food), the movements of the joint will be synchronized with the sagittal incisal path of reference (the trajectory of contact of the lower incisors with the palatal surface of the upper incisors).

If the shape of the slope of the articular tubercle (on which the condyle and articular disc slide) and the palatal surface of the upper incisors (on which the lower incisors slide) are not synchronized, then either the joint will receive excessive loads or the teeth will collapse from excessive pressure.

Similarly, the joint must be protected from overload during lateral masticatory movements. Lateral displacements in the joint must also be protected: When moving to the right, the canines of the working side should provide the right canine path, while moving to the left, the left canine path works.

Braces cause joint problems

But in life there are so-called iatrogenic diseases, when the doctor or the treatment prescribed by him was the cause of the problems. Unfortunately, braces can cause joint dysfunction. In orthodontics, a pathological distal occlusion is often found, due to the underdevelopment of the lower jaw. These are cases in which the chin appears to be underdeveloped and the entire lower jaw appears small or disproportionately receding.

In such cases it is necessary to increase the size of the mandible. But this is a difficult path and orthodontists are looking for ways to get around the complexity. Many choose the pernicious way of stretching the jaw forward, for greater beauty and harmony of the face. For this, Herbst devices, “Forsus bite corrector”, functional devices with an inclined plane of the Twin-block type are used.

After using such techniques, the face really improves. But what happens to the joint? Normally, the articular head is in the middle of the articular fossa. But after such treatment, in quotation marks, the condylar process moves forward to the top of the tubercle. The new position is not functional, since the ratio of the elements of the joint is sharply disturbed: the ligaments are overstretched, the intraarticular disc is in an unstable position, unable to adapt the articular surfaces. Therefore, his movements are not systemic, not coordinated. If it shifts, slipping out from under the condyle, a click or crack occurs. This situation over time leads to the erasure of the articular disc, in severe cases to its perforation.

The general chain of pathological changes is changes in occlusion for the sake of dental signs of occlusion and improvement of facial proportions, resulting in severe joint damage.

The ideal orthodontic treatment is also ambiguous for the temporomandibular joint

Gnathology is not an easy discipline, but we agreed to consider the problems of the joint at a popular level that is understandable to the common man. Here is one of the facts of the structure of the dentoalveolar system.

The sagittal incisal path is synchronized with the movement of the condylar process along the slope of the articular tubercle. Therefore, the depth of the incisal overlap correlates with the height of the articular tubercle.

In the case of a small incisal overlap, the articular tubercle is gentle and low

In case of deep incisal overlap, the articular cusp is high and sheer.

It is this law of the structure of the dentoalveolar system that maintains the balance of forces, while maintaining the health of the joint and the integrity of the teeth. But how to be an orthodontist in each clinical case. After all, the final result of any treatment should be such that the depth of the incisal overlap is 2-3 mm.