What are the common causes of TMJ neck pain. How can TMJ neck pain be effectively treated. What strategies can help prevent TMJ neck pain. How does TMJ disorder affect the neck and surrounding areas. When should you seek medical attention for TMJ-related neck pain.

The Connection Between TMJ Disorders and Neck Pain

Temporomandibular joint and muscle disorders (TMD), commonly referred to as TMJ disorders, can cause significant discomfort not only in the jaw area but also in the neck. While many people associate TMJ issues primarily with jaw pain, it’s important to understand that up to 70% of individuals diagnosed with TMD report neck pain as a symptom. This connection between TMJ disorders and neck pain highlights the complex interplay between the jaw and cervical spine regions.

The temporomandibular joint (TMJ) is the connection point between the jawbone and the skull, located on both sides of the face. When this joint or the surrounding muscles experience dysfunction, it can lead to a range of symptoms, including pain that radiates to the neck area. This pain typically manifests as muscle tenderness and discomfort in the cervical spine region.

Identifying the Root Causes of TMJ-Related Neck Pain

Understanding the underlying causes of TMJ-related neck pain is crucial for effective treatment and prevention. Several factors can contribute to the development of TMJ disorders and associated neck pain:

• Teeth grinding (bruxism)
• Jaw clenching
• Misalignment of the jaw or teeth
• Arthritis in the TMJ
• Trauma or injury to the jaw or neck area
• Stress and tension
• Poor posture
• Excessive gum chewing

These factors can lead to muscle tension, inflammation, and misalignment in the jaw and neck regions, resulting in pain and discomfort that extends beyond the immediate jaw area.

Conservative Treatment Approaches for TMJ Neck Pain

When it comes to treating TMJ-related neck pain, medical professionals typically recommend starting with conservative, non-invasive approaches. These treatments aim to alleviate pain, reduce inflammation, and improve jaw and neck function without resorting to more aggressive interventions.

Self-Care Strategies

There are several self-care measures that individuals can implement to manage TMJ neck pain:

• Eating soft foods to reduce stress on the jaw
• Applying heat or cold packs to the affected areas
• Avoiding extreme jaw movements
• Practicing stress-reduction techniques
• Performing gentle jaw and neck stretching exercises
• Using over-the-counter pain relievers or NSAIDs

Professional Interventions

For more persistent or severe cases, healthcare providers may recommend additional treatments:

1. Physical therapy to improve jaw and neck mobility
2. Cognitive behavioral therapy to address stress and pain management
3. Biofeedback techniques
4. Prescription medications such as muscle relaxants or anti-anxiety drugs
5. Intraoral appliances (nightguards or splints)
6. Massage therapy for the neck and jaw muscles

Exploring Alternative Therapies for TMJ Neck Pain Relief

Some individuals may find relief from TMJ-related neck pain through alternative or complementary therapies. While the evidence supporting these treatments is limited, some people report benefits from:

• Acupuncture
• Transcutaneous electrical nerve stimulation (TENS)
• Chiropractic care
• Relaxation techniques such as meditation or yoga

Do alternative therapies effectively treat TMJ neck pain? While some individuals report positive outcomes, it’s important to note that scientific evidence supporting the efficacy of these treatments for TMJ disorders is limited. Patients should discuss these options with their healthcare provider and consider them as part of a comprehensive treatment plan rather than standalone solutions.

When to Consider More Aggressive Treatment Options

In cases where conservative treatments prove ineffective, healthcare providers may consider more aggressive interventions. However, it’s crucial to approach these options with caution, as they often involve permanent changes to the jaw or teeth.

Botox Injections

Botulinum toxin Type A (Botox) injections into the chewing muscles have been explored as a potential treatment for TMJ disorders. However, the evidence supporting its effectiveness is limited, and more research is needed to establish its long-term safety and efficacy.

Surgical Interventions

Surgery for TMJ disorders is generally considered a last resort due to its invasive nature and the potential for permanent changes to the jaw joint. Surgical options may be considered only when all other treatments have failed and the patient is experiencing severe, debilitating symptoms.

How effective is surgery for TMJ-related neck pain? While surgery can provide relief for some patients with severe TMJ disorders, it’s important to recognize that the outcomes can be unpredictable. The decision to undergo surgery should be made carefully, weighing the potential benefits against the risks and considering the limited evidence supporting its effectiveness.

Preventive Strategies to Minimize TMJ Neck Pain

Preventing TMJ-related neck pain involves addressing the underlying causes of TMJ disorders and adopting habits that promote jaw and neck health. Here are some effective preventive strategies:

• Wearing a mouthguard at night to prevent teeth grinding
• Practicing good posture to reduce strain on the neck and jaw
• Engaging in regular exercise and stretching routines
• Avoiding excessive gum chewing and nail biting
• Managing stress through relaxation techniques
• Maintaining proper dental hygiene and regular dental check-ups
• Using ergonomic pillows and mattresses to support proper neck alignment during sleep

Can lifestyle changes significantly reduce the risk of developing TMJ neck pain? Implementing these preventive strategies can indeed play a crucial role in reducing the likelihood of developing TMJ disorders and associated neck pain. By addressing potential risk factors and promoting overall jaw and neck health, individuals can minimize their chances of experiencing TMJ-related discomfort.

Recognizing the Full Spectrum of TMJ Disorder Symptoms

While neck pain is a common symptom of TMJ disorders, it’s important to be aware of the full range of potential symptoms associated with this condition. Recognizing these symptoms can lead to earlier diagnosis and more effective treatment:

• Pain or tenderness in the jaw joint
• Aching pain in and around the ear
• Difficulty or discomfort while chewing
• Facial pain
• Locking of the jaw joint
• Clicking or popping sounds when opening or closing the mouth
• Headaches
• Tinnitus (ringing in the ears)
• Dizziness
• Tooth sensitivity or pain

Is it possible to experience TMJ disorder without jaw pain? Indeed, some individuals with TMJ disorders may experience symptoms such as neck pain, headaches, or ear discomfort without significant jaw pain. This variability in symptoms highlights the importance of comprehensive evaluation by healthcare professionals when diagnosing TMJ disorders.

The Importance of Proper Diagnosis and Individualized Treatment

Diagnosing TMJ disorders can be challenging due to the wide range of potential symptoms and the lack of a standardized diagnostic test. Healthcare providers typically rely on a combination of patient history, physical examination, and imaging studies to make a diagnosis.

The Diagnostic Process

A thorough diagnostic evaluation for TMJ disorders may include:

• Detailed medical and dental history
• Physical examination of the jaw, neck, and face
• Evaluation of jaw movement and bite alignment
• Imaging studies such as X-rays, CT scans, or MRI
• Assessment of associated symptoms like headaches or ear pain

Tailoring Treatment to Individual Needs

Given the complex nature of TMJ disorders and the variability in symptoms among patients, treatment approaches should be tailored to each individual’s specific needs. This personalized approach may involve a combination of therapies and lifestyle modifications to address the underlying causes and alleviate symptoms effectively.

Why is a multidisciplinary approach beneficial for treating TMJ-related neck pain? A multidisciplinary approach involving dentists, physical therapists, pain specialists, and other healthcare professionals can provide comprehensive care that addresses all aspects of TMJ disorders. This collaborative effort ensures that patients receive well-rounded treatment that targets both the jaw issues and associated neck pain.

When to Seek Immediate Medical Attention

While many cases of TMJ-related neck pain can be managed with conservative treatments, there are certain situations where immediate medical attention is necessary. It’s crucial to be aware of these “red flag” symptoms that may indicate a more serious underlying condition:

• Sudden inability to open or close the mouth
• Severe, persistent pain that doesn’t respond to over-the-counter pain relievers
• Significant swelling in the jaw or neck area
• Sudden changes in bite alignment
• Fever accompanying jaw or neck pain
• Trauma to the jaw or face
• Unexplained weight loss
• Neurological symptoms such as numbness or weakness

Should you wait to seek medical attention if TMJ neck pain persists? It’s advisable to consult a healthcare provider if TMJ-related neck pain persists for more than a few weeks despite home care measures. Early intervention can prevent the condition from worsening and improve the chances of successful treatment.

The Role of Ongoing Research in TMJ Disorder Management

As our understanding of TMJ disorders continues to evolve, ongoing research plays a crucial role in developing more effective diagnostic tools and treatment strategies. Current areas of research focus include:

• Genetic factors contributing to TMJ disorders
• Advanced imaging techniques for more accurate diagnosis
• Novel pharmacological treatments
• Regenerative medicine approaches for TMJ repair
• Improved surgical techniques with less invasive options
• The relationship between TMJ disorders and other chronic pain conditions

How might future research impact the treatment of TMJ-related neck pain? Advances in research may lead to more targeted and effective treatments for TMJ disorders and associated neck pain. This could include personalized treatment plans based on genetic profiles, innovative non-invasive therapies, and improved understanding of the complex interplay between the jaw, neck, and overall musculoskeletal system.

In conclusion, TMJ-related neck pain is a complex condition that requires a comprehensive approach to diagnosis, treatment, and prevention. By understanding the causes, recognizing symptoms, and implementing appropriate interventions, individuals can effectively manage their pain and improve their quality of life. As research continues to advance our understanding of TMJ disorders, we can look forward to even more effective and personalized treatment options in the future.

TMJ neck pain: Causes, treatment, and prevention

Many people with temporomandibular joint and muscle disorders report pain in the jaw, but it can also cause a person to experience neck pain.

Temporomandibular joint and muscle disorders (TMD) is the term for several conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement. People may also call them TMJ disorders.

TMJ is short for temporomandibular joint. This is the name for the two joints on either side of the jaw.

This article looks at whether pain associated with TMJ disorders can affect the neck. It also discusses how to treat the pain and how to prevent it.

TMJ disorders can cause a person to experience pain that affects the face, jaw, or neck. Up to 70% of people diagnosed with a TMD report neck pain as a symptom.

People will typically experience muscle tenderness and muscle pain in the cervical spine area. The cervical spine is the neck region of the spine.

Doctors usually recommend more conservative treatments.

According to the National Institute of Dental and Craniofacial Research (NIDCR), these include:

• eating soft foods
• applying heat or cold to the painful site
• avoiding extreme jaw movements
• avoiding nail biting, using chewing gum, or clenching the jaw
• learning and practicing jaw stretching and relaxing exercises
• using over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
• participating in behavioral therapies such as cognitive behavioral therapy or biofeedback
• massaging the neck muscles

According to MouthHealthy, doctors may recommend medications, including anti-anxiety medications, muscle relaxants, or antidepressants.

A person can also try complementary treatments, such as acupuncture or transcutaneous electrical nerve stimulation (TENs). However, there appears to be limited evidence to suggest that these can help TMDs.

If these treatments are not effective, a doctor may recommend other forms of treatment.

Intraoral appliances

Intraoral appliances are devices that a person places directly inside the mouth. Other names include nightguards, splints, or stabilization appliances.

The NIDCR notes that evidence suggesting that there is limited evidence to suggest these are effective at treating TMD pain.

If a doctor recommends that someone use one of these, people should ensure that it is not designed to change their bite permanently.

People should also stop using them and consult a dentist or doctor if pain develops.

Botox

Botox involves injecting botulinum toxin Type A into the muscles needed for chewing. However, there is limited evidence to suggest the efficacy of Botox as a treatment for TMD.

Surgery

Experts suggest that people should avoid treatments involving surgery or that make permanent changes to the jaw or teeth, as there is not enough supporting evidence to suggest that these treatments work.

If conservative treatments have not worked, surgery may be an option for some people. This surgery permanently changes a person’s joints. This is why doctors do not recommend it often.

The way to prevent TMJ neck pain is by aiming to prevent TMJ disorders in general.

A person may wish to:

• wear a mouthguard at night to prevent teeth grinding
• regularly exercise and stretch to help strengthen muscles in the neck and jaw area
• maintain good posture
• have regular physical therapy
• avoid clenching the jaw
• try to stop nail biting
• avoid chewing gum

Other symptoms that a person may experience alongside neck pain include:

• pain in the jaw joint
• pain in the muscles responsible for chewing
• pain in other areas of the face
• hearing loss
• dizziness
• ringing in the ears
• ear pain
• misalignment of the teeth
• clicking, grating, or popping causing pain when opening or closing the mouth
• limited jaw movement or locking
• grinding of teeth

Some people may experience all the above symptoms, whereas others may only experience some.

There is currently no standard test to diagnose a TMJ disorder. Therefore, it can be difficult to receive a diagnosis. However, people should speak with a doctor if they have pain that does not resolve using home remedies and treatments.

Doctors may refer people to a physical therapist who can design a bespoke exercise plan for them to follow to improve the flexibility and strength of the jaw.

People should contact a doctor if they have experienced trauma to their jaw or surrounding areas that seem to have caused the pain.

Additionally, if any of the following symptoms occur, people should consider these ‘red flags’ according to a 2018 article:

• inability to open the mouth
• persistent pain
• worsening pain
• tinnitus
• difficulty balancing
• asymmetrical swelling of the jaw or neck
• hearing loss
• weight loss

Some people with TMDs find that their symptoms resolve without treatment.

If a person needs treatment, experts usually recommend that this treatment be conservative and reversible. This helps resolve TMDs in most people.

Neck pain is a common symptom of TMDs and can often cause people a lot of discomfort.

Lifestyle changes and conservative treatment is usually enough to remedy this pain.

In more severe cases, doctors may recommend surgery, but it is important to remember that this is not reversible and can sometimes be ineffective or even worsen the problem.

Do You Have TMJ? 8 Symptoms Not to Ignore

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Temporomandibular joint disease, or TMJ, is a complex condition that often worsens over time. Typically caused by the misalignment of the teeth, TMJ can erode the joint capsule between the skull and the jawbone. It is tricky to diagnose, and some people suffer for years. Once it is properly recognized, though, TMJ responds well to treatment. Here are 8 symptoms you should never ignore.

Not everyone experiences TMJ in the same way, but a clicking or popping sound in the jaw is an extremely common symptom. If this is your only symptom, you might not need treatment, but it is important to make your dentist aware right away.

2. Pain with Jaw Movement

When the teeth are not properly aligned, the jaw muscles try to compensate. Pain in the jaw or ear while chewing is common. Some people also experience pain when yawning or speaking.

3. Other Pain

TMJ can cause referred pain in the form of headaches, neck pain, shoulder aches, and even toothaches. The pain may worsen when moving the jaw, but it can sometimes be felt even at rest.

4. Locking Jaw

A lockup in the jaw can be a sign of TMJ. You might have difficulty opening your mouth wide or closing it again. When you do get it to move, your jaw will likely pop into place with a loud click.

5. Tired Facial Muscles

The muscles of your face may work hard to compensate for TMJ. If your face feels tired or saggy on one side, let your dentist know. Some people have persistent discomfort, while others experience it only after using the jaw.

6. Trouble Chewing

Since the jaw is out of alignment, many people with TMJ have trouble chewing. Your muscles will try to compensate, but this may be impossible if the misalignment is severe. You might feel like your teeth aren’t closing properly, and you might have extreme difficulty with foods that are crunchy or chewy. Check your bite in the mirror to ensure that your top and bottom teeth meet evenly without any straining or stretching.

7. Facial Swelling

It is relatively uncommon, but some people with TMJ have swelling on one side of the face, likely due to damage and inflammation in the joint capsule. The swelling may be mild or severe, and it might appear only after using the jaw or persist even at rest.

8. Nonspecific Symptoms

TMJ is challenging to diagnose because it can cause many different nonspecific symptoms. These may include, but are not limited to, dizziness, hearing difficulties, and ringing in the ears. Log any unusual symptoms you experience to discuss with your dentist at your next appointment.

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Dysfunction of the temporomandibular joint (TMJ): symptoms, causes and treatment

Dysfunction (dysfunction) of the temporomandibular joint (TMJ) is one of the most common joint pathologies ^[1] , often found in dental practice. According to some data, about 80% of dental patients have temporomandibular joint dysfunction syndrome ^[1]

The main symptoms of TMJ dysfunction

Diagnosis of TMJ dysfunction is difficult, since the disorder manifests itself in the form of multiple and varied symptoms ^[2] . There are frequent cases when they spontaneously (spontaneously) arise and disappear ^[1] .

One of the most striking symptoms of the disorder is pain. At the same time, they can be so intense and sharp that the patient loses the ability to normally chew and swallow food, speak, and open his mouth. Pain may be the only symptom of the disorder, or it may be accompanied by characteristic clicks in the joint and limited mobility of the lower jaw. It is not uncommon for dysfunction to manifest itself only with sound phenomena, while other symptoms are absent ^[2]

Pain in TMJ dysfunction is localized not only in the articulation itself, but in the area of ​​masticatory muscles ^[4] . In addition, pain and discomfort can manifest itself in the forehead and eyes, ears, temples, head in general, spread (radiate) to the neck, shoulders and back ^[4] .

Other most common symptoms include ^[4]

• tinnitus;

• feeling of pressure on the eyes and sensitivity to light;

• dizziness, nausea, lack of concentration;

• clicks and other sounds during jaw movement;

• swelling in the facial area (mainly in the area of ​​the joint).

The discomfort associated with TMJ dysfunction can be severe enough to significantly reduce a patient’s quality of life ^[4] .

Causes of TMJ dysfunction

There are many causes behind TMJ dysfunction. Among them ^{[1, 2]}

• disorders of the psycho-emotional state of patients;

• head (maxillofacial region) and neck injuries;

• dentition defects with impaired closure and chewing function;

• fillings and dentures in the oral cavity;

• pathological abrasion of hard dental tissues;

• dental anomalies;

• periodontal diseases;

• bad habits and others.

As a rule, these factors act in a complex manner and increase the negative influence of each other, leading to the development of TMJ diseases.

The mechanism of the development of disorders, according to experts, is quite complex. If the lower jaw is symmetrical, the muscles of the head do not experience any tension. But if for some reason there are problems with the bite, the function of the chewing muscles is disrupted. In response to this, the spatial position of the lower jaw also changes. To hold it, the muscles of the head, neck, torso and even the lower extremities are additionally strained ^[2]

For several months, and in some cases even years, the patient may not notice muscle tension. But if additional negative facts arise (stress, bruxism ), TMJ dysfunction develops ^[2] .

Arthritis and arthrosis of the temporomandibular joint

TMJ dysfunction leads to such dangerous pathologies as chronic arthritis, and then arthrosis of the joint ^[1] .

Arthritis of the TMJ is an inflammatory disease. Negative factors that can provoke its development are hypothermia, hormonal changes, and pathologies of the nervous system. Acute arthritis may be preceded by exacerbation of sinusitis, tonsillitis or otitis media ^[6] .

Symptoms of TMJ arthritis: joint pain that may radiate to different areas of the face. At the same time, pain is less intense at rest. In acute arthritis, there may be swelling in the joint area, the jaw is shifted to the affected side. The patient complains of general malaise, weakness, he may have an increased body temperature.

Arthrosis of the TMJ develops due to excessive stress on the joint. As a rule, this disease is accompanied by an irreversible change in the tissues of the joint, first cartilage, and then bone. Arthrosis often develops as a complication of arthritis of the temporomandibular joint. A characteristic symptom is a feeling of stiffness, pain in the jaw area after sleep and towards the end of the day ^[6] .

Arthritis and arthrosis of the temporomandibular joint can occur with complications and require complex, often surgical treatment. And in the absence of therapy, they can lead to serious conditions of the patient, limitation of his activity ^[7] and even disability ^[4] .

Treatment of TMJ dysfunction

TMJ dysfunction requires complex and long-term treatment, rehabilitation and subsequent prevention of recurrence of the disorder ^[4] .

Treatment of patients with TMJ dysfunction is a very complex and multifaceted problem. There cannot be a single and simple treatment regimen here, since the same correct diagnosis requires the doctor to influence various adverse factors that caused and continue to maintain the TMJ pain dysfunction syndrome in each patient -mandibular joint, Ph.D. Shemonaev V. I.

As a rule, the treatment of TMJ includes several directions ^{[4, 6]} .

1. Dental therapy. First of all, they carry out sanitation of the oral cavity (treatment of caries, pulpitis). In addition, if necessary, eliminate foci of infection in the oral cavity, tonsils, maxillary sinuses.

2. Orthopedic therapy. In order to normalize the bite, prosthetics are performed, grinding of irregularities in fillings.

3. Medical therapy. It is aimed at reducing chronic and acute pain with the help of a variety of pain medications and alleviating the patient’s condition. In addition, anti-inflammatory therapy is also carried out.

4. Physiotherapy. Includes electrical stimulation, ultrasound and magnetotherapy, phototherapy, compresses, massage. They help to relax muscles and eliminate spasms.

5. Therapeutic gymnastics. It should include exercises both for the chewing muscles and for developing a healthy posture and the habit of correct movements (the so-called motor stereotype).

6. Psychotherapy. Includes a variety of methods and tools aimed at reducing the overall stress of the patient (including conversations with a psychotherapist, auto-training, sleep restoration).

7. Other means. Used according to the specific symptoms of TMJ dysfunction and other diseases or conditions of the patient. For example, in case of manifestations of bruxism, special protective caps or splints are used to help eliminate involuntary grinding of the teeth and prevent abrasion of their surface.

Treatment of arthritis and arthrosis of the TMJ, in addition to general therapeutic measures, necessarily includes unloading the joints, for which they are trying to immobilize ^[6] . If the inflammation is purulent, the necessary surgical intervention (puncture) is performed. Also, surgical treatment is performed in complex cases of arthrosis, when the temporomandibular joint is subjected to significant deformation ^[6] .

List of sources

1. Vyazmin A. Ya., Podkorytov Yu. M., Klyushnikov OV Temporomandibular joint dysfunction and its treatment // Innovation Science. 2015. No. 1-2. URL: https://cyberleninka.ru/article/n/disfunktsiya-visochno-nizhnechelyustnogo-sustava-i-ego-lechenie (date of access: 20.02.2020).

2. Besschastny DS, Vyazmin A. Ya., Klyushnikov OV, Podkorytov Yu. M. Pathogenesis of temporomandibular joint dysfunction // Acta Biomedica Scientifica. 2010. No. 5. URL: https://cyberleninka.ru/article/n/patogenez-disfunktsii-visochno-nizhnechelyustnogo-sustava (date of access: 03/06/2020).

3. Shemonaev V. I., Mikhalchenko D. V., Kuznetsova O. A., Klimova T. N., Poroshin A. V. Dental rehabilitation of patients with combined pathology of occlusion and dysfunction of the temporomandibular joint // Volgograd Medical Scientific Research magazine. 2013. No. 2 (38). URL: https://cyberleninka.ru/article/n/stomatologicheskaya-reabilitatsiya-patsientov-s-sochetannoy-patologiey-okklyuzii-i-disfunktsiey-visochno-nizhnechelyustnogo-sustava (date of access: 03/06/2020).

4. Silant’eva EN Multidisciplinary approach to the diagnosis and treatment of craniomandibular dysfunction of the temporomandibular joint [Electronic resource] / EN Silant’eva // Topical issues of medical prevention, diagnosis and treatment of dental diseases: Sat. Art. intl. scientific-practical. Conf., Minsk, May 17, 2019 / Belorus. state honey. un-t, 2nd department. therapist. dentistry; under total ed. T. N. Manak, L. G. Borisenko, L. N. Polyanskoy. – Minsk, 2019. http://rep.bsmu.by/bitstream/handle/BSMU/23943/170_178.pdf?sequence=1&isAllowed=y (accessed 03/06/2020).

5. Yakupov BR, Gerasimova LP Diagnosis and treatment of muscular-articular dysfunction of the temporomandibular joint with pain syndrome // Medical Bulletin of Bashkortostan. 2013. No. 1. URL: https://cyberleninka.ru/article/n/diagnostika-i-lechenie-myshechno-sustavnoy-disfunktsii-visochno-nizhnechelyustnogo-sustava-s-bolevym-sindromom (date of access: 03/06/2020).

6. Artyushkevich AS Diseases of the temporomandibular joint // Modern Dentistry. 2014. No. 1 (58). URL: https://cyberleninka.ru/article/n/zabolevaniya-visochno-nizhnechelyustnogo-sustava-1 (date of access: 03/06/2020).

7. Tarasov IV, Nikitin AA et al. Conservative treatment of arthrosis of the temporomandibular joint // Bulletin of Modern Clinical Medicine. 2016. No. 4. URL: https://cyberleninka.ru/article/n/konservativnoe-lechenie-artroza-visochno-nizhnechelyustnogo-sustava (date of access: 20.02.2020).

Treatment of TMJ (joint dysfunction)

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TMJ dysfunction is a fairly common pathology today, since it is largely caused by stress factors. Here it can be difficult to understand what is primary, what is secondary, because people with joint dysfunction come, as a rule, with bite pathology, pathology of the musculoskeletal system (curvature of the spine, neck). Therefore, joint treatment is a complex story. It happens that the primary pathology is the pathology of the joint, it happens that the musculoskeletal system.

Causes of TMJ dysfunction

The orthodontist should find out what was primary – bite, misalignment of the teeth or the absence of some teeth, possibly not very successful orthodontic treatment in history, early treatment when they were children or adolescents and subsequent treatment could serve reason. It is important to correctly diagnose.

Comprehensive TMJ treatment

When the doctor has determined the cause of the joint pathology, or causes, he determines the patient’s readiness for a comprehensive treatment plan. In addition to the orthodontist, an osteopath or a chiropractor, or even an orthopedist, can be involved if a more complex correction of the musculoskeletal system is needed.

The patient should be aware that it is possible to align the jaw with a splint or splint, but not solve the problem of malocclusion. Orthodontic treatment is required to correct the bite. If you have already had orthodontic treatment before, then it is more difficult to decide on a second treatment.

Therefore, first the problem with the joint is solved by means of a splint or joint splint, then the bite is corrected, and, if necessary, prosthetics. In parallel, work is underway with an osteopath to restore the muscular corset of the back and neck.

It happens that a patient refuses treatment with braces after solving a problem with a joint. In this case, we warn him about the need to wear an articular splint constantly in order to avoid the appearance of old problems with the TMJ. After all, a relapse can happen against a background of stress quite quickly.

What are the symptoms of TMJ dysfunction?

• Soreness or pain in one or both TMJs at rest or when opening the mouth.

• Crackling, clicking, crepitus and other noises in the area of ​​one or both TMJs when opening the mouth.

• History of TMJ injuries (previously), incl. dislocation, subluxation, chronic subluxation.

• Restrictions in the mobility of the TMJ, restriction in opening the mouth.

• Excessive masticatory muscle tone, bruxism (“grinding” of teeth during sleep, at rest).

• Asymmetry of chin, lips, frenulum of lips, asymmetry of mouth opening, S-shaped opening.

• Suspicion of the presence of a forced position of the lower jaw.>

One or more of the above symptoms may indicate TMJ dysfunction.

Conventional orthodontic treatment does not address TMJ dysfunction. In the process of orthodontic treatment, the severity of dysfunction may not change, decrease or increase. At the moment, in the world scientific orthodontic literature there is no convincing data on the relationship between orthodontic treatment and the state of the TMJ. Deterioration of the joint after treatment may not be related to this treatment.

Please note! Even in the absence of visible clinical manifestations of joint dysfunction, there may be hidden disorders that require special diagnostics to identify them.

If there is a forced incorrect position of the lower jaw, its position may change during treatment with a change and complication of the treatment plan (the need to extract individual teeth, an increase in the duration of treatment). A reliably forced position cannot be diagnosed by traditional orthodontic methods; to check its presence, as a rule, a special analysis is required (manual functional analysis, determination of the central ratio of the jaws), the use of a special articular splint for a period of several months, which, however, does not give 100 % guarantees.

For a detailed joint diagnosis, clarification of the specifics of your case, further production of an articular splint, you can make an appointment with a dentist-orthodontist who deals with the issue of TMJ dysfunction.

TMJ dysfunction is a chronic condition that can be managed but not cured (i.e. it is possible to eliminate the symptoms, however, the pathological changes in the joints, if they have already occurred, are likely to persist).

What happens if TMJ dysfunction is not treated?

If the dysfunction is not treated, the body’s compensatory capabilities may be exhausted sooner or later, the symptoms will worsen, the pathology will begin to progress, causing more discomfort (sometimes for several years), thereby affecting the deterioration of the function of the dentition.

In order to try to prevent this and treat the individual temporomandibular joint structure and function, patients are usually offered the following approach.

Structure of the TMJ

Method of treatment of TMJ dysfunction

1. Diagnosis of TMJ dysfunction.

• During the diagnosis of the joint in the clinic, a number of measurements and tests are carried out, all sensations in the joint area are recorded (discomfort, clicks, pain, jaw deviation when opening and closing), the difference in sensations in the right and left joints.

• The orthodontist also takes casts of the jaws and takes photographs of the face and intraoral photographs, as well as a three-dimensional computed tomography of the face (3D CT), if necessary, the doctor can give a referral for an additional study – magnetic resonance imaging of the TMJ (MRI).

• Often, an orthodontist, in addition to manual functional analysis, conducts a visual assessment: posture, symmetry of the shoulder girdle, shoulder blades, hip bone structures, etc., performs the necessary tests, photographs. According to the results, it is possible to appoint an appointment for a consultation with an osteopath or a chiropractor for joint management of the patient. Allied specialists (orthopedist, surgeon, periodontist) can also be involved in the preparation of the treatment plan.

What exercises are prescribed to patients to normalize the work and relax the masticatory muscles?

Exercise No. 1

Draw a vertical line on the mirror with a marker, stand opposite, so that the line divides the face into right and left halves, place your fingers on the area of ​​the articular heads, lift your tongue up and back, open and close your mouth along the line (maybe it will not work right away), 2-3 times / day for 30 repetitions. You do not need to open your mouth wide (comfortable width), the main thing is symmetrically (so that the jaw does not “move out” in any direction). If there is a click, open until it clicks.

Exercise No. 2 (cycle)

Do it whenever possible, for example, in front of the TV, at the computer, in a traffic jam while driving. Open – close your mouth without closing your teeth for 30 seconds, then reach your tongue alternately to the right, then to the left cheeks for 30 seconds. Open again – close your mouth, then for 30 seconds move your tongue in a circle inside the vestibule (behind the lips), first in one direction, then in the other direction (clockwise – counterclockwise), open again – close your mouth, etc. During this half-hour cycle, the teeth should not touch, the lips should be closed. If you want to close your mouth or take a sip, put your tongue between your teeth. Repeat the cycle for 20-30 minutes 2-3 times/day

2. Occlusal therapy for TMJ dysfunction

After the diagnosis, the patient is booked to the orthodontist for an appointment to determine the central ratio of the jaws (“true” position of the lower jaw, the position in which your joint and masticatory muscles will be most comfortable).

In order to more accurately establish and fix this position, an occlusal splint (splint) will be individually made for the patient from a special plastic that is erased as it is worn. The tire must be worn constantly (sleep, talk, eat in it if possible) – this is the meaning of occlusive therapy, which will help the joint and masticatory muscles to reorganize into the most comfortable functional state.

Cleaning and care of the splint is very simple – after eating (as well as while brushing your teeth) clean with a soft brush and toothpaste or soap.

3. Installation of a bracket system for a patient with TMJ dysfunction

Installation of a bracket system on the upper jaw is carried out after an average of 3 months of occlusive therapy. The splint is adjusted once every 1-2 weeks, or at the discretion of the doctor, until the main complaints from the TMJ are eliminated (in parallel with the alignment of the teeth in the upper jaw), then the bracket system is installed on the lower jaw with a partial reduction (grinding) of the interfering parts of the occlusal tires, or complete removal. Here the patient needs to be patient – the process can take several months.

At the same time, the new position of the lower jaw is monitored: repeated manual functional analysis, photometry, bite registration is possible, computed tomography of the face during treatment, continuation of orthodontic treatment on a bracket system.

Upon completion of orthodontic treatment, the final control of the position of the lower jaw follows (manual functional analysis, photometry, bite registration, 3D CT of the face upon completion (after) treatment).

Splint

Joint splint with braces

TMJ dysfunction treatment result

The treatment results in a satisfactory aesthetic result, full occlusion with multiple even fissure-tubercle contacts and elimination or reduction of TMJ dysfunction. Mandatory, if indicated, is a full-fledged rational prosthetics or functional and aesthetic restoration of teeth, as the final stage of treatment – at this stage, a detailed consultation of an orthopedic dentist is necessary.

Treatment and diagnosis of TMJ dysfunction in the Confidence Clinic

Orthodontists with education in the field of maxillofacial surgery work in the Confidence Clinic. They own modern diagnostic methods, and the clinic is equipped with modern diagnostic equipment. The treatment uses an integrated approach, including the recommendation of exercises, wearing an articular splint, and installing braces. For the full restoration of the health of the joint and oral cavity, depending on the case, implantologists, orthopedists, and periodontists are involved.