What are the main causes of TMJ disorders. How can TMJ spasms be effectively treated. What are the symptoms of temporomandibular joint dysfunction. How does TMJ affect daily life and quality of sleep. What are the latest advancements in TMJ disorder management.

The Anatomy and Function of the Temporomandibular Joint

The temporomandibular joint (TMJ) is a complex structure that plays a crucial role in our daily lives. Located on both sides of the head, it connects the jawbone to the skull and facilitates essential movements such as chewing, speaking, and yawning. Understanding the anatomy of this joint is key to comprehending TMJ disorders and their impact on our well-being.

The TMJ consists of several components:

• The mandibular condyle: The rounded end of the lower jawbone
• The articular disc: A cushioning pad between the bones
• The temporal bone: The skull’s portion that forms the joint’s socket
• Ligaments: Connective tissues that stabilize the joint
• Muscles: Responsible for jaw movement and positioning

When functioning properly, these elements work in harmony to allow smooth and pain-free jaw movement. However, when issues arise within this delicate system, TMJ disorders can develop, leading to discomfort and reduced quality of life.

Common Causes and Risk Factors of TMJ Disorders

TMJ disorders can stem from various factors, often involving a combination of physiological, environmental, and lifestyle elements. Identifying these causes is crucial for effective treatment and prevention.

Physiological Factors

Certain physical conditions can predispose individuals to TMJ disorders:

• Misalignment of teeth or jaw (malocclusion)
• Arthritis affecting the TMJ
• Connective tissue disorders
• Hormonal imbalances

Environmental and Lifestyle Factors

Our daily habits and environment can significantly impact TMJ health:

• Chronic stress leading to jaw clenching
• Habitual gum chewing
• Poor posture, especially while working at a desk
• Trauma to the jaw area
• Teeth grinding (bruxism), often occurring during sleep

Are certain professions more prone to TMJ disorders? Studies suggest that individuals in high-stress occupations or those requiring prolonged periods of concentration may be at higher risk due to increased likelihood of jaw clenching and teeth grinding.

Recognizing the Symptoms of TMJ Spasms and Disorders

Identifying TMJ disorders early can lead to more effective treatment and prevention of long-term complications. The symptoms of TMJ disorders can vary widely among individuals but often include:

• Pain or tenderness in the jaw area
• Aching pain around the ear
• Difficulty or discomfort while chewing
• Facial pain
• Clicking or popping sounds when opening or closing the mouth
• Locking of the jaw joint, making it difficult to open or close the mouth
• Headaches, particularly in the temple area
• Neck pain and stiffness
• Tinnitus (ringing in the ears)
• Dizziness

Can TMJ disorders cause referred pain in other parts of the body? Indeed, TMJ issues can lead to pain in seemingly unrelated areas such as the shoulders, back, and even fingertips due to the complex network of nerves connected to the jaw region.

Diagnostic Approaches for TMJ Disorders

Accurate diagnosis of TMJ disorders is essential for developing an effective treatment plan. Healthcare professionals employ various diagnostic tools and techniques to assess the condition of the temporomandibular joint and surrounding structures.

Clinical Examination

A thorough clinical examination typically includes:

• Palpation of the jaw and surrounding muscles
• Assessment of jaw movement and range of motion
• Listening for joint sounds during movement
• Evaluation of dental occlusion (bite)

Imaging Techniques

Advanced imaging can provide detailed insights into the joint’s structure:

• X-rays: To visualize bony structures and detect arthritis
• CT scans: For detailed bone imaging
• MRI: To assess soft tissues, including the articular disc
• Arthrography: Contrast-enhanced imaging to evaluate joint function

How does computerized imaging enhance TMJ disorder diagnosis? Computerized imaging techniques allow for 3D visualization of the joint, enabling clinicians to detect subtle abnormalities and plan treatments with greater precision.

Conservative Treatment Options for TMJ Spasms

Initial treatment for TMJ disorders often focuses on conservative, non-invasive approaches aimed at relieving pain and restoring normal jaw function.

Self-Care Measures

Patients can often find relief through simple self-care strategies:

• Applying hot or cold packs to the affected area
• Practicing gentle jaw stretching exercises
• Avoiding hard or chewy foods
• Maintaining good posture
• Stress reduction techniques such as meditation or yoga

Medications

Various medications can help manage TMJ symptoms:

• Over-the-counter pain relievers (e.g., ibuprofen, naproxen)
• Muscle relaxants for severe spasms
• Tricyclic antidepressants for chronic pain
• Corticosteroid injections for inflammation

Physical Therapy

Physical therapy can be highly effective in treating TMJ disorders:

• Ultrasound therapy to reduce inflammation
• Exercises to strengthen jaw muscles
• Manual therapy techniques to improve joint mobility
• Posture correction exercises

What role does biofeedback play in TMJ disorder management? Biofeedback techniques can help patients become more aware of jaw muscle tension, enabling them to consciously relax these muscles and reduce symptoms.

Advanced Interventions for Persistent TMJ Issues

When conservative treatments prove insufficient, more advanced interventions may be necessary to address TMJ disorders effectively.

Dental Approaches

Dental interventions can help correct underlying issues:

• Occlusal splints or night guards to prevent teeth grinding
• Dental restorations to improve bite alignment
• Orthodontic treatment to correct malocclusion

Minimally Invasive Procedures

Less invasive surgical options include:

• Arthrocentesis: Joint fluid aspiration and lavage
• Arthroscopy: Minimally invasive joint surgery
• Botox injections to relax overactive jaw muscles

Open Joint Surgery

In severe cases, open joint surgery may be considered:

• Arthroplasty: Reshaping of joint surfaces
• Total joint replacement for severe degenerative conditions
• Discectomy: Removal of a damaged articular disc

How has the success rate of TMJ surgeries improved in recent years? Advancements in surgical techniques, including the use of computer-assisted navigation and 3D-printed implants, have significantly improved the outcomes of TMJ surgeries, reducing complications and enhancing long-term results.

Lifestyle Modifications and Prevention Strategies

Preventing TMJ disorders and managing existing conditions often requires long-term lifestyle adjustments. Implementing these changes can significantly reduce the risk of developing TMJ issues or experiencing recurrent symptoms.

Stress Management

Effective stress reduction techniques include:

• Regular exercise and physical activity
• Mindfulness and meditation practices
• Adequate sleep and rest
• Time management and prioritization skills

Ergonomic Considerations

Improving workplace ergonomics can help prevent TMJ issues:

• Proper positioning of computer screens to avoid neck strain
• Use of ergonomic chairs and desks
• Regular breaks to avoid prolonged static postures
• Proper lighting to reduce eye strain and associated muscle tension

Dietary Adjustments

Modifying eating habits can support TMJ health:

• Avoiding excessively hard or chewy foods
• Cutting food into smaller pieces
• Limiting caffeine intake to reduce muscle tension
• Ensuring adequate hydration for joint lubrication

How can individuals with TMJ disorders maintain a balanced diet while managing their symptoms? Focusing on softer, nutrient-dense foods and using food processors or blenders to modify food textures can help maintain proper nutrition without exacerbating TMJ symptoms.

The Impact of TMJ Disorders on Quality of Life

TMJ disorders can significantly affect various aspects of an individual’s life, extending beyond physical discomfort to impact emotional well-being and social interactions.

Physical Limitations

TMJ disorders can lead to:

• Difficulty eating and enjoying meals
• Challenges in verbal communication
• Reduced participation in physical activities
• Sleep disturbances due to pain or discomfort

Emotional and Psychological Effects

The chronic nature of TMJ disorders can result in:

• Increased stress and anxiety
• Depression and mood changes
• Reduced self-esteem, particularly if facial appearance is affected
• Frustration with ongoing pain management

Social and Professional Impacts

TMJ disorders may affect:

• Social interactions and relationships
• Work performance and productivity
• Ability to engage in leisure activities
• Overall quality of life and life satisfaction

How can healthcare providers better address the multifaceted impact of TMJ disorders on patients’ lives? A holistic approach that combines physical treatment with psychological support and lifestyle counseling can help patients manage both the symptoms and the broader life impacts of TMJ disorders more effectively.

Future Directions in TMJ Disorder Research and Treatment

The field of TMJ disorder management is continually evolving, with ongoing research and technological advancements promising improved diagnostic and treatment options for patients.

Emerging Diagnostic Technologies

Cutting-edge diagnostic tools under development include:

• Advanced imaging techniques with higher resolution and lower radiation exposure
• Biomarker analysis for early detection of joint degeneration
• Artificial intelligence-assisted diagnosis for more accurate and efficient assessments

Innovative Treatment Approaches

Promising new treatments on the horizon include:

• Regenerative medicine techniques using stem cells or growth factors
• Personalized 3D-printed joint replacements
• Novel pharmacological agents targeting specific pain pathways
• Virtual reality-based rehabilitation programs

Interdisciplinary Collaborations

Future advancements may arise from increased collaboration between:

• Dentists and oral surgeons
• Pain management specialists
• Physical therapists and occupational therapists
• Psychologists and mental health professionals
• Biomedical engineers and material scientists

What role will personalized medicine play in the future of TMJ disorder treatment? As our understanding of genetic and environmental factors in TMJ disorders grows, treatments may become increasingly tailored to individual patients, considering their unique genetic profiles, lifestyle factors, and specific symptoms to optimize outcomes.

The field of TMJ disorder management continues to evolve, offering hope for improved outcomes and quality of life for those affected by these conditions. As research progresses and new technologies emerge, patients and healthcare providers alike can look forward to more effective, personalized approaches to diagnosing and treating TMJ disorders. By staying informed about these advancements and working closely with healthcare professionals, individuals with TMJ issues can take proactive steps towards managing their symptoms and improving their overall well-being.

TMJ (Jaw Joint) Disorder – Anacapa Oral Surgery Dental Implant Center

The temporomandibular joint (TMJ) is a small joint located in front of the ear where the skull and lower jaw meet. The pair of TMJs allows the lower jaw to move and function.

Determining the cause of a TMJ problem is critically important. The three broad categories of TMJ disorders are spasm of the jaw muscles, problems with the actual jaw joint structures, and chronic neurologic pain. Many patients have a combination of these problems. A careful history, thorough exam, and computerized imaging will help Dr. Stout arrive at the correct diagnosis.

Muscle Problems: Muscle pain usually is felt on the entire side of the lower face, and may even extend up toward the ears, temples and side of the scalp. TMJ muscle pain often worsens after chewing. The actual jaw muscles are usually painful to touch, and the jaws may not open as wide due to pain. Chronic jaw muscle spasm is usually caused by chronic overuse such as clenching or grinding of the teeth, gum chewing, or habits such as cheek biting or nail biting. Stress or even cold weather can also cause acute or chronic muscle spasm. Missing posterior teeth also place an excessive burden on the jaw muscles and joints and can contribute greatly to TMJ disorders. This is one of the reasons replacing missing back teeth is so important, even if they are not seen by others.

Problems in the Joint Structures: Pain from the actual TMJ joint structure is usually felt in the area directly in front of the ears. There is pain to the touch or during motion or chewing. There may be clicking, popping, or grating noises, and the jaw may feel locked in an open or closed position.

Temporomandibular joint inflammation may be caused by osteoarthritis, the typical “wear and tear” degeneration that can affect any joint in the body. It may also be an extension of an autoimmune condition such as rheumatoid arthritis. Joint inflammation causes progressive limitation of motion, changes in the fit or occlusion of your teeth, and grating sounds as the smooth joint surface degenerates.

Another type of joint problem involves dislocation of the disc between the jawbone condyle and the socket. A displaced disc may produce clicking or popping sounds, limit jaw movement, and cause pain when opening and closing the mouth. After a time, the disc can become permanently deformed or even develop a perforation. Chronic disc problems can lead to degenerative arthritis of the joint.

Neurologic Pain Disorders: Some neurologic pain disorders mimic TMJ disorders because the pain is felt in the area of the jaws, teeth, or joints. These pain disorders are caused by nerve inflammation unrelated to the teeth or jaws. After other causes have been eliminated, a neurologic disorder might be considered and appropriate treatment using medicines might be appropriate.

Understanding Jaw Spasms | TMJ & Other Causes of Jaw Cramps

Take a quiz to find out what’s causing your jaw spasms.

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Dental causes

Damage from needles used in your inner cheek muscles, as with those used for dental anesthesia (Novocain injections) or damage to your jaw from oral surgery, such as molar extraction, can result in jaw spasms.

Traumatic causes

Traumatic causes of jaw spasms may include the following.

• Injury: Such as fractures or dislocations of your jaw from an impact
• Foreign body in the muscles of your jaw: Although this sounds strange, debris may become lodged in the jaw from falling down or being in an automobile accident.
• Surgical damage: If you have had surgery on your head, neck, or face, or especially to your temporomandibular joint (TMJ), this may result in jaw spasms if a complication occurred. Jaw spams can also occur if you incur damage to your jaw structure from intubation during surgery or other lifesaving procedures.

Medication-related causes

Taking the following medications may result in jaw spasms as a side-effect.

• Tricyclic antidepressants
• Phenothiazine medications: Used as anti-psychotics
• Some chemotherapy drugs
• Some types of radiation therapy
• Some illicit stimulant drugs

This list does not constitute medical advice and may not accurately represent what you have.

Tooth abscess (infection)

A tooth abscess is a collection of infected material (pus) in the center of a tooth. It is due to a bacterial infection.

You should seek dental care within 24 hours. The diagnosis is made based on your history, an exam, and an x-ray of the mouth. If the abscess is affecting your breathing, it’s considered a medical emergency and you should seek emergency care. Treatment involves incision and drainage of the abscess in addition to antibiotics.

Temporomandibular joint (TMJ) dysfunction disorder

Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.

The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.

TMJ disorder has three types:

• Pain or discomfort in the muscles controlling the TMJ.
• Dislocation or injury to the jawbone.
• Arthritis of the TMJ.

Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.

Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.

Rarity: Common

Top Symptoms: dizziness, pain, restricted movement, and clicking sounds from jaw, history of headaches, jaw pain, pain in the back of the neck

Symptoms that always occur with temporomandibular joint (tmj) dysfunction disorder: pain, restricted movement, and clicking sounds from jaw

Urgency: Primary care doctor

Swimmer’s ear (otitis externa)

Swimmer’s ear, or otitis externa, is an infection of the canal which runs from the eardrum to the opening of the ear.

It is caused by anything that introduces bacteria, fungus, or a virus into the canal. Water that stays inside the ear after swimming is a common cause, as are cotton swabs used for cleaning or earpieces that create irritation.

Most susceptible are children, because they have narrower ear canals that do not drain well.

Early symptoms include redness, itching, and discomfort inside the ear canal, sometimes with drainage of clear fluid.

Even mild symptoms should be treated because they can quickly get worse. The infection can spread and intensify, becoming very painful with increased drainage, swelling, fever, and loss of hearing.

Diagnosis is made through patient history and physical examination of the ear canal. Lab tests may be done on a sample of the discharge from the ear.

Treatment includes having a medical provider clean the ear canal of debris and discharge, and a prescription for antibiotic and/or steroid eardrops.

Myofascial pain syndrome

Myofascial pain syndrome is also called chronic myofascial pain (CMP. ) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.

The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.

This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points, since they trigger pain at any stimulus.

Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.

Myofascial pain syndrome should be seen by a medical provider, since it can develop into a similar but more severe condition called fibromyalgia.

Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.

Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.

Rarity: Common

Top Symptoms: dizziness, spontaneous shoulder pain, pain in the back of the neck, tender muscle knot, general numbness

Symptoms that always occur with myofascial pain syndrome: tender muscle knot

Urgency: Primary care doctor

Malignant hyperthermia

Malignant hyperthermia is a rare life-threatening condition usually triggered by drugs like general anesthesia. In certain individuals, these drugs can cause a drastic increase in carbon dioxide, decrease in body temperature, muscle rigidity and ultimately death if not immediately treated.

Call 911 for an ambulance now. This is a life-threatening condition that needs to be treated at the hospital.

Low calcium level

Hypocalcemia is a condition where there is not enough calcium in the blood. Calcium is a mineral contained in the blood and helps the heart and other muscles function properly. It is also needed to maintain healthy teeth and bones. Low calcium levels can cause bones to become brittle and more easily fractured. Parathyroid issues and vitamin D deficiency are common causes of this condition.

You should consider visiting a medical professional to discuss your symptoms. Low calcium levels can be evaluated with a review of your symptoms and a blood test. Once diagnosed, treatment depends on the cause of your low calcium levels.

Rarity: Rare

Top Symptoms: fatigue, shortness of breath, irritability, general numbness, tingling foot

Urgency: Primary care doctor

Fibromyalgia

Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient’s quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

Treatment of TMJ dysfunction – diagnostics, methods and prices in Moscow

TMJ dysfunction – disruption of the temporomandibular joint, partial or complete loss of its functions. Accompanied by pain, restriction of movement of the jaws when opening the mouth, chewing, talking. It is difficult to treat due to the variety of symptoms and causes. In our Center, this complex problem is successfully solved by candidates of medical sciences , doctors with specialized training in gnatology and practical experience of 11 years.

TMJ dysfunction syndrome – what is it?

The temporomandibular joint (TMJ) connects the movable lower jaw and the fixed temporal bone of the upper jaw. There are two such joints – located on both sides of the skull in front of the ears. Each consists of a temporal fossa above and an articular head (mandible) below. Between them is the articular disc, which softens the friction of the articular surfaces during the movement of the lower jaw.

The main assistants of the joints are chewing muscles, which help to move the lower jaw relative to the upper one, as well as to keep it in the correct anatomical position, while easing the load on the joint.

Joints are quite mobile, work synchronously, provide:

• jaw movements, typical for conversation;
• movement of the jaw during chewing;
• maximum mouth opening, e.g. when yawning.

Normally, all elements of the system provide an easy, smooth, silent movement. But if there are changes in the articular surfaces and (or) the muscles that are attached to the joints, the whole system fails. There is a violation of the mobility of the joint or its dysfunction (one or two at once).

Causes of dysfunction of the temporomandibular joint

The main causes of TMJ dysfunction can be divided into several categories:

Dental

Lead to dysfunction of the joint due to physiologically incorrect closure of the jaws (occlusion) and their interaction in general:

• Injuries of the lower jaw
• Malocclusion
• Inadequate prosthetics
• Partial or total absence of teeth

Myogenic

Lead to increased stress on the joint and development of TMJ dysfunction in the jaw muscles (muscle dysfunction):

• Prolonged mechanical tension of facial muscles
• Hypertonicity of masticatory muscles due to bruxism
• Excessive muscle tension due to entrapment of the facial nerve

Diseases of the joint

Progressive pathologies affect the TMJ and impair its functions:

• Osteoarthritis
• Rheumatoid arthritis
• Inflammatory processes of the articular surface of infectious etiology

Anatomical factors

Increase the likelihood of TMJ dysfunction:

• Congenital anomalies of the structure of the lower jaw, pathologically low alveolar processes
• Anatomical discrepancy between the temporal fossa and the articular head, incorrect position of the disc at their articulation

Characteristic symptoms and signs

TMJ destruction is characterized by:

Pain tends to increase during speech, eating or yawning, when the range of motion of the lower jaw increases.

Symptoms characteristic of the manifestation of the destructive process in the joint may be pronounced or blurred. This is typical for a protracted chronic process. There are also likely periods of remission, followed by exacerbations – the symptoms can appear sharply against the background of emotional experiences.

The general condition also deteriorates, :

Less typical symptoms should also be treated with caution :

Treatment of TMJ dysfunction must be immediate !

Due to the variety of symptoms and lack of understanding which doctor to contact, a person comes to a competent specialist with an advanced chronic form that accompanies him for many years and reduces the quality of life with debilitating manifestations. And without timely therapeutic measures, the onset of complete or partial ankylosis (immobilization of the jaw), which is difficult to treat, is possible.

Levin Dmitry Valerievich

Chief Physician and Founder of the Doctor Levin Medical Center

Who treats TMJ pain dysfunction and how?

The complexity of the situation is the lack of competent specialists in this field. Disappointed patients often turn to our Center after a long walk through various clinics from one doctor to another, who already have a huge number of pictures and tests on their hands, but have not received the long-awaited relief.

Few people know that degenerative processes in the joint of the lower jaw are treated by a gnathologist. Orthopedic dentists or orthodontists who have undergone special gnathological training can also be treated.

For help! Gnathology is a branch of medicine that studies the relationship of all elements of the dental system (jaw bones, ligaments, muscles, joints) and the treatment of pathologies that violate this physiologically correct interaction.

After diagnosing, the doctor will determine the causes of failures, suggest the most optimal ways to ensure a balanced operation of the entire system. Having outlined the methods of correction, he will also control the course of treatment.

Also, to ensure maximum effectiveness of therapeutic measures, consultation or direct participation of doctors may be required:

• Traumatologist – in case of displacement of the temporomandibular joint due to injury
• Neurologist – in case of infringement of the facial nerve or involvement in the process of nerve endings of nearby tissues and organs.
• Psychologist – if the destruction in the joint was formed due to prolonged tension of the muscles of the face due to psychological trauma or stress.

Diagnosis of the joint of the lower jaw

Diagnostics of the pathology of the joint, volumetric and multi-stage. Includes a set of examinations:

Primary history taking and examination

• Finding out the characteristics of the patient’s life – the specifics of work, the presence of chronic diseases, psycho-emotional background
• Questioning the patient about the probable cause of pathological changes in the jaw – trauma, inflammatory processes in the oral cavity, past dental history, the presence of neurological pathologies
• Visual inspection of the external surface of the projection of the joint and oral cavity, if possible
• Palpation examination of the joints, which helps to detect muscle tension, swelling and displacement
• Listening to sounds when opening the mouth, which may be clicks or pops
• Determining the amplitude of jaw mobility, identifying the range of possible movements
• External bite test
• The doctor also draws up a photo protocol – takes a photo of the face and intraoral photographs.

The gnatologist also performs a general posture assessment, as TMJ disorders are directly related to skeletal changes in general.

Functional and computer diagnostics

Impressions are taken, diagnostic models are made to analyze the relationship between the upper and lower dentitions when they are closed, to establish contacts of teeth on opposite rows.

The most informative diagnostic methods for suspected TMJ dysfunction are:

• 3D computed tomography (CT) . Allows you to explore the bone structures of the joint and jaws.
• Magnetic resonance imaging (MRI) . It is carried out to study the soft elements of the joint (cartilage, capsule, bone marrow).

The results of a comprehensive study help to determine the severity of the pathology, draw up a plan and sequence of treatment, and the need to involve narrow specialists.

Treatment of diseases of the temporomandibular joint

Methods of therapeutic measures are selected depending on the degree of the pathological process and the causes of its occurrence. But the basic principle and sequence of treatment of TMJ dysfunction is as follows:

Elimination of soreness and removal of muscle hypertonicity

Comprehensive treatment using the above methods and means, in most cases, gives a positive effect and long-term remission.

Recommended for the duration of treatment:

1. Complete exclusion of solid food, which will make it possible to maintain conditional rest for the joint
2. Maximum restriction of mobility – you can not yawn widely, open your mouth
3. Alternating warm and cold compresses
4. Performing myogymnastics, a set of exercises is selected by a doctor

Occlusion correction

Necessary for jaw occlusion disorders that have affected TMJ dysfunction. Correction is performed using braces or aligners, which are installed only after the condition improves, the pain syndrome is eliminated and muscle tone is reduced.

After a course of orthodontic treatment, the jaws take a physiologically correct position, their exact closing and contact of the teeth of the opposite row is achieved.

Restoration of missing teeth

In the absence of teeth, their restoration is mandatory. These can be bridges or implants. The second option is preferable because it solves the problem once and for all. The implant completely replaces the lost tooth – both the root and the crown part. This provides a uniform load on the jawbone, prevents its atrophy. In addition, unlike bridge prosthetics, it is not necessary to grind adjacent teeth to fix the structure.

Frequently Asked Questions from Patients

How can I distinguish symptoms of TMJ dysfunction from other diseases?

Symptoms of pathological processes in the joint are similar to manifestations of other processes:

• myocardial infarction is characterized by pain radiating to the neck, lower jaw and shoulders;
• otitis – accompanied by severe pain in the ears, hearing loss;
• violation of cerebral circulation – proceeds with the presence of dizziness, flickering flies and nausea;
• cervical and thoracic osteochondrosis – similar in localization of pain;
• infringement of the facial nerve – also due to unilateral facial muscle tension and swelling;
• complicated diseases of the gums and teeth – accompanied by inflammation and immobility of the lower jaw.

Therefore, in order to avoid making an incorrect diagnosis, our doctor carefully studies the patient’s life and illness history, conducts a visual and palpation examination, and prescribes the necessary functional and instrumental studies.

Levin Dmitry Valerievich
Oral and maxillofacial surgeon, chief physician of the Center

What if the treatment does not work?

Conservative treatment does not help in cases where changes in the joint are serious. In this case, one of the types of surgical operations is performed:

• puncture of the cavity and arthroscopy of the joint;
• a small incision to eliminate pathological tissue, adjust the location of the cartilaginous disc and condyle;
• intra-articular intervention in the presence of a tumor process, bone fragments and destruction of bone tissue.

The type of surgical intervention is determined by a council of doctors after all the necessary studies confirming its expediency.

Dmitry Levin
Oral and maxillofacial surgeon, chief physician of the Center

Levin Dmitry Valerievich

Author of the article. Oral and maxillofacial surgeon, chief physician of the Center

Published: 06/09/2022

Updated: 06/06/2023

Treatment of bruxism in adults, prices at the CPS Dr. Levin in Moscow

Bruxism – involuntary grinding of teeth due to muscle spasm, often manifests itself in sleep. Constant trauma to the teeth and soft tissues around them leads to pathological abrasion of enamel, gum disease, loosening and loss of teeth, problems with the jaw joint, and against this background – to a general deterioration in health. The treatment of pathology in our Center is complex , it includes the elimination of the cause, only then – the consequences.

Causes of bruxism

The occurrence of the disease is explained by combined disorders of various systems in the body – digestive, nervous, endocrine.

The main groups of causes of bruxism are distinguished:

Dental

Patients have:

• Partial loss of teeth with dentition defects
• Gingival inflammation and loose teeth, periodontitis
• Bite anomalies
• Poorly fitted braces and dentures
• Pain and limitation of mobility in the temporomandibular joint (TMJ)

In all these cases, there is a violation of the contact between the teeth of the upper and lower jaws, the chewing load is distributed unevenly, the muscles of the face are overstrained and spasmodic.

Osteopathic

It is traditionally believed that the bones of the human skull are mobile only at birth and in early childhood. Proponents of osteopathy believe that in adults they are also in motion and perform from 8 to 12 contractions and expansions per minute. Osteopaths call such cycles the “breath of life” or the cranio-sacral rhythm. It can be broken and block the cranial sutures in case of birth injuries, complicated childbirth, malocclusion.

Bruxism is an unsuccessful attempt by the nervous and muscular systems to remove the blockage and return the “breath of life”. Osteopaths consider the installation of prostheses connecting the left and right halves of the skull to be incorrect – they also provoke spasmodic contraction of the facial muscles.

Psychological

Symptoms of the disease first appear after a sharp change in emotional state – stress or a difficult life situation. Constant psychological stress leads to muscle strain.

Tendency to depression, anxiety clearly correlates with the presence of night gnashing: in ¾ of the patients of the departments of neuroses, masticatory muscle dysfunctions are found.

Personality type, human temperament also affect the appearance of the disease: in choleric patients with increased irritability and aggressive mood, pathology of the facial muscles is not uncommon.

Neurogenic

Bruxism is closely related to the pathology of the nervous system. It is often accompanied by sleep apnea, snoring, nightmares, somnambulism. Chronic diseases are also detected – parkinsonism, epilepsy, enuresis, dementia. A thorough examination reveals a violation of the transmission of impulses along the nerve fibers.

Effective treatment of these conditions results in marked improvement in the symptoms of bruxism.

Pathological manifestations also develop with an incorrect lifestyle (disturbance of the rhythm of sleep and wakefulness, the influence of harmful production factors), the presence of bad habits (nicotine, alcohol addiction and drug addiction), diseases of internal organs, chronic eating disorders.

Complications

Frequent bouts of bruxism with constant trauma to the hard and soft tissues of the oral cavity cause premature wear of the teeth, inflammatory diseases of the soft tissues, dysfunction of the temporomandibular joint.

Increased abrasion of teeth

Under natural conditions, age-related changes in tooth enamel occur – it gradually wears off on chewing and cutting surfaces. Teeth adapt to loads and continue to function. Pathological abrasion in bruxism affects not only the enamel, but also the dentin, and further exposes the pulp. The crown of the tooth is completely destroyed.

Naturally, problems appear :

Against the background of a decrease in bite, the formation of senile facial features with disturbed proportions occurs – a reduced size of the lower jaw, asymmetry of the face.

TMJ dysfunction

Manifested by partial or complete inability to chew and speak clearly.

Warning signs: soreness of the masticatory muscles, tension and increased tone, rapid fatigue of the muscular apparatus during eating.

If untreated, the disease progresses :

Repeated episodes of bruxism lead to difficulties in orthopedic and orthodontic treatment – the installed prostheses quickly collapse, so most methods of restoring the dentition are not available to such patients. Before making a decision on prosthetics, it is necessary to identify and eliminate the provoking factor.

Bruxism is a complex pathology, but is not a sentence

The disease has many causes and consequences, but a competent approach to diagnosis and treatment allows you to get rid of it and avoid dangerous consequences.

Levin Dmitry Valerievich

Chief Physician and Founder of Doctor Levin

Which doctor should I contact?

Initially, a consultation with a gnatologist or an orthopedic dentist or orthodontist with gnathological training is necessary to establish a diagnosis and select a treatment strategy. Gnathology is the science of the interaction of all components of the dentition. He studies and treats diseases associated with disruption of the jaws, masticatory muscles, ligaments, and joints.

Gnathologist finds the causes of bruxism, plans dental treatment. If necessary, the doctor refers the patient to a specialist. It can be:

• Neurologist – detects abnormal brain activity, the presence of hidden epileptic foci and other organic brain lesions.
• Psychiatrist — notices disturbances in the psycho-emotional state and corrects manifestations of depression.

Allied professionals prescribe sedatives, muscle relaxants, antidepressants, and multivitamins.

Diagnosis

Diagnosis of bruxism is complex and multilevel, includes:

How to get rid of bruxism

The treatment of this pathology is complex, aimed at eliminating the identified cause and consequences in the following sequence:

1. Protection of teeth
   A special soft mouth guard for bruxism, which is worn at night and prevents the abrasion of teeth.
2. Elimination of cause
   Dental measures are taken to reduce muscle hypertonicity, antidepressants, sedatives, and vitamins are prescribed in parallel.
3. Treatment of consequences
   In case of mild tooth wear, the enamel is strengthened. In other cases, restoration with photopolymer fillings or prosthetics is carried out.

Methods of treatment at Doctor Levin Center

Night mouthguards for bruxism

At the first stage of bruxism treatment, special night mouthguards are used – relaxation splints for teeth made of low-allergenic plastic. They are installed on one or both jaws.

The main role of the mouth guard is to keep the teeth from being erased and displaced at night, when a person grinds his teeth involuntarily and does not control himself.

In case of kappa attack :

• unloads facial muscles, relaxes them;
• protects teeth from further decay.

Night mouth guard does not affect the cause of the disease and does not eliminate its consequences.

Grinding teeth

The method is used at the second stage of treatment, if the cause of the disease is found to be an incorrect ratio of the chewing surfaces of the upper and lower teeth. In this case, contacting teeth are found and hard tissues are partially grinded off from them.

The main goal of the procedure is to create an even contact throughout the entire dentition.

After grinding :

• excessive stress on the jaw is removed;
• it is evenly distributed over all plots;
• the sharp edges of the teeth that have injured the tongue and mucous membrane are eliminated;
• the patient gets rid of minor injuries and injuries in the oral cavity.

TENS-therapy

The next stage of treatment is TENS-therapy, hardware electrical stimulation of masticatory muscles. It is needed to relax the muscles and return the correct position of the lower jaw and temporomandibular joint. The procedure is carried out before orthopedic or orthodontic treatment.

Low-frequency microcurrents increase the supply of oxygen and nutrients to the muscles, accelerate the outflow of stagnant venous blood.

As a result of :

• muscle spasm is removed, the elasticity of muscle fibers is restored;
• eliminates TMJ dysfunction and increased masticatory muscle tone;
• jaws are perfectly closed and do not cause pain.

Splint therapy

Splint therapy can be used as an alternative to TENS stimulation or in parallel with it. This is a method of relaxing muscles and restoring normal TMJ function using an individual silicone splint. It is installed on the jaw and worn around the clock for an average of 2-6 months. The patient periodically visits the doctor to correct the position of the lining.

Relief comes already in the first days :

• masticatory muscles return to normal tone;
• shortened ligaments are stretched;
• the jaw and head of the joint return to the physiological position;
• headaches and muscle spasms quickly decrease;
• reduces discomfort in the cervical region.

Botulinum therapy

Neuroproteins (botulinum toxins) block the transmission of nerve impulses through the muscles. The drug is administered pointwise in the form of injections into certain areas of the face at the stage of eliminating the causes of bruxism. This method is necessary to relieve the tone of tense facial muscles and improve the work of the TMJ.

After one treatment :

• chewing muscles relax and become partially immobile;
• pain and tension disappear;
• it is not possible to tightly clench the jaws even with unconscious attempts.

The effect is long – up to several months.

Bite correction

After the condition improves, muscle tone decreases, they proceed to the stage of bite correction with the help of braces and aligners.

• Bracket systems – orthodontic devices with locks on the teeth, connected by a rigid arc. Before installation, she is given the correct position in the shape of the future dentition. She seeks to return to this position, being already on her teeth, putting pressure on them. The orthodontist periodically adjusts the force of pressure, and the teeth gradually move and align.
• Aligners are transparent, removable mouthguards made using computer technology for constant pressure on the dentition. Provide movement of teeth according to a pre-compiled 3D plan.

Both systems are worn for a year or more.

Restoration of teeth

When the causes of the violations are eliminated, they proceed to the final stage – restoration:

• Destroyed and worn teeth are restored using fillings and inlays, thin ceramic overlays – veneers and single prostheses-crowns. All of them protect teeth from further wear.
• Implants or bridges are made to replace missing teeth.

Implantation and prosthetics procedures are possible only if the root causes of the disease are eliminated. Otherwise, no orthopedic structure will survive and will inevitably collapse.

Effectiveness of measures

The effectiveness of treatment depends on the timely initiation of therapy.

• In the initial stages of the disease, grinding teeth, taking medications and several TENS sessions is enough for recovery.
• With a long course of the disease, when the teeth are destroyed and numerous complications appear, all components of the complex will be required, incl. expensive prosthetics of all teeth.

Signs and symptoms requiring a visit to a doctor

An attentive patient notices symptoms that should immediately come to the clinic: joint and instability of the cervical spine, respectively, long-term and financially costly treatment.

Patient FAQ

Can implants be used for bruxism?

You can, because the restoration of lost teeth is an obligatory stage of treatment. The only condition is to preliminarily conduct an in-depth diagnosis and eliminate muscle spasm. When bruxism is indicated, even after restoration of muscle tone, additional measures are taken to increase the strength of structures on implants.

Levin Dmitry Valerievich
Oral and maxillofacial surgeon, chief physician of the Center

What can be done to prevent the development of bruxism?

If a person or his relatives have noticed at least single symptoms of bruxism, you need to undergo a diagnosis. The doctor will voice a plan on how to comprehensively approach the problem and eliminate it.

It is worth coordinating self-help measures with a specialist: before going to bed, carry out a light massage of the chin and temples, do exercises to relax the muscles.