19 June 2015
Mr Pinaki Sen, consultant oral and maxillofacial surgeon at Spire Norwich Hospital, discusses a common condition which can affect one in ten people at some point in their lives, temporomandibular joint disorder (TMJ).
Temporomandibular joint disorders, or TMJ for short, are a condition which affect the jaw muscles and nerves of the jaw joint, usually as a result of an injury. Symptoms of the condition may include, pain with chewing, clicking, and popping of the jaw, swelling on the sides of the face, nerve inflammation, headaches, tooth grinding to name but a few.
It’s not clear as to what causes TMJ disorders. It is generally thought there are a number of contributing factors to the condition, which can be grouped into problems linked to the muscles working the jaw joint and problems inside the joint itself. Typically the jaw joint muscles are the most common cause, particularly for young patients.
Muscle complaints may be caused by over activity of the jaw muscles such as clenching/grinding your teeth at night or more rarely from a rare movement disorder (orofacial dystonias) which causes excessive jaw clenching. An increased sensitivity to pain, possibly linked to stress, which affects pain sensitivity may also contribute to the cause.
Problems in the joint may be caused by wear and tear to the inside of the joint - for example, wear and tear to the cartilage. Sometimes this is due to a type of arthritis. This problem tends to affect older rather than younger patients. In addition, trauma to the TMJ or to the surrounding arear can cause TMJ pain.
Whilst diagnosis of the condition can often be confirmed on the basis of your symptoms and an examination by your GP or specialist, investigations are available to support the diagnosis. A simple blood tests may rule out other causes for the pain in addition to looking for signs of inflammation.
Diagnostic investigations such as an MRI scan can show detailed imagery of the joint for any abnormalities or trauma. A nerve block, which may help to clarify whether the pain is coming from the joint or the muscles, or finally an arthroscopy (using a telescopic camera to view inside the joint) may be possible if all other investigations have exhausted a diagnosis.
Treatment for TMJ can be as simple as using pain relief or by self-help measures such as resting the jaw. Try adapting your diet to eat soft foods and refrain from using chewing gum along with yawning and opening your mouth wide. Whilst there is no evidence to suggest a mouth guard helps with the symptoms of TMJ, some patients have found them to be beneficial as they reduce clenching and grinding of the teeth, especially if worn at night.
Physiotherapy may also be used to extend the range of movement within the jaw joint. As patients feel discouraged to use their jaw, due to pain, physiotherapy can oppose these negative effects.
Attempts over the last few decades to develop surgical treatment now receives less attention. These techniques are reserved for the most difficult cases where other therapeutic measures have failed. Around 20% of patients need to proceed to surgery.
It has been suggested that the history of TMJ is benign (non-cancerous) and self-limiting, with symptoms slowly improving and resolving over time. The prognosis for suffers is therefore good. However, the persistent pain symptoms, psychological discomfort, physical disability and functional limitations may detriment quality of life.
Mr Sen suggests that If you’re suffering from pain, clicking or popping of the jaw and grinding your teeth at night, speak to your local GP or healthcare professional as help is available.
For further information regarding temporomandibular joint disorders arrange an appointment with your family doctor or call 01603 255 614 to make a private appointment with consultant oral and maxillofacial surgeon Mr Pinaki Sen.
All surgery carries an element of risk and the content of this page is provided for general information only. It should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professional.