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Jaw Problems

What is the TMJ?
What causes TMJ problems?
Why have I got TMJ problems?
Are my problems anything to worry about?
What are the treatments?
What happens if these methods do not produce an improvement?

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What is the TMJ?

The temporomandibular joint (TMJ) is found in front of the ear, where the skull and the lower jaw meet. The joint allows the lower jaw (mandible) to move and function. The joint is made up of two bones that are separated by a disc of cartilage. Ligaments and muscles surround the joint.

Problems with the TMJ are very common but normally only last a few months before getting better. Sometimes only the muscles are affected (myofacial pain dysfunction) whereas in others the cartilages and ligaments may also be at fault (internal derangement of temporomandibular joint).

The most common symptoms are:

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Joint noise; such as clicking, cracking, crunching, grating or popping

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Pain; usually a dull ache in and around the ear. The pain may move forwards along the cheekbone or downwards into the neck.

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Headache

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Limited mouth opening

Most TMJ problems are made worse by chewing and are aggravated at times of stress.

What causes TMJ problems?

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Pain is caused by the muscles in and around the jaw joint tightening up.

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Joint noise occurs if the disc of cartilage moves out of its normal position

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Most commonly the cartilage slips forwards and a noise is made when it returns to its normal position in between the bones of the jaw joint. The noise sounds loud to some patients because the joint is just in front of the ear.

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The muscles surrounding the joint can go into spasm, producing pain and limited mouth opening.

Why have I got TMJ problems?

The cartilage in the TMJ is thought to slip forwards because of over-use and tightening of the muscles surrounding the jaw.  This may occur as a result of chewing habits, for example, grinding or clenching the teeth when under stress, or at night.  Nail biting or holding things between the teeth can also cause TMJ problems.  Missing back teeth, an uneven bite or an injury to the jaw can also lead to the problem.  Often no obvious cause is found.

Are my problems anything to worry about?

TMJ problems are usually not serious and very rarely lead onto other problems, for example: arthritis of the jaw joint; they are however a nuisance. Fortunately, TMJ problems usually respond to simple measures over a period of time. Patients themselves can manage most of these treatments.  Occasionally TMJ problems may return after several years.

What are the treatments?

Treatments can vary. On the whole, treatment is aimed at trying to reduce the workload of the muscles. This allows the disc of cartilage to return to a normal position in the joint.
The following things can help:

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A soft diet that requires little chewing; this allows over-worked muscles to rest.

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Painkillers; anti-inflammatory medication (for example: Nurofen) is good and can be taken as either tablets or applied as a gel on the outside of the joint.

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Heat; warm water in a hot water bottle (avoid boiling water) wrapped in a towel applied to the side of the face

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Identify and stop any habits, such as clenching or grinding. Remember that these may be “subconscious”, so you may not be aware of them.

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Relaxation therapy and techniques to control tension and stress.

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Jaw joint exercises; the exercises that are best for you will have been discussed by the dentist seeing you. Please remember to carry them out as instructed.

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Resting the joint as much as possible

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Providing a clear night guard that fits over the teeth and is worn mainly at night. This helps support the joint and surrounding muscles.

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Physiotherapy

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Replacing missing teeth to balance the bite

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Minor adjustment to the bite.

What happens if these methods do not produce an improvement?

Surgery is only carried out in a small number of cases. This can involve manipulation of the joint whilst you are asleep or more rarely surgery carried out with a mini telescope. In extreme cases it may be necessary to open the joint and operate on the bones, cartilages and ligaments.

Adapted from:

British Association of Oral and Maxillofacial Surgeons. Blepharoplasty. http://www.baoms.org.uk/

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dentist bedale, dentists in bedale, cosmetic dentist bedale

dentist bedale, dentists in bedale, cosmetic dentist bedale