TMJ, also known as Temporomandibular disorders, affect the Temporomandibular joint. This is the joint connecting your jawbone and temporal bone on each side of your face. It also links your jaw to your skull. The common word for this area is the mandible.
A specific type of pain in your jaw joint, and the muscles which control your jaw movement, can arise due to several different factors. Arthritis, genetics, jaw injury, or grinding too forcefully during sleep can all cause TMD (Temporomandibular disorder).
Crescent Dental offers a range of different treatments, specialized to help you if you suffer from TMD.
Identifying whether you suffer from TMD is the start to getting treatment. Ask yourself: do you suffer from sensitivity or pain around your jaw area? This, combined with difficulty chewing or opening your mouth, can be clear symptoms of TMD.
Other symptoms include:
- Pain around the ear
- Facial pain
- Locking of the jaw
So, keep a lookout. If you suffer from a combination of these symptoms, it’s well worth booking an appointment with Crescent to find out if any treatment options could work for you.
1. Pain relievers/anti-inflammatories
Your dentist may prescribe you with stronger pain relievers, should over the counter medications prove redundant.
2. Tricyclic antidepressants
Medications such as amitriptyline can be prescribed, in lower doses, for pain relief.
3. Muscle relaxants
Your dentist can prescribe you with a muscle relaxant to help with TMD-induced muscle spasms.
These are non-drug therapies, which work to ease and relieve pain without surgery. They include:
1. Oral splints/mouth guards
These are soft or firm devices inserted over the teeth. Nobody knows quite why this eases the pain, but it is known to provide relief from TMD symptoms.
2. Physical therapy
Exercises can strengthen and stretch your jaw muscles, providing relief around the jawbone area. Moist heat and ice can also be applied to the painful areas to ease aches and pains.
For finding the root cause of your TMD, many find that psychological counselling can work to prevent jaw clenching, grinding, biting, or leaning on the chin. Changes to behaviour and lifestyle have been shown to improve the symptoms of TMD significantly.
Getting surgery to fix severe symptoms of TMD can be discussed and decided between you and your dentist – especially when symptoms are persistent and don’t seem to be getting any better with any of the options discussed above.
Some of the surgical procedures your dentist may suggest to you are:
This is the least invasive procedure. Small needles are inserted into the joint to inject fluid. This reduces any inflammation and removes debris which may be causing the pain.
Corticosteroid injections may need to be injected into the joint to ease pain and swelling. Botox has also been shown to help with TMD and ease the pain, especially if TMD is caused or made worse when chewing.
3. TMJ arthroscopy
Arthroscopic surgery is quite effective in helping TMJ disorders. A small, thin tube, known as a cannula, is placed into the joint space. Next, an arthroscope is inserted and keyhole surgery is performed.
4. Modified condylotomy
This is a more direct approach. Surgery is performed on the mandible and the joint. This way is perfect if you find that your jaw is locking a lot or if you’re in a lot of pain.
5. Open-joint surgery
This surgery is pretty much the strongest approach to TMD, reserved for when less drastic treatments don’t seem to be working. This surgery is performed when there’s a ‘structural’ problem with the joint. It consists of a repair or even a replacement of the joint.
This surgery is done according to the patient’s pain level and the way that jaw is set. In most cases, the surgeon will make an incision around the ear (but sometimes the incision extends up towards the hairline). Once the treatment is done, the scar behind or around the ear is stitched up. This usually heals quite well. Any blood collected during the surgery is also drained.
The area in front of the ear can get quite sore a few days after surgery – this can be treated with painkillers. Swelling can also occur but this usually dies down after a few days to a week. In some cases swelling can reduce within hours and most patients find that the area settles quite nicely within a week.
Because open joint surgery comes with a set of side-effects, it’s usually the last approach to TMD. Some of the side-effects are:
- Bleeding around the ear – this is due to the incision the surgeon has to make.
- Infection – this is uncommon, especially if you’ve been prescribed antibiotics. But as with all wounds, infections can occur.
- Nerve damage – a riskier side-effect (although uncommon). The facial nerve runs along the jaw, next to the joint. Damage to this nerve can occur due to bruising during the surgery. This usually causes weakness in the surrounding muscles and take a few months to recover fully. The nerve which supplies feeling to the earlobe is also at a risk of being bruised during this surgery, but the damage will normally cure itself after a few months. Permanent nerve damage is rare and occurs in the riskier operations. Make sure you are aware of all possible risks and side-effects before undergoing surgery.
TMD is definitely curable. In most cases, surgery isn’t required. It’s reassuring to know that there are many options available to ease the pain associated with TMD.
TMD sufferers should ideally have a chat with their dentist or doctor – just walk into your local clinic and book an appointment. Make sure you cover all the bases.
Remember to remain positive, and rest assured that your dentist and doctor are there to help.