Temporomandibular Disorders - symptoms and treatment

What is Temporomandibular Disorders

A group of conditions in which there is INFLAMMATION and often degeneration of the temporomandibular JOINT, the large joint that connects the lower jaw (mandible) to the temporal BONE of the cranium. There are numerous possible causes for temporomandibular disorders, ranging from a CONGENITAL ANOMALY of structure (such as uneven bite) to OSTEOARTHRITIS and grinding the TEETH (bruxism).

Symptoms of Temporomandibular Disorders and Diagnostic Path

The symptoms of temporomandibular disorders include

  • inability to fully open the MOUTH
  • locking of the jaw when open
  • clicking sounds or sensations when chewing
  • PAIN in the temporomandibular joint
  • chronic HEADACHE

The diagnostic path begins with a comprehensive examination of the head and mouth. Sometimes the doctor determines the cause is primarily dental, such as uneven bite, and refers the person to a dentist for evaluation and treatment. Deterioration and inflammation of the joint are medical problems the doctor can attempt to treat. X-RAY can show whether there is a misalignment of the joint structures or deterioration of the bones. There is usually no need for additional diagnostic procedures unless the doctor feels the need to rule out other causes for the symptoms.

Temporomandibular Disorders Treatment Options and Outlook

Treatment for temporomandibular disorders may include medications such as NONSTEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS) to relieve inflammation and pain, heat or cold to the joint, dental splints or other devices to realign the bite, and dental repairs, if necessary. Temporomandibular disorders tend to be chronic. Many people put up with the discomfort for a considerable time before seeking medical care, by which time joint deterioration or other problems may be serious. Treatment may take time to be effective. In rare circumstances, usually when injury or congenital anomaly causes a structural problem with the joint, surgery may be necessary.

Risk Factors and Preventive Measures

Stress is often a significant factor in the circumstances that contribute to temporomandibular disorders, particularly with bruxism and clenching of the jaw, which causes irritation of the muscles and other tissues in the joint area. Many people find their symptoms improve with a combination of direct treatment (such as NSAIDs and heat) and indirect approaches such as MEDITATION or other stress-reduction techniques. These measures can reduce MUSCLE tension.

See also CHRONIC PAIN.

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