The TMJ or “Jaw Joint” is a hinge joint allowing jaw opening and side to side movement when chewing, speaking, swallowing or yawning. Jaw joint pain is quite common and may come from the jaw joint itself, or from the surrounding muscles, or both. Causes of jaw joint disorders are numerous and are often difficult to determine. The most common cause of temporomandibular joint disorders is trauma (eg a heavy blow to the face/jaw), they may have an obvious cause such as arthritis or other pathology, or be due to a less obvious cause such as clenching or grinding of the teeth at night, which most patients are not aware they are doing.
Symptoms of Temporomandibular Dysfunction (TMD) can include: Pain, Clicking, Grating noises, Popping, Locking and Reduced mouth opening, and can also be associated with: Ear pain, Headache, Facial pain and swelling or Jaw locking.
Symptoms are often worsened when eating tough foods, yawning, in cold weather and in the morning on awakening. For most patients the condition will usually progress from a painless click in the joint, through joint pain to joint locking, although the time frame will vary enormously from patient to patient. Diagnosis of these problems involve a thorough history and clinical examination, plus review of X-rays and sometimes a CT and/or MRI scan
Conservative treatment It is most important to remember that most TMJ disorders may respond well to simple conservative (non-invasive) treatment if a patient presents in the early phases of the condition. Such treatments may include dietary modifications and avoidance of extreme jaw movements (such as yawning, loud singing and gum chewing) prescribed jaw exercises and the use of pain relieving anti-inflammatory drugs.
Another conservative measure is the construction of an occlusal (bite) splint. The splint is removable and is made of clear plastic and fits over the upper (usually) or lower teeth. The splint is usually worn only during sleep and can help reduce the effects of clenching and grinding by keeping the teeth apart.
Surgical treatment For TMJ disorders that do not respond fully to conservative management, Dr Curtis may recommend an ‘arthrocentesis’, or injection of cortisone into the jaw joint. This is a relatively simple ‘day only’ procedure performed under a general anaesthetic in a private hospital facility . Much more rarely, the more invasive procedure of an open surgical operation on the joint can be considered.