Temporomandibular Joint Issues

The temporomandibular joint (TMJ) is a complex joint that connects the lower jaw to the skull and enables essential functions such as chewing, speaking, swallowing, and yawning. Disorders affecting the temporomandibular joint and the surrounding muscles are collectively referred to as Temporomandibular Joint Disorders (TMD).

These disorders may present with symptoms such as locking, catching, or slipping sensations during jaw opening, joint noises, pain, or limited mouth opening. The underlying causes may include displacement of the joint disc, muscle spasms, joint movement disorders, or degenerative changes within the joint structure. Today, TMJ disorders are relatively common in the general population.

Symptoms of Temporomandibular Joint Disorders

·         Patients with TMD may experience the following complaints:

·         Pain, sharp discomfort, or dull aching during jaw movements

·         Restricted jaw opening or inability to open the mouth fully (locking)

·         Clicking, popping, or grinding sounds during mouth opening or closing

·         Pain radiating to the face, ear, temples, or head

·         Ringing in the ears (tinnitus) or a feeling of fullness

·         Dizziness

·         Muscle pain spreading to the neck and shoulders

·         Mild swelling on one or both sides of the face

·         Muscle spasms and stiffness in the chewing muscles

Pain may not be limited to the joint area alone; due to muscle involvement, it can radiate to the head, neck, and ear region.

Causes of Temporomandibular Joint Disorders

TMJ disorders may develop or worsen due to various factors:

·         Teeth clenching or grinding (bruxism)

·         Missing teeth and unilateral chewing habits

·         Crowded teeth and bite (occlusal) disorders

·         Jaw discrepancies

·         Trauma to the jaw area (impact, accidents)

·         Developmental joint anomalies

·         Degenerative joint diseases (e.g., osteoarthritis)

·         Autoimmune diseases (rheumatoid arthritis, lupus)

·         Stress and muscle tension

·         Improperly made dental restorations or prostheses

These factors increase the load on the joint over time, leading to disc displacement, muscle spasms, and loss of joint function.

Diagnosis of Temporomandibular Joint Disorders

Advanced diagnostic methods are used in the evaluation of TMJ disorders:

·         Clinical examination and functional analysis

·         Radiographic evaluations

·         Magnetic Resonance Imaging (MRI)

·         Ultrasonography

·         Electromyography (EMG)

·         Computer-assisted jaw movement analysis

·         Muscle function assessment using low-frequency TENS

These techniques allow detailed evaluation of the joint disc, muscle activity, and joint structures, enabling accurate diagnosis and appropriate treatment planning.

Treatment of Temporomandibular Joint Disorders

Treatment is planned according to the underlying cause and severity of the disorder. Options range from conservative approaches to surgical interventions.

 Conservative (Non-Surgical) Treatments

·         Use of night guards or splints

·         Muscle relaxants and pain relievers (under medical supervision)

·         Avoidance of activities that overload the chewing muscles

·         Avoidance of hard and difficult-to-chew foods

·         Avoiding excessive mouth opening such as yawning widely or shouting

·         Stress management and relaxation exercises

·         Hot and cold compress applications

·         Physiotherapy and jaw muscle exercises

When necessary, orthodontic or prosthetic treatments may be used to correct bite discrepancies. In some cases, a multidisciplinary approach involving oral surgery or periodontology may be required.

Surgical Treatment Options

In cases where conservative treatment is ineffective or advanced joint pathology is present:

·         Arthrocentesis (joint lavage)

·         Arthroscopic surgery

·         Open joint surgery

·         In advanced cases, joint surface repair or joint prosthesis

may be considered. Surgical decisions are made on an individual basis after thorough evaluation.

Important Considerations for Patients

Individuals with TMJ disorders should:

·         Avoid hard foods

·         Refrain from chewing gum

·         Avoid chewing on one side only

·         Avoid prolonged activities that require excessive mouth opening

·         Manage stress and control clenching or grinding habits

·         Attend regular dental and specialist check-ups

Early evaluation of symptoms contributes significantly to more effective and successful treatment outcomes.