Temporomandibular joint (TMJ) dysfunction
TMJ dysfunction refers to pain/restriction of movement due to the dysfunction regarding the jaw joint and muscles surrounding the jaw.
Subjective and Objective Findings
Patients suffering from TMJ disorders can report a variety of signs and symptoms including pain and difficulty opening their mouth/eating food, lock jaw, clicking/clunking or grating noises from the TMJ, toothaches, muscular spasms, referred pain to the face, cheeks, ears, neck, upper back, shoulders and even in the teeth.
Objectively patients presenting with TMJ disorders typically will be tender upon palpation of their jaw musculature, reduced and painful active and passive jaw range of motion, subjective reports of clicking/crunching noises during examination and the buccal caps (top edges) of the teeth may also exhibit noticeable signs of wear.
There also seems to be a link between TMJ disorders and difficulty with balance/vertigo. Although the exact mechanism explaining the connection is not fully clear.
Treatment of TMJ Disorders
Whilst TMJ disorders can produce a lot of pain and difficulty, there are plenty of treatment options available. These include manual therapy (joint mobilisations, soft tissue massage etc), exercise targeting jaw mobility and strength, customized splints minimizing painful jaw movements, relaxation and stress relieving techniques (cognitive behavior therapy), medications at doctors’ discretion (non-steroidal anti-inflammatory, painkillers, muscle relaxers, anti-stress etc.), resting from aggravating movements (yawning, chewing gum, eating large foods like apples etc) as well as heat/ice packs to reduce tension and pain.1,2,,3
With more persistent and complication presentations, referral to specialists among the dental, medical and physiotherapy community can be made, otherwise in very rare circumstances surgical intervention can be indicated provided manual therapy, exercise and cognitive behavior therapy were ineffective. 2,3
Reference List
- Yuasa H, Kurita K; Treatment Group on Temporomandibular Disorders. Randomized clinical trial of primary treatment for temporomandibular joint disk displacement without reduction and without osseous changes: a combination of NSAIDs and mouth-opening exercise versus no treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Jun;91(6):671-5. doi: 10.1067/moe.2001.114005. PMID: 11402280.
- Yoshida H, Sakata T, Hayashi T, Shirao K, Oshiro N, Morita S. Evaluation of mandibular condylar movement exercise for patients with internal derangement of the temporomandibular joint on initial presentation. Br J Oral Maxillofac Surg. 2011 Jun;49(4):310-3. doi: 10.1016/j.bjoms.2010.05.016. Epub 2010 Jul 13. PMID: 20630631.
- Nandhini J, Ramasamy S, Ramya K, Kaul RN, Felix AJW, Austin RD. Is nonsurgical management effective in temporomandibular joint disorders? - A systematic review and meta-analysis. Dent Res J (Isfahan). 2018 Jul-Aug;15(4):231-241. PMID: 30123299; PMCID: PMC6073942.