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TMJ Disorders

TMJ (temporomandibular joint) disorders are a family of problems related to your jaw joints that are very complex structures. Symptons can arise at any time in life, even in childhood. However,onset is usually during 

early adulthood. If you have had symptoms like pain or a "clicking" sound, you'll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the jaw joints and the chewing muscles (muscles of mastication) do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions so early detection and treatment are important.

Frequently no one treatment can resolve TMJ disorders completely and most treatments take time to become effective. Dr. Evans can help you to have a healthier and more comfortable jaw. If you would like to speak to Dr. Evans about a TMJ condition, please call our office to arrange a consultation, 07 839 1394

Trouble With Your Jaw?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disc within the joint, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a malaligned bite, pain, clicking or a grating noise when you open your mouth, or restriction when attempting to opening your mouth wide.

Do You Have a TMJ Disorder?

  • Are you aware of grinding or clenching your teeth?
  • Do you wake up with sore, stiff muscles around your jaws?
  • Pain in or around your ears or cheeks?
  • Face, neck and shoulder pain?
  • Do you have frequent headaches,migraines or nausea?
  • Does the pain get worse when you clench your teeth?
  • Does stress make your clenching and pain worse?
  • Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  • Is it difficult or painful to open your mouth, eat or yawn?
  • Have you ever injured your neck, head or jaws?
  • Have you had problems (such as arthritis) with other joints?
  • Do you have teeth that no longer touch when you bite?
  • Do your teeth meet differently from time to time?
  • Is it hard to use your front teeth to bite or tear food?
  • Are your teeth sensitive, loose, broken or worn?

The more times you answered "yes," the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

Non-Surgical Treatment:

There are various treatment options that Dr. Evans can utilise to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Evans will determine the proper course of treatment. It is important to note that treatment often works best with a team approach of self-care joined with professional care.

The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with an intensive physiotherapy programme and an understanding of this condition.

Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:

  1. Resting your jaw
  2. Keeping your teeth apart when you are not swallowing or eating
  3. Eating soft foods
  4. Applying ice and heat
  5. Exercising your jaw
  6. Practicing good posture.

An appliance known as a MCI A splint or nightgaurd is sometimes recommended. It fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. An MCI helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces.

What about bite correction or surgery?

If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options such as arthroscopy and open joint surgery are sometimes needed but are generally reserved for severe cases. The joints are frequently investigated with CT scans and occasionally MRIs where symptoms are severe or pathology is suspected before a decision is made regarding arthroscopy or surgery.

Arthroscopy:

The temporomandibular joint can be examined arthroscopically. This involves a day stay general anaesthetic in hospital and the insertion of a very fine videoarthroscope into the jaw joint via a tiny puncture to allow careful investigation of the contents of the joint. It is also possible to carry out certain limited surgical procedures through the arthroscope.

Open Joint Surgery:

Where severe pathology exists, an open operation may be indicated. There is a range of procedures utilised encompassing simple joint exploration and debridement through to a joint reconstruction using grafted material such as muscle, dermis or cartilage. Where the pathology is very severe, it can become necessary to carry out a total joint replacement. This is frequently done using a custom device fabricated by TMJ Concepts in California. This usually involves a two stage procedure wherein the joint is removed and a silicone spacer inserted, post-operative scans are sent to the USA where a custom joint is fabricated on a biomodel, this is then inserted as a second stage procedure following which it is possible to function immediately. Occasionally a costochondral graft (rib) may be utilised but this operation is used less frequently these days due to the superior performance of custom devices. For further information on these devices, please go to the following website: www.tmjconcepts.com

Post-operative care following open TMJ surgery involves a significant amount of post-operative physiotherapy. Frequently a jaw exercising device called a “Therabite” is utilised to encourage patients to mobilise their joints following surgery.

  • Telephone (07) 839 1394

  • Radnor House, 170 Collingwood Street, Hamilton

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