Temporomandibular joint is the bilateral joint that connects our skull and lower jaw bone namely mandible. It is the bilateral fibrous capsule between the temporal bone of the skull above and the head of the mandible below and hence named as temporomandibular joint. These joints are present on both sides of the jaw and functions simultaneously. It is a synovial joint which encloses the synovial fluid. The joint is structurally made up of ligaments, an outer capsule namely articular capsule that keeps the two bones intact and the inner synovial membrane that encloses the synovial fluid.
The temporomandibular joint is a hinge joint that allows the movement of the jaw in backward and forward direction in one plane and gliding motion of the occlusal jaw surfaces. It helps in mastication (pressure required while eating), food chewing, respiration, speech and mouth opening (normally 40-43mm). It also plays an important role in the growth of craniofacial structures. Interruption in these functions leads to the joint disorder and malfunction.
Temporomandibular joint disorder also known as temporomandibular joint pain dysfunction syndrome is pain and malfunction of the joint and muscles of the mastication and jaw movements.
How Long Does TMJ Disorder Last?
There are two types of Temporomandibular Joint disorder: Acute and Chronic
Acute TMJ disorders lasts for approximately 3 months or less and will present acute symptoms; whereas, the chronic temporomandibular joint disorder lasts for more than 3 months and is associated with all the symptoms as described above. Chronic TMJ disorders is more common than acute presentation and may require secondary care.
Can TMJ Disorder Go Away On Its Own?
Many people suffering from joint pain and irritation due to stressful conditions or emotional imbalance like depression, anxiety, may experience teeth grinding, and inflammation of TMJ. Each individual has his own causes and trigger factors; hence, it is difficult to predict the root cause of the TMJ disorders.
Such episodes of TMJ pain may subside on its own within few days or weeks post the elimination of trigger factors or once the stressful conditions are managed; however, the symptoms of TMJ disorders might show episodes of recurrence. It is advisable to understand the root cause and undergo proper management therapy to improve the quality of life.
Causes of TMJ Disorder
TMJ or Temporomandibular joint disorder may be associated with various causes. The most common cause of TMJ disorder or pain is myofascial pain dysfunction syndrome that occurs due to malfunction of muscles of mastication.
Other common causes of TMJ disorder are:
- TMJ ankyloses
- Internal disc displacement
- Injury to the joint during a dental or any facial surgical procedure
- Inflammatory disorders like Osteoarthritis of TMJ which is degenerative in nature, Rheumatoid arthritis, Temporal bone arthritis, inflammation of the synovial joint, capsulitis, myositis etc.
- Traumatic injury to the joints causing fracture, mandible dislocation, subluxation.
- Congenital disorders like Aplasia (defective development) of mandible, aplasia of cranial bones, hypoplasia (bone undergrowth) of facial and skull bones, dysplasia (abnormal bone growth) of mandible or temporal bone.
- Temporomandibular disorder also known as temporomandibular joint pain dysfunction syndrome is an idiopathic disorder (causes is unknown) and is very prevalent all over the world.
Symptoms of TMJ Disorder
Pain during the palpation of muscles of mastication or at the joint itself. The pain is located nearly in the area anterior to the ear hence termed as preauricular pain and is the classic characteristic of the disorder.
- Pain aggravates when muscles begin to function like chewing, clenching, yawning and is mostly seen to be worse after waking up.
- Pain is dull aching in nature, occurs intermittently and not constant in occurrence.
- Limited range of mouth movements
- Jaw locking
- Stiffness in joint
- Clicking sound while opening mouth and bruxism (clenching of teeth).
Other symptoms are:
- Headache and migraine
- Loss of hearing
- Radiating pain in neck, shoulders and back
- Facial muscle pain
- Emotional stress and anxiety
- Depression and aggressive reaction
- Sleep deprived nights.
Management of TMJ Disorder
TMJ disorder is best managed by medications. It is more effective than surgical or dental intervention. Management of TMJ disorder includes:
- Analgesics, benzodiazepines like Clonazepam, Diazepam etc, Anti-convulsant like Gabapentin, muscle relaxants, NSAIDs (non-steroidal anti-inflammatory drugs) like Diclofenac, Naproxen etc are very helpful.
- Botulinum toxin is used treat the pain.
- Physiotherapy is combined along with the medications to improve the range of jaw movements. Patients are instructed to perform some at-home jaw exercises.
- Occlusal jaw correction can be performed by restorative dental procedures, orthognathic surgeries and other orthodontic procedures to improve the mastication and chewing functions.
- Acupuncture is also helpful in reducing muscle pain.
- Chiropractic treatments help in headaches and radiating pain management.
Since TMJ disorder is associated with psychological factors like anxiety, depression and stress, Cognitive Behavioral therapy is seen to be effective as an adjuvant therapy. Relaxation exercises such as yoga, meditation etc. are also very useful.