TMJ stands for temporomandibular joint. The TMJ is the joint that connects your jawbone to your skull. You have one on both sides of your face. Your jaw joint acts as a hinge that allows you to open and close your mouth and move your jaw side to side. The TMJ is just like every other joint in your body. It has ligaments, muscles, and tendons. The TMJ also has a disc that contains synovial fluid, which is crucial for the proper function of the jaw joint.
You may not always think about your jaw joint, but when it’s not working properly it can cause a lot of pain. When your jaw joint is damaged or misaligned, it is known as a TMJ disorder. Pain in your TMJ can happen for a number of different reasons, including arthritis, injuries, and even stress. Poor jaw alignment and teeth grinding can also cause issues with your jaw joint.
Symptoms of TMJ Disorders
TMJ disorders can often go undiagnosed or misdiagnosed for years because many of the symptoms associated with the TMJ are seen in other conditions. It’s important to have a thorough diagnosis to make sure you get the proper treatment. If you have one or more of the following symptoms, you may want to talk to your doctor about TMJ disorders:
- Jaw pain
- Clicking and popping in the jaw
- Difficulty chewing and opening your mouth
- Frequent headaches
Ear pain is another common symptom of TMJ disorders. A lot of our TMJ patients are referred to us from the ENT after they thought they had an ear infection. The nerves that surround the TMJ are many of the same sensory nerves that supply the ear with sensation as well. So, when there is an injury or damage to the TMJ it can feel like an ear infection. Many physicians assume that the ear is hurting because of pressure in the ear when really it’s because of issues in the jaw. Of course, if you have ear pain an infection is a possibility. But if you have been treated for ear infections without any relief, it may be time to consider taking a look at your jaw joint.
How We Diagnose TMJ Disorders
Your jaw joint is a very complex system. This complexity can make it difficult to diagnose properly. When you come to PRECiDENT with jaw pain we will thoroughly evaluate your jaw. We want to look at every part of your jaw. When we’re evaluating you for TMJ disorders we’re not just looking at the joint itself. We want to look at the whole system. We’re asking questions like:
- What do the ligaments look like?
- What do the muscles look like?
- How is your joint moving?
We take a comprehensive, orthopedic approach to diagnosing TMJ disorders. The TMJ is similar to other joints in the body like the knee or the hip, and it’s important to keep that in mind when evaluating patients with jaw pain. A thorough diagnosis is crucial for offering the best treatment possible. It’s not enough to simply provide pain management for TMJ pain. We want to find solutions for you that last long term.
The Diagnostic Process
We’ll start by getting some information about your medical history. Medical conditions such as arthritis or past injuries can help us understand more about what is going on with your jaw. We also want to know about things like mouth breathing while you sleep or a bad bite so we can address those issues while we’re evaluating your TMJ. Any information on orthodontic or previous dental work will be helpful as well. Sometimes adjustments to your bite or other dental procedures can have an effect on your jaw joint. The more information you can provide about your symptoms and medical history, the easier it will be for us to understand the underlying problem.
The next step in the diagnosis process is the physical exam. We’ll look for any sign of misalignment by feeling your jaw while you open and close it. We’ll also listen for any popping or clicking sounds.
After reviewing your medical history and examining your jaw joint, we may need to get a better look at what’s going on in the jaw joint. So, we may need to get an X-Ray, CT scan, or MRI. These scans will give us a better picture of what is actually happening with your jaw joint.
Treatment Options for TMJ Disorders
The treatment for a TMJ disorder depends on what is causing it. That’s why we take so much time evaluating your jaw joint before offering treatment options. When the diagnostic process is rushed, physicians end up prescribing treatments that don’t help the patient. They manage the pain and symptoms instead of treating the underlying cause.
For mild cases of TMJ disorders, symptom management may be a viable, non-surgical treatment option. In those cases, we recommend various combinations of the following:
Keep in mind, your jaw joint is similar to the other joints in the body. When you hurt your knee or your hip your doctor will usually tell you to stay off of it for a while to let it heal. Your TMJ is no different. If your TMJ is damaged in any way it’s important to rest it. We usually recommend going on a soft diet for a while to see if that helps your pain at all.
Ever wear a knee wrap or brace? Depending on the case, your surgeon may prescribe a bite splint that acts in a similar way, by supporting your jaw in its correct position relative to the joint. This can reduce pain and further damage. Some patients respond well to this mouthpiece, relieved from pain and symptoms for months or years, before needing to take additional measures.
Anti-inflammatory medications, such as ibuprofen, can also be very helpful in the management of pain in the joint. Heat and/or ice are another option to help reduce inflammation and stress on the jaw.
Treatment for More Severe TMJ Disorders
In more severe cases, the only lasting treatment for a TMJ disorder is surgery. Of course, all surgery has risks, so your surgeon at PRECiDENT will carefully consider all other options, first. If surgery is necessary for optimal health, then your surgeon will review all of your health history and risk factors to minimize any risks for your best outcome. Again, at PRECiDENT, we take an orthopedic approach to these surgeries, since the TMJ is a ball-and-socket joint, like a knee, hip, or shoulder. Depending on your particular case, your surgeon may recommend one or a combination of the following:
If your disc is malpositioned or “slipped” from the top of your jaw, inside the joint, it will not provide the proper cushioning and lubrication to the joint and bone. In that instance, your surgeon may perform an “arthroplasty.” This is a technique in which the surgeon makes a small incision just behind your jaw joint and repositions your disc.
If your surgeon finds that you have ligament damage, this can be repaired as well. At PRECiDENT, our surgeons’ approach is to use MITEK anchors, which will give stability back to the joint while allowing for optimal flexibility for eating, chewing, and talking (without that pain you may be experiencing now!) after healing.
In some of the most severe cases where the disc and ligaments have been damaged beyond repair and the bone in the joint has started to degenerate (such as with arthritis, for example), or has been broken or crushed (such as after a trauma to the facial bones), it may be necessary to have your joint replaced. Advancements in this type of surgery have allowed for a customized joint replacement that has superior and lasting results.
Our TMJ Specialists Are Here for You
Our goal at PRECiDENT is always to make sure we find solutions that really work for our patients. We know that living with the pain of TMJ disorders can be frustrating and painful and can get in the way of your life. That’s why we take so much time working with you to understand what is going on with your jaw joint. If you are tired of dealing with the pain of a damaged jaw joint, our TMJ specialists are here to help you find relief. Schedule a consultation today and we will help you get started on the path to a pain-free life.