Temporomandibular joint dysfunction or disorder


Temporomandibular joint dysfunction abbreviated to TMD or TMJD and also termed temporomandibular joint dysfunction syndrome, the temporomandibular disorder is defined as an umbrella term covering pain and dysfunction of the muscles of mastication and the temporomandibular joints.
There occurs pain with restriction of mandibular movement. TMJ disorder can cause pain in your jaw joint and in muscles that control jaw movement.

Age/sex group affected by Temporomandibular joint dysfunction or disorder

Individuals of any age can be affected by TMD depending upon the cause behind its occurrence.
Most affected people are in the 20-40 age groups. People suffering from TMD tend to be younger adults.

Races affected by Temporomandibular joint dysfunction or disorder

Individuals of any race can be affected by TMD.

Causes of Temporomandibular joint dysfunction or disorder

The definite cause of the temporomandibular joint disorder is not clear but doctors believe that symptoms arise from problems with the muscles of the jaw or with the parts of the joint itself.
Injury to temporomandibular joint, jaw or muscles of the head and neck such as a heavy blow or whiplash can cause TMD. Other possible causes include as following
• Dislocation of the soft cushion or disc between the ball and socket.
• The presence of osteoarthritis or rheumatoid arthritis in the temporomandibular joint.
• Grinding or clenching the teeth, which put a lot of pressure on the TMJ.
• Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth.

Temporomandibular joint dysfunction or disorder sign and symptoms

Sign and symptoms of temporomandibular joint dysfunction vary in their presentation.
The symptoms will usually involve more than one of the various components of mastication system, muscles, nerves, tendons, ligaments, bones, connective tissue and the teeth.
The three classically described cardinal signs and symptoms of TMD are as follows
• Pain and tenderness on palpitation in the muscles of mastication or of joint itself. Pain is the defining feature of TMD and is usually aggravated by manipulation or function such as when chewing, clenching or yawning and is often worse upon waking.
• The range of mandibular movements get limited, which will further cause difficulty in eating or even talking.
• There may occur locking of the jaw or stiffness in the muscles of the jaw and the joints especially present upon waking.
• During mandibular movement there occur noises from the joint, which may be intermittent. Noises may be described as clicking, popping or crepitus.

Other sign and symptoms are as follows
• A headache such as pain in the occipital region or the forehead, there are also present another type of facial pain including a migraine, tension headache or myofascial pain.
• Pain elsewhere such as the teeth, neck or shoulder.
• Tinnitus
• Dizziness
• Blinking
• Pain or feeling of pressure behind the eyes.

Investigations of Temporomandibular joint dysfunction or disorder

There are different criteria’s set to diagnose the case of temporomandibular joint dysfunction and are as follows
TMD diagnostic criteria are as follows
• Pain in the muscles of mastication
• Asymmetric mandibular movement with or without clicking.
• Limitation of mandibular movements
• Pain present for a minimum of three months.
Recurrent pain in one or more regions of the head or face fulfilling criteria C and D
X-ray, MRI or bone scintigraphy demonstrates TMJ disorder.

There is evidence that pain can be attributed to the TMJ disorder based at least one of the following:
• Pain is precipitated by jaw movements or chewing of hard and tough food
• Reduced range of or irregular jaw opening
• Noise from one or both temporomandibular joints during jaw movements.
• Tenderness of the joint capsule of one or both temporomandibular joints.
A headache resolves within 3 months and does not recur after successful treatment of the TMJ disorder.

Treatment of Temporomandibular joint dysfunction or disorder

Basic treatment for TMD is as follows
• Eat soft foods
• Apply moist heat or cold packs
• Take medications such NSAIDs to relieve muscle pain and swelling.
• Lower-level laser therapy
• Undergo corrective dental treatments
• Avoid extreme jaw movements
• Don’t rest your chin on your hand.
• Keep your teeth slightly apart
• Learning relaxation techniques
• Waer a splint or night guard

Other treatment ways for TMD are as follows
• Radio wave therapy
• Transcutaneous electrical nerve stimulation

Surgeries to be done for treating TMD are as follows
• Arthrocentesis
• Arthroscopy
• Open joint surgery

Complications of Temporomandibular joint dysfunction or disorder

• Chronic facial pain
• Alterations in dentition
• Malocclusion

Prognosis of Temporomandibular joint dysfunction or disorder

Symptoms of TMD slowly improve and resolve over time.

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