TMJ Disorders

TMJ (temporomandibular joint) is a commonly used term to describe a multitude of temporomandibular joint and muscle disorders. There are several treatment options for this condition but it depends on the predominant cause and the severity of the disease or symptoms.

The TMJ is a complex and unique joint that performs two types of movements.  The bimodal joint initially rotates like a hinge. This accounts for the initial 20mm of jaw opening. The joint then translates or slides in order to open further. Normal function of these movements requires an intricate relationship of the joint muscles, as well as the internal components of the joint.  The internal components of the joint include a cartilaginous disk and the articulating bone of the mandible and skull base. I like to separate TMJ disorders into either muscle or internal causes. It must be noted that some patients have disorders of both.

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Muscle disfunction

There are 4 primary muscles that control the function of the jaw.  There are many conditions that can cause pain and dysfunction of these muscles. In Dr. Strawn‘s clinical experience, muscle dysfunction is the most common source of pain in patients who have been diagnosed with “TMJ”. These patients frequently experience headaches with pain and soreness along the lower part of the face that causes difficulty with opening. 

Types of Jaw Pain:

  • Myalgias: dull persistent ache of the head, neck, ear, teeth; difficulty opening; excessive fatigue and stiffness of the jaw
  • Myospasms: sudden severe pain in jaw with severe muscle contraction that results in difficulty opening
  • Bruxism: severe wear of the teeth, TMJ pain, tension type headaches

Internal TMJ dysfunction

These causes are direct pathologic conditions affecting the joint. They include conditions that affect the bones of the joint and/or the cartilaginous disk contained within the joint.

Signs of issues with the bone or disk of the TMJ:

  • Persistent pain in front of the ears,
  • severe difficulty opening jaw,
  • pain with chewing,
  • clicking or locking of jaw

Causes of TMJ:

  • Bruxism
  • Disruption in position of the cartilage disc
  • Connective tissue disorders
  • Congenital malformation
  • Arthritis (OA, RA, inflammatory)
  • Trauma

Treatment of TMJ

  • Joint rest
  • Soft food diet
  • Heat packs and massage techniques
  • Physical therapy
  • Medications – anti inflammatory, muscle relaxants
  • Occlusal splint, night guard
  • Botox

Signs You May Need Surgical Treatment

  • Inability to open or close the mouth
  • compromised eating secondary to jaw pain and/or immobility
  • TMJ destruction from trauma or disease
  • facial deformity from congenital TMJ issues

Signs You May Not Need A Surgical Treatment Option:

  • symptoms respond to non-surgical treatment
  • normal jaw range of motion
  • inconsistent symptoms
  • muscle pain is deemed primary cause

Types of Jaw Surgery:

  • TMJ Arthrocentesis: this is a common first line of surgical treatment. It is minimally invasive and very effective.
  • Corrective Jaw Surgery: this procedure can be helpful when the patient has an underlying skeletal deformity that has affected the appearance of the face in addition to the function of the TMJ
  • Total Joint Replacement: this surgery is reserved for the most severe cases

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Contact our office today to schedule an appointment!

Maui Facial and Dental Surgery Phone Number (808) 242-0077 Book Online