TEMPOROMANDIBULAR JOINT DISORDER (TMJ)
Temporomandibular joint disorder (TMJ) is defined by an aching in the chewing muscles of the jaw. It is often associated with limitations in the ability to move the jaw as well as with clicking or popping sounds in the jaw. The pain generally occurs around the temporomandibular joint in the jaw, the sides of the face and head, the back of the head and the neck and shoulders. The pain is usually described as intermittent, dull and aching, but can sometimes be constant. The pain is often made worse by chewing hard food or by yawning. Symptoms can continue for years. Some patients feel their jaw does not move correctly when opening or closing the mouth. Their teeth may not meet when the mouth is closed as well.
Careful examination of the mouth and dental structures is usually undertaken as a first step. Additionally, careful examination of the muscular structures at the sides and back of the head, neck and shoulders helps to determine the extent of the problem. X-rays of the temporomandibular joint are sometimes used. MRI examinations can give additional detail and show if there is displacement of the disk or arthritis in the temporomandibular joint itself. Other diseases including rheumatoid arthritis, inflammation of the arteries at the sides of the head, infections and tumors can also cause these symptoms. Appropriate tests for these diseases are undertaken as necessary.
Treatment of temporomandibular joint dysfunction (TMJ) often involves a team of specialists for best results. Dental specialists help with splints applied in the mouth. Injections of anesthetic medications around the muscles over the joint can be helpful in reducing the pain from TMJ dysfunction. Nerve block treatments to help reduce pain in regions of the head, neck and shoulders related to this disorder are also helpful in long-term treatment. Physical therapy methods to reduce muscle irritability in the jaw as well as in the neck and shoulders are also useful treatments for TMJ dysfunction. The utilization of biofeedback training and relaxation therapy in conjunction with these other measures can provide additional relief in selected patients.