A sharp bolt of pain that travels through your jaw after eating a hard apple or a granola bar. The inability to open or close your mouth after waking up in the morning. These are both signs of a TMJ disorder which affects the Temporomandibular Joint that allows you to move your jaw up, down, right and left. If you’re wondering if you are one of the 10 million Americans suffering from a TMJ disorder, then you may be wondering what to expect for a next step. The thing about TMJ disorders is that they aren’t just an annoyance that impedes on your day-to-day life, they can make things like eating and talking increasingly painful and debilitating for sufferers.
What is the Temporomandibular Joint?
If you move your jaw around and feel the space in front of your ears, you can probably feel the muscle in there shifting. This is your TMJ, which connects your lower jaw (the mandible) to your skull (the temporal bone, to be exact). There are also other muscles that are attached to the jaw joint that help control the movement of your jaw.
Warning Signs to Look Out For
If you suffer from the following symptoms, or have noticed them getting increasingly worse, you may want to consult a dentist or an oral surgeon for a diagnosis:
- Stiff jaw muscles
- Pain or tenderness in the jaw area, jaw muscles, neck and shoulders, or face
- Pain or Tenderness near your ears while eating or talking
- Locked jaw that limits movement and gets mouth “stuck” in the open or closed position
- Clicking, popping, or grating in the jaw joint that is painful (or not) when eating, talking, or opening your mouth
- Upper and lower teeth don’t fit together as well as they used to; an uncomfortable or ineffective bite
- Face feels tired
- Pain on one side or both sides of the face
- Dizziness, headaches, earaches, hearing problems
Potential Causes of TMJ Disorders
In general, the two root causes of TMJ disorder symptoms can be placed into one of two categories: muscle spasms, which cause problems that revolve around pain and tightness of the jaw, or problems with the actual joint itself, like when a disk moves out of place. TMJ disorders can be caused by different things:
- A car accident in which the patient suffered whiplash or a heavy blow to the head, neck, face or jaw.
- Grinding teeth due to stress
- Presence of osteoarthritis or rheumatoid arthritis
- Dislocation of the cushion or disc between the ball and socket joint.
What to Do Next
People who experience these systems are smart to seek out the advice of their dentist or oral surgeon. Oral surgeons will familiarize themselves with the patient’s medical history and do an examination of the jaw, neck, head, teeth, and face before making a diagnosis. Because the symptoms of a TMJ disorder are similar to other maladies like toothaches or earaches, it’s important for a dentist and/or an oral surgeon to do a thorough examination. Sometimes, an X-ray, MRI or CAT scan is ordered to examine the joint in further detail. Usually, patients who have self-diagnosed themselves with severe symptoms like a locking jaw, go straight to an oral surgeon.
There are many treatment options that will temporarily relieve symptoms for patients that don’t involve surgery. Some examples of non-surgical treatment options are:
- Using heat or ice packs to help with pain. If you hold an ice pack to each side of your face for ten minutes, do some jaw stretches, then apply a hot pack, you can stave off symptoms.
- A preventative treatment such as eating softer foods can help as well. Foods like yogurt, fish, mashed potatoes, soup, and scrambled eggs are just a few options. If needed, patients should cut food into smaller pieces in order to reduce chewing time and avoid crunchy or chewy foods like pretzels or caramel.
- Bite splints or mouth guards are thin plastic guards that are fitted over upper and lower teeth to protect them from grinding together. They can also correct your bite by allowing your teeth to come together in the most correct way.
- Physical therapy
- Drug therapy includes prescriptions for muscle relaxants or over-the-counter anti-inflammatory medicines like ibuprofen. Antianxiety medications or low doses of antidepressant medications can reduce stress
Non-surgical treatments do a good job of controlling the symptoms, but in some cases surgery is the best option. Perhaps the patient has already exhausted all of the non-surgical treatment options and hasn’t gotten results, or they have a severe case that requires immediate surgery. In cases of rheumatoid arthritis or cancer, surgery is the most effective option. It’s important to consider surgery only if the right circumstances call for it. Surgical treatments for TMJ disorders include the following:
- Arthrocentesis is a minimally-invasive in office or outpatient procedure. It’s usually used in cases of sudden-onset closed-lock cases in which the patient can’t open his or her mouth. The purpose of TMJ arthrocentesis is to lubricate the joint, loosen scar tissue, reduce inflammation, and improve range of motion.
- Arthroscopic surgery, an outpatient procedure done under general anesthesia. A small incision is made in front of the ear and using a very small and thin scope for the surgeon to visualize the joint and any abnormalities. If necessary, the surgeon can opt to remove inflamed tissue or move the disc to realign it.
- Arthroplasty surgery, an inpatient surgery done under general anesthesia, typically requiring one night in the hospital. An incision along the ear is made to expose the joint, allowing for the removal of adhesions, bone spurs, tumors, etc. The surgeon can also repair discs, suturing them into place or implanting a graft. There are varioous types of arthroplasties, including disc repositioning, tissue grafts, and disc removal.
- Total Joint Replacement surgery is an inpatient procedure performed under general anesthesia, where the patient’s natural temporomandibular joints are removed and prostheses are placed. There are a variety of different types of open-joint surgeries. These types of surgeries are often needed if the bone of the jaw joint is deteriorating, there are tumors present on or around the TMJ, or if there is severe scarring or bone chips present in the TMJ.
Austin Oral Surgery is comprised of a surgical team that is well-trained in every aspect of TMJ surgery. Contact us today to schedule an appointment.