Pain in the temporomandibular joint (TMJ) - treatment in St. Petersburg at an affordable price in the clinics of the Medica holding company

There are two main types of TMJ dysfunction:

Myogenic (source: muscle pain);
Arthrogenic (associated with TMJ condition).

Myogenic TMJ dysfunction usually occurs due to fatigue or tension in the masseter or accessory muscles. Leads to facial pain, headaches, and sometimes neck pain.

Arthrogenic dysfunction of the TMJ, as a rule, is the result of inflammation, degenerative changes in hard and soft tissues in the joint. It most often occurs due to capsulitis or synoviitis (inflammation), slipped discs, and degenerative arthritis.

Symptoms of arthrosis of the jaw joint and diagnosis of the disease

The first signs of the disease usually appear between the ages of 32 and 50 years. If the patient is well informed about the symptoms and treatment of arthrosis of the jaw joint, the disease can be recognized in its infancy.

Symptoms of arthrosis of the jaw - a reminder for self-diagnosis!

You should be alert to the following changes:

regular clicking in the joint when moving the lower jaw - the crunching seems to “send to the head”;
limited mobility - for example, when yawning, the mouth does not open as wide as before;
deterioration of hearing - sounds become muffled, the ears are often blocked, a characteristic noise is heard (as if a seashell was applied to the ear), deafness develops over time;
blurred vision, which is usually accompanied by pain in the eye from the affected joint;
pressing and bursting headaches, especially in the temporal, parotid-masticatory region;
frequent cramps, usually painful;
nasal congestion;
dizziness and other problems with the vestibular system;
abnormalities in the functioning of the salivary glands (usually dry mouth);
facial asymmetry that has not been observed before - caused by misalignment of the jaw, the formation of bone spurs or swelling of the joint;
fatigue when chewing food, discomfort when chewing hard and tough foods;
morning stiffness in the jaw joint;
decreased facial expression and difficulty swallowing food;
increasing pain in the joint;
toothache and tooth wear;
numbness of the skin or mucous membranes near the affected joint;
a feeling of “jumps” in the joint - sometimes even noticeable from the outside.

Acute piercing pain with arthrosis of the jaw joint can radiate to the ear, temple or back teeth on the affected side. However, more often patients suffer from a dull, aching pain in the jaw. In old age, pain due to arthrosis of the lower jaw may be absent, giving way to aches (including when the weather changes), heaviness and discomfort in the joint.

Medical diagnosis of arthrosis of the jaw

When diagnosing arthrosis of the lower jaw, the doctor uses X-rays to determine the type of changes in the joint - sclerotic (replacement of normal bone tissue with abnormal one) or deformational (associated with bone abrasion or the growth of bone growths - osteophytes).

Also, x-ray examination allows us to determine the stage of arthrosis of the facial jaw:

1st - onset of the disease without significant changes in the bone;

2nd - destruction of the articular head with noticeable signs of the recovery process;

3rd - pronounced growth of bone tissue, which prevents movement in the joint;

4th - complete immobility of the jaw due to the fact that the elements of the joint are not consistent with each other.

In addition to x-rays of the jaws, the doctor may prescribe a general blood and urine test, a biochemical blood test, zonography of the affected joint, or diagnostic arthroscopy.

Between the onset of the disease and its final stage, 20-30 years may pass, or maybe 6-12 months. Do not ignore the first symptoms of arthrosis of the jaw joint. Arthrosis of the jaw is completely reversible only at the 1st stage!

Factors that provoke the development of TMJ dysfunction:

Injury

Injury or overstrain of the jaw, or the habit of clenching the jaw tightly can injure the joint. Long-term dental procedures (or those in which the doctor uses force) and some other medical interventions can also lead to injury to the TMJ.

Wrong habits

Clenching teeth, clenching the jaw, grinding teeth (bruxism), biting lips or nails, chewing gum.

Malocclusion

At first, dentists generally considered this pathology as the main cause of TMJ dysfunction. But recent studies have shown that malocclusion, with rare exceptions, does not lead to such a disease.

Psychological factors

Many patients say that symptoms of TMJ dysfunction appeared (or worsened) due to stress, depression, or psychological trauma.

Temporomandibular joint diseases

Some types of arthritis can affect the TMJ (as well as other joints). For example, this sometimes happens with rheumatoid arthritis and systemic lupus erythematosus. Many other diseases (Parkinson's disease, myasthenia gravis, strokes, amyotrophic lateral sclerosis, etc.) can also lead to uncontrolled movements of the masticatory muscles.

Pain in the temporomandibular joint

Temporomandibular joint dysfunction (TMJ) is one of the most common causes of facial pain and is often incorrectly referred to as temporomandibular dysfunction. There are 2 main types of TMJ dysfunction: myogenic (the source of muscle pain) and arthrogenic (the source of pain is the TMJ). Understanding TMJ Dysfunction

This disorder involves the presence of the following symptoms: - pain or discomfort in or around the ear, TMJ and/or muscles of the jaw, face, temple area and neck on one or both sides.
Pain can occur unexpectedly and increase in frequency and intensity over months and years. Mouth opening with a click, crepitus, closing, restriction of opening or deviation of the lower jaw during movement, difficulty chewing, and headache are also associated with TMJ. Structure of the TMJ The
temporomandibular joint, or TMJ, is a freely rotating and sliding joint, covered with fibrocartilage, a football-shaped ball (condyle), a fibrous pad (disc), a bone socket for the pad (fossa), ligaments, tendons, blood vessels and nerves.
The disc functions as a moving shock absorber and stabilizer between the condyle and fossa. When the jaw opens, the condyle normally rotates first and then slides forward within the fossa with a disc located between the condyle and the fossa. Muscles of mastication
Muscles attached to the lower, upper jaw, skull and neck.
The muscles of mastication open, close, extend, and move your jaw, allowing you to speak, chew, and swallow. The accessory muscles of mastication (neck and shoulder muscles) stabilize the skull on the neck during chewing. Myogenic TMJ dysfunction (muscle-related)
Typically occurs due to overuse, fatigue, or tension in the masseter or accessory muscles, resulting in facial pain, headaches, and sometimes neck pain.
Arthrogenic TMJ dysfunction (joint-related)
Typically results from inflammation and degenerative changes in the hard and soft tissues of the joint.
Capsulitis or synovitis (inflammation), slipped disc (also called internal injury) and degenerative arthritis are the most common causes of TMJ dysfunction. Causes of TMJ Dysfunction The exact causes of TMJ
dysfunction are still unclear.
It is believed that the development of dysfunction is due to a combination of several severe factors, including injury and joint disease. Teeth clenching and grinding (bruxism), as well as tension in the neck and head muscles, are currently not proven causes of TMJ dysfunction, but they can aggravate the symptoms of this disease and must be taken into account in the treatment and management of patients with this pathology. It is important for patients with this dysfunction to understand that this disease can be chronic and can be very dependent on many factors, including emotional stability. Because there is no quick fix or emergency treatment for TMJ, the most successful and expert-supported treatments focus on self-monitoring and managing aggravating symptoms. Factors Associated with TMJ Dysfunction
- Trauma: Direct trauma to the jaw is associated with symptoms of dysfunction.
Direct trauma to the jaw can occur from a blow to the jaw, hyperextension (strain) of the jaw, and in some cases, compression of the jaw. Prolonged or forceful dental procedures, intubation during general anesthesia, and surgical procedures of the mouth, throat, and upper gastrointestinal tract (esophagus and stomach) can injure the TMJ. — Incorrect habits: Habits such as clenching teeth, clenching the jaw, grinding teeth (bruxism), biting lips or nails, chewing gum, and placing the jaw in abnormal positions are common. In relation to them, evidence of their involvement in the development of dysfunction has not been proven. Such habits are often associated with TMJ dysfunction and can contribute to the emergence of factors that translate into a chronic form and aggravate the existing symptoms of the pathology. — Occlusion: Dental occlusion refers to the way the teeth fit together or “bite.” Historically, dentists have viewed malocclusion as the primary cause of TMJ dysfunction. Recent studies have shown that malocclusion does not usually lead to this group of diseases, with the exception of a few cases. Each situation must be considered individually so that the doctor can make a differential diagnosis of facial pain. — Psychological factors: Many patients with TMJ dysfunction say that the onset of symptoms of the disease or worsening of its course is accompanied by an increase in emotional stress and psychological imbalance, leading to depression or anxiety. Scientific research shows that many patients with this dysfunction experience varying levels of depression and anxiety, and these levels are higher than those without this dysfunction. To date, it has not been established whether symptoms of depression or anxiety are present before the onset of TMJ dysfunction and then contribute to its formation, or whether chronic pain associated with this pathological condition leads to the formation of anxiety and depression. Many patients begin to clench and grind their teeth more frequently and intensely when they experience emotional stress, psychological imbalance, or pain. — Disorders of the temporomandibular joint: Some types of arthritis can lead to damage to the TMJ, as well as other joints. This is common in osteoarthritis developing in the aging population. Many other diseases, such as Parkinson's disease, myasthenia gravis, strokes, amyotrophic lateral sclerosis, can lead to excessive or uncontrolled movements of the masticatory muscles. — Other factors: Drug use and some prescribed medications can affect the central nervous system and muscles, and lead to TMJ dysfunction. Diagnosis of TMJ dysfunction.
Diagnosis of this disease should be part of routine practice among general practitioners and dentists.
A short set of diagnostic procedures may include: - History of the disease: complaints of pain in the jaw, headaches, neck pain, discomfort in the TMJ area, jaw closing, clenching of teeth, damage to the jaw, head, neck, as well as a history of cases of TMJ dysfunction or treatment of facial pain. - Objective examination: may include measurement of jaw opening, combined movements, jaw deviation during opening, palpation (finger pressure required) of the joint, jaw, head and neck muscles to determine pressure points and the presence of crepitus. It is also necessary to evaluate the gums, soft tissues of the mouth, teeth and make notes about the disease, the presence of dental lesions, as well as the symmetry of the jaw, face and head. If any abnormalities are found during the examination, a more detailed history should be collected and a more in-depth examination performed. Comprehensive assessment of TMJ dysfunction A comprehensive assessment may include:
- A complete analysis of all symptoms related to TMJ, head, neck, medical history, dental history, life history, heredity, psychological history.
— Comprehensive objective examination of the face, cervical spine, masticatory muscles, head and neck, neurological structures, teeth, gums, hard and soft tissues of the oral cavity. — Psychological history, including a short survey and testing. — Additional tests, including x-rays and imaging tests, biopsies, blood tests, urine tests, neurological tests, diagnostic injections. Treatment of TMJ dysfunction
Since there is no known cure for this pathology, the management of patients with symptoms of dysfunction is similar to the management of patients with other orthopedic or rheumatological disorders.
The goals of managing this group of patients are: reducing pain, adverse pressure and stress on the jaws, restoring jaw function, implementing a well-planned management program to treat the physical, emotional and psychological aspects. Management options and sequence of treatment for TMJ dysfunction are similar to other musculoskeletal diseases. As with many musculoskeletal disorders, the signs and symptoms of TMJ can be temporary and resolve on their own without developing serious long-term consequences. For these reasons, it is particularly important to try to avoid aggressive and irreversible treatment options such as surgery, major dental surgery or orthodontic treatment. Conservative management techniques include changes in behavioral habits, physical activity, medications, jaw exercises, and orthopedic devices. All of them have been found to be safe and effective treatments for cases of TMJ dysfunction. Most patients suffering from this disease achieve long-term remission with conservative therapy. Scientific studies show that in more than 50% of such patients, only a few symptoms persist or disappear completely. Self-monitoring of patients should include: - Limited jaw opening (no more than 2 fingers wide). — It is necessary to give your jaws a rest, avoiding prolonged chewing (chewing gum, bagels, tough meats). - Avoiding grinding and clenching of teeth by relaxing the jaw area and keeping the upper and lower rows of teeth at a distance. - Avoiding leaning or sleeping with the jaw resting. — Avoiding pushing movements with the tongue and chewing non-food items (nails, pens, pencils, etc.), stress, pressure on the jaw. - Use of cold, ice or moist-warm compresses, as prescribed by the attending physician or therapist. — Performing a massage of the affected muscles. - Perform gentle, limited jaw exercises as prescribed by your healthcare professional. — Use of medications as prescribed by the attending physician. Treatment options.
— Orthotics: You may be offered a brace (or a retainer known as a night watchman) that fits over your upper and lower rows of teeth.
The retainer has many different purposes, and it can be worn either constantly or part of the time, it all depends on the prescription of the attending physician. In most cases, retainers are used to separate rows of teeth, realign jaw joints, and help jaws relax. The unique style and adjustment of the brace will depend on your condition, how it changes while you wear the brace, and your overall treatment plan. Managing patients under stress.
One of the goals of treating TMJ dysfunction is to identify therapy for daily stress.
Your doctor may recommend several options for you to do this. These options include: biofeedback (biofeedback), breathing for relaxation, image management, and sometimes, referral to a specialist. Physiotherapy.
Physical therapists are specially trained professionals who assist in the rehabilitation of all types of physical injuries.
There are many treatment options that can help. These include: jaw exercises, posture training, ultrasound, electrical stimulation and mobilization. Your doctor and physical therapist will work together to formulate your treatment plan. Correcting your bite
Sometimes it is necessary to improve the way your teeth fit together.
This can be achieved in various ways. Orthodontics, usually with braces, will help move the teeth so they fit together better. In some cases, when the jaws themselves are not misaligned, they are corrected by a combination of treatment by an orthodontist and an oral surgeon. This is called orthognathic surgery. Correction of the bite occurs through the intensive work of the dentist, with the installation of crowns, bridges, and, if necessary, implants. This is done to replace missing teeth or to change the size and shape of teeth so that they fit together and function more harmoniously with the jaws and muscles. Surgery is sometimes performed to repair or reconstruct the jaws when conservative treatment fails to achieve comfort and good function. Surgery is rarely necessary, but it can be performed to remove debris that may have accumulated in the joint cavity, to repair damaged tissue, or even to replace the entire jaw, such as other joints (knees, hips, and shoulders). Conclusions
Extensive research is now being conducted to determine the safety and effectiveness of treatments for TMJ dysfunction/orofacial pain syndrome. Many researchers and clinicians advocate reversal and conservative treatment of dysfunction. Even when the symptoms of this dysfunction persist for a long time and are pronounced, many patients with this pathology do not require invasive treatment. Treatments designed to change the bite or reposition the jaws through orthodontic or dental reconstructive procedures are usually not necessary. And if they are used, then only when absolutely necessary. If permanent treatment is being considered for TMJ dysfunction or orofacial pain, we recommend seeking a second opinion. Specially trained dentists, physical therapists, psychologists and clinicians are often the best source of correct diagnosis and further management of this group of patients.

Exercises for the temporomandibular joint

Symptoms of TMJ arthritis

Depending on the cause of the disease and the nature of the inflammation, arthritis manifests itself with the following symptoms:

sharp pain when moving the jaw. Increases in opening/closing of the mouth, strongly radiates to the temple, back of the head, tongue;
when you try to open your mouth wider, the jaw moves to the side;
inability to close teeth tightly;
hearing loss, dizziness;
crunching when moving the jaw.

If at least 2 signs are detected, we recommend that you do not wait for the consequences, but contact the dentist. Correct diagnosis ensures the necessary treatment and recovery in a short time. In the later stages, the dentist will not help. And treatment will cost much more.

If you have a problem similar to that described in this article, be sure to contact our specialists. Don't diagnose yourself!
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