Arthrosis of the jaw joint: symptoms and treatment

The human jaw joint is quite complex, because we can move the jaw back and forth, left and right, and even in a circle. This process involves not only the articular fossa and the head of the lower jaw, but also the meniscus, capsule and ligaments of the joint. Therefore, arthrosis of the jaw joint leads to a whole complex of disorders associated with degeneration and destruction of articular cartilage. These include digestive diseases (due to insufficient production of saliva and poor quality of chewing food), accelerated tooth wear, problems with vision and hearing, frequent migraines, slurred speech, as well as psychological problems (depression and others).

Let's figure out what arthrosis of the jaw joint is, whether it can be avoided and how to treat it correctly.

Causes and prevention of arthrosis of the facial jaw

Based on the reasons for their occurrence, it is customary to distinguish between primary and secondary arthrosis of the jaw. The first are typical for older people (50-60 years and older) and are not associated with pathologies of the joints or dentofacial apparatus. The latter occur against the background of other disorders - for example, injury, infection, metabolic disease.

Let us consider the causes of arthrosis of the jaw joint in more detail:

infectious disease (acute or chronic, for example, tonsillitis);
sports or household injury (dislocation or subluxation of the jaw joint, bruise, jaw fracture);
systematic overload (for example, when crunching nuts or intense exercise in the gym);
dental diseases (absence of a tooth or part of it, “gentle” chewing on one side due to a dental problem);
bruxism (unconscious grinding of teeth, usually during sleep), stress, high mental stress, mental disorders and nervous tics;
diseases of the cardiovascular system;
endocrine and metabolic diseases (gout, diabetes, hormonal imbalance);
congenital anomalies of the dentofacial apparatus (including malocclusion), in which the load is distributed incorrectly;
genetic diseases of muscle and cartilage tissue (scapulohumeral-facial muscular dystrophy, collagenopathies, as well as systemic lupus erythematosus and other autoimmune diseases);
age-related changes (both senile and hormonal - for example, with menopause).

Often, arthrosis of the facial jaw (or temporomandibular joint - TMJ) begins due to a violation of occlusion - i.e., contact of teeth and functions of the masticatory muscles (with loss of a tooth, tumor or inflammation of the muscle muscles, lesions of the facial and trigeminal nerves). Therefore, in order to prevent arthrosis of the jaw joint, it is important to promptly replace chewing teeth with prosthetics, eliminate inflammation of the gums and dental pulp, and also treat under-erupted wisdom teeth. Do not ignore innervation disorders and muscle injuries due to stroke, surgery or incorrectly selected dentures.

Regardless of the causes, arthrosis of the jaw joint remains a chronic disease that requires lifelong monitoring and inevitably progresses.

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.

If, shortly before the onset of symptoms of jaw arthrosis, you have suffered from arthritis of the jaw joint, an acute infection, an exacerbation of chronic otitis, facial trauma or tooth loss, consult a doctor immediately.

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!

Features of diagnostic measures for TMJ dysfunction

For the most accurate diagnosis of damage to the articular surface of the lower jaw at the junction with the temporal bone of the skull, specialists use the following methods and the following examination plan:

clarification of the patient’s vital functions (work specifics, presence of chronic diseases, psycho-emotional background);
questioning the patient about the probable cause of pathological changes in the jaw (trauma, inflammatory processes in the oral cavity, past dental history, the presence of neurological pathologies);
visual inspection of the outer surface of the projection of the joint and the oral cavity, if possible;
palpation examination of the joints of the mandible, which helps to identify muscle tension, swelling and displacement;
listening to sounds when opening the mouth, which can be in the form of clicks or crackling sounds;
determination of the amplitude of jaw mobility;
identifying the scope of possible movements;
assessment of the functionality of the masticatory muscles;
determining the correct bite;
X-ray examination of the dentofacial apparatus, which will be the most informative for excluding other pathologies of teeth and gums;
the magnetic resonance imaging method allows you to examine the soft structures of the jaw, for example, intra-articular cartilage and its physiological position, the correctness of which determines the condition of the TMJ;
CT scan results will provide a layer-by-layer image of the bone structure of the jaws.

The results of these examinations may require consultation and treatment with a dental surgeon, traumatologist or orthodontist.

How to treat arthrosis of the jaw?

Treatment for arthrosis of the jaw joint varies depending on the causes of the disease. Its purpose is:

restoration of mobility of the lower jaw;
suppression of degenerative and dystrophic processes in the joint.

As a rule, the doctor prescribes analgesics and recommends wearing a splint - an elastic, removable mouth guard that distributes the load on the jaw. The selection of an individual splint (based on an impression), palatal plate or other orthodontic device for arthrosis of the jaw joint is carried out for relaxation in case of muscle hypertonicity or maintaining a healthy position of the TMJ. If the splint is not enough, a specialist may prescribe a Botox injection. Then permanent dentures are created for the patient, which help support the joint affected by arthrosis and correct the bite. Also, with arthrosis of the lower jaw, selective grinding of teeth can be performed.

Treatment of arthrosis of the jaw joint involves a moderate change in habits. Patients should avoid eating solid foods, frequent vocal exercises, and chewing gum. Therapy for arthrosis of the jaw joint requires lifelong limitation of mechanical loads and regular visits to the dentist or gnathologist. Preventive courses of physical and pharmacotherapy are carried out at least 2 times a year. It is important to minimize stress and physical strain. The further the disease progresses, the softer the food should be - until the patient switches to purees, cereals, soups and juices.

It is considered optimal to start treatment at stage 1 or 2. In advanced cases of arthrosis of the jaw joint, only surgical intervention can help the patient.

Osteoarthritis of the jaw joint - which doctor should I contact?

The first step if you suspect arthrosis of the jaw is to consult an orthodontist or gnathologist. They will give the patient a referral for an x-ray, and will also determine whether there are any malocclusions or dental contact problems. You may also need to consult a prosthodontist.

If the cause of the disease is primary diseases, in parallel with a specialized doctor, narrow specialists participate in the treatment of jaw arthrosis - for example, a rheumatologist, endocrinologist, neurologist, psychotherapist or otolaryngologist.

Drug treatment of jaw arthrosis

Treatment of arthrosis of the jaw joint with medications is usually carried out in a hospital setting. At home, patients can take painkillers, use warming and analgesic local drugs, and also take chondroprotectors.

To relieve inflammation and improve jaw mobility, patients take non-steroidal anti-inflammatory drugs (NSAIDs) intravenously or orally - for example, ketoprofen, ibuprofen, paracetamol, nimesulide. For topical use, ointments and gels are recommended - finalgon, nicoflex, voltaren, butadione and indomethacin. In the absence of allergies, preparations based on medical bile and bee venom are used. Muscle relaxants, such as mydocalm, help relieve spasm in arthrosis of the jaw joint.

For severe pain, in addition to glucocorticosteroids (hydrocortisone), injections of opioid analgesics are prescribed - for example, tramadol, trimeperidine.

If there are injuries or foci of infection in the body, treatment of arthrosis of the jaw joint is accompanied by antibiotic therapy in the form of injections of cefazolin, metronidazole, cefuroxime.

For better regeneration of cartilage and synovial fluid, it is recommended to take chondroprotectors - for example, artracam, Dona or Movex.

Drug therapy for arthrosis of the jaw joint is carried out 2-3 times a year as prescribed by a doctor. The administration of drugs is often combined with physiotherapeutic techniques - for example, in the form of electrophoresis with novocaine, lidase and iodine, Trilon ointment.

Physiotherapy in the treatment of jaw arthrosis

Physiotherapy in combination with properly selected medications and orthodontic devices helps eliminate pain without surgery, even at the 3rd stage of arthrosis. Therefore, the following physiotherapeutic techniques are used to treat arthrosis of the jaw joint and rehabilitate patients.

ultrasound (10-20 sessions);
laser therapy (14 sessions);
microwave therapy (UHF - 10-12 sessions);
electrophoresis (10-12 sessions);
phonophoresis;
mud therapy;
myogymnastics;
massage of masticatory muscles;
balneotherapy (including paraffin therapy and ozokerite);

These procedures improve nutrition of the affected joint, normalize metabolism and activate the processes of natural regeneration of bone and cartilage tissue. With fibrotic changes in tissues, physical therapy helps to soften them and increase the range of motion of the jaw. Also, this type of treatment relieves inflammation, has an analgesic effect and serves to prevent complications of arthrosis of the jaw joint.

Therapeutic exercise for arthrosis of the jaw joint

Therapeutic exercises for arthrosis of the lower jaw help maintain facial mobility, speech intelligibility, improve innervation of the affected area and reduce the impact of the disease on other organs and systems. With hypertonicity of the masticatory muscles, it helps to stretch the ligaments and relax the jaw, and also strengthens the jaw apparatus. This promotes proper distribution of the load, and therefore slows down the progression and reduces the symptoms of arthrosis of the jaw joint. Myogymnastics does not replace wearing a mouthguard, but significantly enhances its effect.

Self-help methods for diseases of the temporomandibular joint:

The following self-help methods may provide temporary pain relief:

Moist Heat: Compressing with a hot pack or bottle wrapped in a warm, damp towel can improve chewing function and reduce pain. Be careful to avoid burns when using high temperature.
Ice: Ice packs can reduce inflammation, numb pain, and promote healing. Do not place the ice pack directly on your skin. When using, wrap the bag with a clean cloth. Do not use the ice pack for more than 10-15 minutes.
Diet - Soft Foods: Soft or mixed foods allow the jaw to rest temporarily. Remember to avoid hard, crunchy, and chewy* foods. Do not stretch your mouth when trying to bite off large pieces or the whole fruit.
Over-the-counter analgesics: Over-the-counter (over-the-counter) analgesics are useful for temporarily reducing pain. Together with your doctor, carefully read the instructions for each medication before using it.
Lower jaw exercises: Slow, gentle exercises of the lower jaw can help increase jaw mobility. Your doctor or physical therapist can evaluate your condition and suggest appropriate exercises based on your individual needs.
Relaxation techniques (relaxation techniques): Relaxation can help combat the pain that accompanies TMJ dysfunction. Deep, slow breathing increases relaxation and reduces pain sensitivity.

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