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Temporomandibular Joint (TMJ) Dysfunction
What is Temporomandibular JointDysfunction?
Before we discuss the Temporomandibular Joint Dysfunction it isnecessary to understand the basic anatomy of the joint. The jaw ormandible is connected with the temporal bones of the skull throughthis joint. This synovial articulation is located on both sides ofthe skull and is dependent on each other.
This joint allows the clenching, unclenching of the jawincluding acts like swallowing, chewing, talking, andyawning. Temporomandibular Joint Dysfunction, orTemporomandibular Joint Syndrome, is a musculoskeletal andneuromuscular disorder in which the functional ability of the jointis deranged.
In this condition, the bones constituting the joint and themuscles which control the movement of the jaw contribute to painand discomfort. Damage to the bones i.e. temporal bone and mandibleand muscles of mastication i.e. masseter, temporalis, lateral, andmedial pterygoid are involved.
Pain in the joint while clenching or unclenching it, swelling onthe side of the face, and headaches are commonly observedconditions in Temporomandibular Dysfunction. Usually, the cause ofdysfunction is unclear. However, physical trauma or inflammation isconsidered to be the most possible causes which lead to thiscondition.
What are the causes?
The exact cause of TMJ dysfunction is still unknown. However,there are multiple possible causes derived by doctors. Dentistsalso claim that injury to only jaw bones and muscles is not theculprit but the muscles of the head and neck are equallyresponsible.
In most of cases the individuals intentionally orunintentionally grind (bruxism) or clench their teeth by exerting alot of pressure on them. The force is too much for the joint tobear and causes dysfunction. Other causes include chronic stress inwhich the muscles of the face, jaw, head, and neck tighten insteadof staying relaxed.
Stretched muscles clench teeth and gradually lead to thedysfunction of joints. The History and lifestyle of individualssuffering from TMJ dysfunctions also reveal some other causes. Toomuch gum chewing keeps the joint functioning for long hours withouta break causing fatigue.
Braces for the alignment of teeth are also considered to be acause. Also, due to severe trauma to the neck and head, any damageto cranial nerve V and VII can compromise the activity of severalmuscles concerned with the activity of the jaw.
Other than bruxism, malocclusion, anxiety, braces, andinflammatory musculoskeletal diseases, poor posture also plays arole in developing TMJ dysfunction. The accurate mechanism for itsinterference is still unclear.
What are the symptoms of TMJDysfunction?
There is persistent crackling or whiplash pain on one or bothTMJs. Pain is often coupled with a tenderness that often worsensinto swelling on the affected side of the face. Since the joint isexactly around the ear, therefore, the pain extends up to the eardue to which a condition called Tinnitus is also experienced by thesufferer.
In some cases, the complete face, head, and neck ache and feeltender. Moreover, it becomes really difficult for the patient tochew, talk, or yawn. The jaw becomes quite stiff and deniesunclenching. When the affected person tries to open or close thejaw they hear a clicking or popping sound as if the jaw is expelledfrom the socket.
This kind of sound is called crepitus. The jaw appears to bestuck or locked while clenching or unclenching. This condition isreferred to as lockjaw. However, the locking of the joint is notassociated with pain.
Other than the conditions associated with the jaw their othersymptoms as well which include toothache, headache, neck ache,dizziness, earache, loss of hearing, shoulder pain, andtinnitus.
Who is at risk to suffer from TMJDysfunction?
According to statistics, women are more at risk than men.Mostly, individuals aged between 20 and 40 are at risk to developthis condition. People suffering from osteoarthritis,rheumatoid arthritis, jaw injury, and bruxism are more likely tosuffer from TMJ dysfunction.
How is it diagnosed?
The diagnosis of TMJ dysfunction mainly relies on history andphysical examination. There is no laboratory test or imaging scanwhich can indicate the accurate diagnosis for this condition. Thepatients of TMJ dysfunction are referred to as oral ormaxillofacial specialists.
They ask the patient to perform some movements includingyawning, talking, chewing, clenching, and unclenching of the jaw.They inquire about popping or clicking sound when moving the jawand intensity and extent of pain.
Close examination of the jaw and gently pressing the areasaround the jaw to identify tenderness and pain give clear clues.The apparent symptoms, history of bruxism, jaw injury or arthritis,and failure to perform any of the mentioned movements smoothlyindicate TMJ dysfunction.
If the diagnosis is still not confirmed then the doctor performsa simple full-face X-ray, CT scan, or MRI. X-Ray reveals thecondition of teeth and jaw. CT scan shows any damage to themandible and temporal bone. MRI focuses on trauma to the cartilageand surrounding soft tissue.
However, after history and physical examination arthroscopy isthe most reliable procedure for the diagnosis. In this procedure, asmall tube is inserted into the joint space with a camera to viewany apparent cause there. [2}
Upper Cervical Chiropractic does not let the pain comeback! Since we know how intimate the link between neck andjaw is, we can clearly give Upper Cervical Chiropractic care theresponsibility for helping a patient with TMJ dysfunction.
Other treatment approaches are not as effective as this one.Chiropractic experts reveal that the first and second vertebrae ofthe cervical spine are directly responsible for the TMJdysfunction. These vertebrae, known as Atlas and Axis, whenexperience misalignment inhibit the side-to-side and u-and-downmovements of the head.
The surrounding muscles are stretched which are also connectedfrom the skull to the jaw. This proves the vitality of the UpperCervical area in the case of TMJ dysfunction pain andcomplications. Chiropractic experts carry out gentle and simpleadjustments in the cervical spine. Before and after every sessionX-ray is taken to confirm the correct alignment.
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