The temporomandibular joint (Jaw Joint) is the joint that connects the lower jaw to the head. Diseases of the jaw joint concern the jaw bones forming the joint, the cartilaginous disc of the joint and the masticatory muscles. Although it is seen in a very large part of the society, it mostly affects female patients. Patients with jaw joint disease are mostly between the ages of 20 and 40.
Treatment of diseases of the jaw joint and jaw muscles is one of the fields of activity of Oral, Dental and Maxillofacial Surgery.
The temporomandibular joint (TMJ) is one of the most mobile joints, located between the temporal cavity (mandibular fossa) and the temporal bone nodule (mandibular condyle), located under the temporal bone, quickly in front of the external auditory canal where the lower and upper jaw meet.
The jaw joint is quickly located in front of the ear at the junction of the lower and upper jaws, and is a complex structure consisting of jawbone, muscles, cartilage structures, ligaments (rubbery connective tissues that restrict the excessive opening of the jaw). Thanks to the contraction and relaxation of the jaw muscles and the simultaneous movement of the jaw joint, the mouth opens and closes, the person can talk, chew something, and yawn.
Some of the Causes of Jaw Joint Disorders
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Clenching, grinding, lip biting, nail biting, long-term gum chewing habits
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Very tired of the jaw muscles, gaining too much strength (as a result of bruxism)
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Dental treatments that keep the mouth open for a long time
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Wide opening and straining of the jaw while administering general anesthesia
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Habit of chewing food unilaterally
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Chewing only in certain areas due to missing lower and upper jaw teeth
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The lower and upper teeth are not in harmony with each other (Dental Crowding)
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Structurally incompatible mandibular and maxillary interests (Skeletal disorders)
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Dental fillings and porcelain prostheses that are applied incorrectly, have problems such as incompatibility, height
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Impacts, injuries and accidents affecting the joint area
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Sitting with an arm resting on the chin in a style that puts pressure on the jaw joint
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Pressure on the lower jaw joint due to lying on an incompatible high or low pillow
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Some systemic diseases
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psychological disorders
Some of the Symptoms of Jaw Joint Disorders
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Clenching and grinding of teeth and accordingly pain in the jaw area or cheeks, especially when waking up in the morning
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Pressure and pain radiating from the jaw joint to the ear, neck, teeth, even nose and eyes
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Inadequacy in jaw movements (inability to fully open the jaw, creaking in the jaw when opening the mouth, snagging, clicking sound, opening by sliding to one side)
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Painful and difficult opening of the mouth when yawning and/or eating
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Difficulty in biting and/or taking a bite with the front teeth while eating, pain
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Differences in the closure of the teeth constantly or occasionally (when the teeth are closed, there is a gap in the middle of the upper jaw and the lower jaw, the lower and upper teeth coincide and a regular closure cannot be achieved),
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Facial pain and feeling of tiredness, swelling
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Teeth become sensitive, wear, breakage and/or wobble.
Inspection Methods
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Taking a detailed history from the patient about joint complaints
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Inspection of teeth and closing system
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Examination of the chewing muscles
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Examination of the jaw joint
In order to diagnose jaw joint disorders, some auxiliary tests can be used together with the examination. In addition, classical or computed tomography and magnetic resonance imaging can be used.
The most valuable point in the examination phase is to determine the underlying factor of the jaw joint discomfort.
As a matter of fact, almost all treatments, except surgical interventions, are symptomatic treatments.
TMJ Treatment
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Treatment of symptoms (Symptoms)
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Treatment of the underlying cause
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Elimination of predisposing factors
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Treatment of pathological effects
Treatment Options
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Patient education and preventive treatment
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splint therapy
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Medication
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BOTOX applications to chewing muscles
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Exercises
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Physiotheraphy
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manipulation
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psychiatric support
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Advanced treatments (Surgery etc.)
The main aim of the treatment is to regulate the pressure in the jaw joint and to provide normal jaw functions. For the treatment of jaw joint disorders, correction of regional factors causing discomfort (necessary dental treatments), dental plaque application to eliminate multiple forces on the jaw joint, intra-articular injections called arthrocentesis for disc-related disorders can be applied.
Orthopedic appliance (splint) use is also in the middle of current treatment methods. At this point, it is very valuable for the patient to take certain precautions, comply with the offers and defend himself.
The points that the patient should comply with during the treatment can be listed as follows;
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He should protect his teeth, take care of his mouth and dental health,
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Pay attention to the jaw condition,
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Soft foods should be preferred.
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Gum should not be chewed,
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Avoid biting hard foods with the front teeth,
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Should not open the mouth opening more than a reasonable size, should support the chin (For example, while yawning)
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You should do the jaw training recommended by the physician,
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Compliance with medical treatment for pain,
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He should take his medication regularly,
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If applied, the splint should be fitted with absolute fidelity.
