Jaw Pain

Temporomandibular Disorders (TMD)

The temporomandibular joint (TMJ) refers to the jaw joint. The TMJ is considered the most complicated joint in the body. It holds the attachment of masticatory muscles and ligaments to ensure proper jaw movement. It consists of the joint head attached to the mandible (condylar head) that articulates within a concavity in the base of the skull. In between exists a cartilage disc that facilitates jaw movement.

Temporomandibular disorders comprise any disease affecting the joint bone, muscles, ligaments, and articular disc. They are the second most common dental disease after tooth decay and were reported to affect 1 in 15 people in the UK.

Temporomandibular disorders affect quality of life by impairing overall jaw movements, which can affect opening and closing your mouth, chewing, and speaking. They can also cause severe headaches.

Dulwich Dental Centre is your go-to dental destination for diagnosing and treating TMD. Our world-class diagnostic Centre is equipped with cutting-edge technologies. It is led by expert surgeons capable of professionally handling your TMD to relieve your pain and resume your daily activities.

Symptoms of Temporomandibular disorders (TMD)

• Jaw pain and tenderness
• Pain in the facial muscles and around the ears.
• Inability to open or close your mouth (jaw stiffness).
• Impaired chewing.
• Clicking sounds during opening and closure (popping).
• Headache and migraines.
• Shoulder and neck pain.
• Malocclusion or your teeth do not properly close on each other.
• Toothache.

Causes of Temporomandibular disorders (TMD)

Jaw disorders may be caused by several factors that affect the anatomical structures of the temporomandibular joint (TMJ) including the bone, masticatory muscles, and the articular disc. The causes of TMD may include:

1. Trauma to the joint that causes joint dislocation or fracture.
2. Arthritis of the joint.
3. Articular disc erosion of thinning.
4. Inflammation of the masticatory muscles.
5. Excessive mouth opening during yawning, causing masticatory muscles and ligaments strain.
6. Lengthy dental procedures that require mouth opening for a long time.
7. Infection in the surrounding structures, such as tooth abscess or sinusitis.

Some habits may increase your risk of developing TMD or aggravate the symptoms if they already exist, such as grinding your teeth (bruxism) which increases stresses on your TMJ, or performing bad habits, such as nail and pen biting.

Most Common Temporomandibular Disorders

1. Myofascial pain: This includes pain related to the masticatory muscles attached to the TMJ.
2. Articular disc displacement: The articular disc is a cartilage located between the articular head of the jaw and the bony concavity where it fits in the skull. This disc acts as a cushion to prevent bone friction. Jaw displacement can be caused by anterior displacement of the disc of the articular jaw head coming out of its place.
3. Degenerative diseases: This includes the destruction of the anatomical structures of the TMJ due to systemic diseases, such as osteoarthritis or rheumatoid arthritis.

Diagnosis of Jaw Disorders

TMDs can be caught through data collection from your symptoms, clinical examination, and imaging.

As an initial step, our dental experts will attentively listen to your complaint and collect your history regarding any recent lengthy dental procedures and parafunctional habits you may have, such as bruxism or pen biting. Additionally, questions regarding the history of pain, its recurrence, and whether you hear any popping sounds during opening and closing your mouth will add valuable information for the diagnosis.

A thorough clinical examination is essential to catch any abnormal jaw movement. You may be asked to open and close your mouth to investigate the existence of and shifting of your jaw during opening, clicking sounds, or limitation of jaw opening.

Imaging may be required to examine any anatomical changes of the joint or its associated structures more closely. Digital and Panoramic X-rays may be used to check for teeth and jaw health, CT scans to look for bony changes in the joint, or MRI scans to identify soft tissue lesions in the TMJ’s associated structures.

Another valuable diagnostic tool is TMJ arthroscopy, in which a small camera is inserted inside the joint to record any lesions. Sometimes, arthroscopy has a therapeutic use to remove inflammatory or scar tissue from the joint.

Dulwich Dental Office Solutions for TMD

Treatment of the temporomandibular disorder depends mainly on the underlying cause. Dulwich Dental Office offers valuable treatment solutions to relieve your jaw pain. In general, if you suffer from jaw problems, eating soft foods is advised to decrease muscle stress and avoid more complications.

The treatment modalities for TMD include:

1. Medications

Several drugs may be prescribed to manage your TMD, such as painkillers to ease the pain, anti-inflammatories to manage any existing inflammation, muscle relaxants to relieve TMD caused by strained muscles, or antidepressants to decrease your stress level.

2. Non-surgical treatments

This includes conservative solutions to manage the TMD, such as:

• Nightguards: If you are a bruxer, fabricating customised nightguards by our dental experts is essential to avoid damage to your teeth and decrease the tension of your masticatory muscles.
• Physical therapy: Our professional oral surgeons may recommend special exercises to strengthen the masticatory muscles and stretch your jaw.
• Behavior changes: it is important to stop any parafunctional habits such as crushing ice, or biting on pens, and nails biting.
• Trigger points injection: If examination revealed trigger points in your muscles, injection of corticosteroids or Botox in these points may be an effective conservative solution.

3. Surgical treatments

Surgical treatment of TMD is indicated when all conservative solutions fail. Surgical treatments involve either inserting a needle to remove excess inflammatory fluids (Arthrocentesis), arthroscopy to remove inflammatory and scar tissue, and a complete open jaw surgery where the TMJ is exposed in surgery to repair or even replace the joint, or to stabilise a jaw fracture.