What is TMJ?
Temporomandibular Joint and Muscle Disorder (commonly called “TMJ”, nowadays we call it “CMD” (Cranio Mandibular Disorder) are a group of conditions that cause pain/headaches and dysfunction in the jaw joint and muscles/ligaments that control jaw movements.
Some people develop significant and long term symptoms which need medical intervention and treatment. Clinicians and researchers generally agree that the conditions fall into three main categories:
· Myofacial pain
· Internal derangement (displaced disc, dislocated jaw or injury to the condylar)
· Arthritis (a group of inflammatory joint disorders)
In some cases we have other symptoms as well, like chronic fatigue syndrome, sleep disturbances, fibromyalgia ear ache or dizziness.
How is CMD diagnosed?
There is not a specific and widely accepted test to correctly diagnose the disorders. However we always take a detailed medical and dental history, we examine clinically the patient (including the head, neck, face, joints). Then we ask for imaging studies which include OPG, Tomograms, CT-scan or MRI depending on the symptoms.
It is common to ask for blood evaluation to exclude several disorders as well for example Rheumatoid arthritis.
How is CMD treated?
When we exclude any severe conditions (which are rare, like tumours etc.) we try to treat the patients conservatively. That includes:
a) Information to the patient about his problem and what to avoid
b) Self-care practices, changes of habits (biting nails, apples)
· Eating soft foods
· Avoiding extreme jaw movements (such as yawning, loud singing, gum chewing)
· Learning techniques for relaxing
· Jaw exercises (gently)
c) Physiotherapy and laser (helps a lot)
d) Pain Medications - Usually are prescribing non steroidal anti-inflammatory drugs. Other times we may need to add muscle relaxants or anti-depressants to help the disappearance of symptoms
e) Most Important – Occlusal/stabilization splints. Usually we recommend an oral appliance which is an acrylic guard that fits on the upper or lower teeth. Most of the time if the surgeon has the correct diagnosis that kind of treatment helps a lot. 85% of our patients are treated in that way and they have excellent results
f) Surgical Treatments - Surgical treatments are controversial and only when it is absolutely necessary we perform such kind of operations
g) Botox - Used in small doses, Botox injections can help the situation. Botox has not been approved by the FDA for use in CMD. Research is going on. |