Temporomandibular Joint Syndrome Disease

DESCRIPTION

Syndrome characterized by pain and tenderness in the jaw muscles, sound and/or pain over the temporomandibular joint (TMJ), with limitation of mandibular movement

System(s) affected: Musculoskeletal
Genetics: N/A
Incidence/Prevalence in USA: Symptoms or signs of TMJ dysfunction are present in up to one half of the population but only 5-25% seek treatment
Predominant age: Symptoms more common age 30-50
Predominant sex: Female > Male (3:1)

SIGNS AND SYMPTOMS

Facial and/or TMJ pain
Locking or catching of the jaw
TMJ noises – clicking, grinding, popping
Headache
Earache
Neck pain

CAUSES

TMJ synovitis
TMJ disc derangement
Hyper- or hypomobile TMJ
Occluso-muscular dysfunction (bruxism)
Masticatory muscle spasm
Trauma
Poorly fitting dentures

RISK FACTORS

Chronic oral habits such as clenching or grinding of the teeth
Osteoarthritis, rheumatoid arthritis
Dental malocclusion
Fibrositis
Psychosocial stress

LABORATORY

N/A

Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A

PATHOLOGICAL FINDINGS

Condylar head displacement
Anterior disc displacement
Posterior capsulitis
Loosening of disc and capsular attachments
Chondroid metaplasia of the disc leading to disc perforation and degeneration

SPECIAL TESTS

Jaw range of motion (opening, closing, lateral, protrusive) and masticatory muscle strength

IMAGING

Single-contrast videoarthrography demonstrates joint dynamics and disc movement
Panoramic dental radiographs
MRI – a noninvasive study for disc position. Information gained helps in deciding conservative versus surgical management.

DIAGNOSTIC PROCEDURES

Arthroscopy

APPROPRIATE HEALTH CARE

Outpatient treatment

GENERAL MEASURES

Jaw rest
Local heat therapy
Anti-inflammatory medications
Muscle relaxants
Analgesics
Correction of malocclusion with an orthodontic appliance
Stress reduction
Behavior modification to eliminate tension-relieving oral habits
Buccal separator orthodontic appliance

SURGICAL MEASURES

N/A

ACTIVITY

Jaw rest

DIET

Soft diet to reduce chewing

PATIENT EDUCATION

Be aware of any teeth-clenching or grinding habits, and relax the jaw by disengaging the teeth
Avoid wide uncontrolled opening such as yawning
Management of stress. Behavioral modification counseling may be helpful.

PREVENTION/AVOIDANCE

Elimination of tension-relieving oral habits and reducing overall muscle tension

POSSIBLE COMPLICATIONS

Secondary degenerative joint disease
Chronic TMJ dislocation
Loss of joint range of motion
Depression and chronic pain syndromes

EXPECTED COURSE AND PROGNOSIS

With conservative therapy, symptoms resolve in 3/4 of the cases within three months
Patients benefit the most from a comprehensive treatment approach including correction of occlusal discrepancies, restoration of normal muscle function, pain control, stress management, and behavior modification

ASSOCIATED CONDITIONS

Cranio-mandibular disorders

AGE-RELATED FACTORS

Pediatric: N/A
Geriatric: N/A
Others: N/A

PREGNANCY

No association

OTHER NOTES

N/A

ABBREVIATIONS

N/A

Clinical Investigations

ROLE OF HOMOEOPATHY

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