Temporomandibular Joint Dysfunction (TMJ)

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What is the temporomandibular joint (TMJ)

The temporomandibular joint (TMJ) is located where the lower jaw (mandible) attaches to the base of your skull on each side of your head. The TMJ allows your mouth to open and close and move from side to side. A disc within each TMJ acts as a cushion and protects the mandible from wear. Muscles attached to the TMJ control its position and jaw movements during talking, chewing and swallowing.

A TMJ disorder can affect one or both TMJs, muscles and surrounding tissues.These disorders can cause pain, clicking, locking, facial pain and headache.

What are the symptoms of TMJ disorder?

Symptoms may range from mild to severely debilitating.  People may have a wide range of symptoms, some specific to the TMJ and others vague.

Signs and symptoms include:

  • Difficulty in opening the mouth

  • A limited range of jaw movement

  • A stuck or locked jaw

  • Clicking, grating or popping noises from the TMJ

  • Pain on opening the jaws, on chewing and yawning, particularly when opening the jaws widely

  • Clenching and grinding of teeth

 Associated symptoms may include:

  • Pain in or around the ears and cheeks

  • Headaches, migraines and nausea

  • Earaches, loss of hearing and ringing in the ears

  • Face, neck, back and shoulder pain

  • Sensitive teeth and tooth pain

  • Facial swelling

  • An uncomfortable bite

How do you treat TMJ Disorders?

At your initial consultation, Dr Chellappah will take a thorough history, perform a comprehensive examination and review any x-rays or CT scans which your Dentist or GP may have organised. He will advise if any further investigations are required.

Dr Chellappah will explain to you the options for surgical management of your condition and discuss the procedure and any associated risks in depth. He will also advise you of what to expect in the post-operative period.

What does TMJ treatment involve?

As most TMJ disorders are temporary and do not usually worsen, simple and conservative treatment is often all that is required.

Many TMJ disorders can be treated without surgery by using pain relievers, anti-inflammatories or relaxing medications. This is usually in combination with physiotherapy and bite-splint therapy.

A team approach to treatment is often needed. It may involve input from Dr Chellappah, your dentist and healthcare professionals such as a physiotherapist, pain specialist or psychologist.

The basic aims of surgery are to reduce or eliminate symptoms and improve jaw function. Surgery is indicated only after all conservative options have been assessed or a significant internal problem with the TMJ has been diagnosed.

The main reasons for surgery are:

  • The TMJ disorder is not responding satisfactorily to non-surgical treatment.

  • The TMJ disorder is causing chronic pain and dysfunction and interfering with the patient’s normal activities and enjoyment of life, in spite of non-surgical treatment.

Four surgical procedures are commonly used to treat TMJ disorders:

  • Arthrocentesis

  • Arthroscopy

  • Arthrotomy

  • TMJ Replacement

Where will I have my TMJ surgery?

All surgical TMJ procedures are performed in hospital under general anaesthetic. You will be asleep for the duration of the procedure. You will be admitted on the day of your procedure and usually will be discharged the next day following review by Dr Chellappah.

How long is the recovery after TMJ surgery?

The postoperative recovery period varies among patients but is usually about two weeks. Although pain in the TMJ usually starts to subside within three days after surgery, swelling and discomfort may continue for a while. Swelling is normal after any surgery and usually lasts about two weeks.

Physiotherapy, particularly jaw manipulation and exercise, is needed during the healing period.