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Temporomandibular Joint Disease
Temporomandibular joint disease, or TMJ disease refers to pain secondary to inflammation of the jaw joint, where the lower jaw bone (mandible) is connected to the skull. TMJ problems may occur secondary to trauma to the jaw, stress from eating, or from chewing gum. TMJ disease can result in arthritis in the joint and destruction [over time] of the articular cartilage inside the joint. The articular cartilage normally provides a smooth surface over which the joint can freely function with minimal friction. TMJ disease tends to be a chronic and recurrent problem, triggered by any increases in chewing food or gum. Common symptoms include pain to the face in front of the ear lobe, made worse by chewing or yawning. There may be some mild swelling noted at this site. Popping and crackling can be felt over the TMJ when the mouth is opened and closed. More marked cases will be met with the inability to completely close the upper and lower molars so that they touch. Exacerbations of TMJ disease are often precipitated by chewing gum or yawning. Evaluation will include history and physical examination. The TMJ joint, like other joints, may be studied by using an x-ray examination known as a arthrogram. In this test a "dye" is injected into the joint and an x-ray is taken. The arthrogram will show the condition of the joint, its articular surfaces, and the need for any surgical procedure. Arthroscopy has also been used for this problem. Treatment will include the use of anti-inflammatory agents (ibuprofen) and rest to the joint (liquid diet). Muscle relaxants may be helpful in some cases. Warm compresses applied to the painful and swollen area can help. Mouth inserts, or splints, have been used in more severe cases to reduce the inflammation and swelling. An Oral Surgeon is the expert in the management of this relatively common problem.
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