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. Exacerbation's 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 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.