What are TMJ (Temporomandibular Joint) Disorders and Their Treatments?

What are TMJ (Temporomandibular Joint) Disorders and Their Treatments?

The number of people with pain in the temporomandibular joint area or joint dysfunction is much higher than thought. In the temporomandibular joint, which is a complex structure, there may be disorders related to the structure of the joint, as well as changes in neighboring structures outside the joint, and systemic diseases cause various clinical findings. The important thing is to reach a correct diagnosis of the affected structure due to these complex and different factors and to direct the treatment accordingly.

It should be known that if TMJ disorders are caused by a disorder related to the surrounding muscles, that is, myofascial pain and dysfunction, they can be treated with non-surgical methods, but pain and dysfunction originating from the structure within the joint itself (intra-articular) may require surgery. In order to make this distinction, the patient must be evaluated thoroughly.

A different sound occurring in the joint when opening and closing or the sounds the person notices while eating are not symptoms that will initiate the treatment process. However, in addition to such findings, symptoms such as pain while eating, persistence of pain while sleeping at night, inability to close the teeth when waking up in the morning, limitation in opening the mouth or not being able to open it at all are indicators of the need for treatment.

What are the Causes of TMJ Problems?

TMJ diseases can be due to many reasons. Arthritis is among the causes of joint diseases. Reasons such as trauma to the joint, unilateral chewing, missing teeth, clenching and grinding of teeth cause the formation of this disease. Stress is another factor. This condition, which causes teeth clenching and grinding, causes contraction in the jaw muscles.

• Partial or complete missing teeth in the mouth,
• Trauma; A traffic accident, a collision, a severe blow to the area, a difficult tooth extraction or other dental interventions taking a long time,
• Prostheses that are not fully adapted,
• Sudden and dramatic change of the closing balance in the mouth, which we call occlusion (covering all of the teeth with porcelain, etc.).
• Voluntary or involuntary habit of clenching/grinding teeth during the day or night (bruxism),
• Anatomical weakness that exists or may develop due to a familial predisposition in the structures that form the joint,
• Osteoporosis. Changes in the bone structure of women in older ages, when combined with some other factors, may cause a problem.
• Rheumatoid arthritis. This condition, which causes discomfort in all joints, can also affect the jaw joint.

Patient evaluation includes a good history, physical examination of the muscles, mouth, face, joints and routine TMJ x-ray control. In addition to these methods, sometimes special examination methods such as laboratory tests, electromyography, arthrography, CT and MRI are also used.

TMJ diseases have various symptoms. Many patients complain of earache, headache and difficulty in jaw movements. For this reason, patients generally first go to an ear, nose and throat specialist.

In cases where the relationship between the jaw joint and the disc is disrupted, complaints such as a clicking sound from the joint, in more advanced cases, a crepitation (friction) sound, limitation in opening the mouth, and pain are observed. The clicking sound heard when opening and closing the mouth is present in most patients. Clicking sound may be a sign of TMJ diseases.

What are the treatments for TMJ disorders?

In our clinic, low energy level laser is used in the treatment of TMJ disorders. Low energy level laser application is applied to patients who do not require absolute surgical intervention, such as the presence of ankylosis or tumor formation in the TMJ and its surrounding area.

The analgesic, anti-inflammatory and biostimulating effects of low-energy laser are utilized. Laboratory and clinical studies show that laser treatment in temporomandibular disorders has an antiphlogistic, antiedematous and stimulatory effect on cell metabolism, and the secondary effect of the laser is to reduce pain.

In chronic joint diseases, laser applied to the joint capsule reduces pain by preventing inflammatory activity. This shows that the laser has an anti-inflammatory effect. Studies have concluded that low-energy laser treatment applied to the joint in intra-articular inflammatory diseases reduces inflammation and controls the pain caused by inflammation. Successful results are achieved by using laser along with the use of orthopedic appliances, especially in the treatment of arthrogenic-related pain.

With low-energy laser treatment applied to trigger points in muscle-related temporomandibular disorders, there is a decrease in pain and trigger points, as well as resolution of muscle spasm. Low energy laser is also a conservative treatment option.