Jaw joint diseases are usually due to a disturbed interaction of teeth, jaw joints and jaw muscles. About 70 percent of Germans are affected by pain of various degrees in the neck, head and face area, which in many cases can be traced back to functional disorders or diseases of the temporomandibular joint.
What are temporomandibular joint disorders?
First and foremost, temporomandibular joint disorders can lead to tinnitus or other noises in the ears. This noise in the ears has a very negative effect on the quality of life and can usually also lead to sleep disorders in the patient. See AbbreviationFinder for abbreviations related to Temporomandibular Disorders.
Jaw joint disorders (also known as craniomandibular dysfunction) are different malfunctions in the interaction of the lower and upper jaw that are due to functional disorders of the teeth, jaw joints and/or the jaw muscles.
Malfunctions of the temporomandibular joint can manifest themselves as pain in the cheek and eye area, restricted jaw opening, grinding teeth (bruxism), speech problems, migraines, headaches and body aches, jaw (joint) pain, cracking of the temporomandibular joint, earache and tinnitus, neck tension, hardened muscles, blockages in the spine, difficulty swallowing, shoulder pain through to dizziness, lack of concentration, fatigue and sleep disorders.
Causes
In many cases, temporomandibular joint diseases are multifactorial and can be traced back to a dysregulated interaction of muscular, bony and neural structures.
Orthopedic malpositions affect the entire statics of the human body and can also trigger jaw joint diseases. Malpositions of the back, knee or ankle as well as leg length differences and pelvic obliquity can lead to jaw joint malpositions.
Rheumatic or wear and tear (arthrosis) impairments and nerve pain (including trigeminal neuralgia) or neuropathies can also cause temporomandibular joint disorders and corresponding pain symptoms. In many cases, psychological factors such as stress, difficult living conditions and/or tension are derived from the teeth and cause those affected to clench their teeth and grind their teeth (bruxism) at night.
Poorly fitted bridges or crowns, deficient fillings, misaligned teeth or jaws, loss of tooth substance (abrasion) as a result of caries can also result in jaw joint disorders.
Symptoms, Ailments & Signs
Disorders of the temporomandibular joint can cause a wide variety of symptoms and complaints. Generally, there is jaw pain that is localized in the area of the affected joint and can radiate to the ears. It can also lead to difficulty swallowing, grinding your teeth at night and increased salivation. The eyes can also be affected, which can lead to blurred vision and eye pain.
Temporomandibular joint diseases can also cause dizziness, lack of concentration, sleep disorders and fatigue. Serious illnesses are associated with restricted mobility. Those affected can then only move their jaw or neck to a limited extent, with every movement causing pain. If the disease is not treated, serious complications can develop.
Constant grinding of teeth can lead to chronic toothache and finally to abrasion of the teeth, which often results in nerve damage and problems with eating. In addition to the physical consequences, a malposition of the teeth can also cause psychological problems such as an inferiority complex.
Externally, a temporomandibular joint disease is usually not recognizable. However, inflammation manifests itself in the form of visible swelling and reddening, and cysts rarely form, or tooth misalignments occur. Fractures can be recognized by a visible misalignment of the jaw.
Diagnosis & History
The clinical symptoms provide the first indication of possible temporomandibular joint disorders. A clinical functional analysis and somatic (physical) examination of the jaw muscles, jaw joints and jaw opening enable statements to be made about possible malfunctions and the interaction of teeth, jaw joint, jaw and muscles.
The causes of the temporomandibular joint disease can be determined by means of an X-ray panoramic tomographic image of the entire jaw. In the context of instrumental functional analysis, the temporomandibular joints can be precisely measured and then custom-fit models of the jaws can be made.
With the help of an axiograph, the lower jaw movements and joint positions can be precisely analyzed in order to use the measured values with an articulator (chewing simulator) to simulate the optimal position of the jaw and teeth of the specifically affected person. In addition, questionnaires are used to determine possible psychosocial factors influencing the temporomandibular joint disease.
With consistent and, if necessary, interdisciplinary therapy (including self-therapy), temporomandibular joint diseases are easily treatable and show a favorable course with a significant improvement in symptoms within a few weeks.
Complications
First and foremost, temporomandibular joint disorders can lead to tinnitus or other noises in the ears. This noise in the ears has a very negative effect on the quality of life and can usually also lead to sleep disorders in the patient. Furthermore, it is not uncommon to experience pain in the ears or jaw and also to swallowing difficulties.
At night, many patients also suffer from what is known as teeth grinding, which can lead to various dental problems. There is also dizziness or general tiredness and exhaustion. Patients suffer from visual disturbances and concentration problems. In some cases, the patient also has restricted mobility.
A malposition of the teeth can lead to aesthetic problems and limitations, which often lead to psychological problems or inferiority complexes. Temporomandibular joint diseases can be treated relatively well with the help of surgery or therapy.
There are usually no complications. The treatments are often carried out in childhood so that there are no complaints in adulthood. Life expectancy is not reduced by temporomandibular joint diseases.
When should you go to the doctor?
Pain in the area of the teeth, gums or jaw must be clarified by a doctor. Since spontaneous healing does not normally occur in this region of the body, a doctor should be consulted as soon as possible. If there are irregularities in the chewing process, problems with the crushing of the food eaten or abnormalities in the vocalization, a doctor is needed.
Irregularities when wearing braces or inserted dentures must be checked and corrected. If food or liquids are refused, food hypersensitivity develops, or jaw misalignment occurs, a doctor is needed. A doctor’s visit is also advisable as soon as existing pain spreads to other areas of the upper body. If you experience headaches, sore ears or eyes, you should consult a doctor. Insomnia, tension in the neck or shoulders and concentration problems should be examined and treated.
If you notice facial deformities or discoloration of the facial skin, consult a doctor. Swelling in the mouth, changes in the mucous membranes and disturbances in saliva production are indications that should be examined by a doctor. Bleeding, pus formation or blisters and pimples in the mouth require medical attention. If the symptoms develop slowly and gradually, they indicate a disease that needs to be treated.
Treatment & Therapy
In the case of temporomandibular joint diseases, the therapeutic measures correlate with the respective underlying causes and aim for permanent and long-term freedom from symptoms.
Individually adapted occlusion splints (bite or crunching splints) are often used to coordinate bite and body statics and to relieve the chewing muscles and jaw joints. Physiotherapeutic measures are used to reduce muscular tension, specifically strengthen the masticatory muscles and eliminate malpositions and/or dysfunctions of the jaw joint.
As part of holistic orthodontic therapy approaches such as bionator therapy, tooth and jaw misalignments, impairments of the tongue and swallowing function and insufficient lip closure are corrected, whereby these are usually treated at the same time as possible misalignments of the spine and pelvis. Additional massages, stretching and exercises to strengthen the neck, shoulders and back are also used for this purpose.
In addition, soft food, cold and heat applications as well as independent stretching and relaxation exercises are recommended as part of self-treatment, especially in the case of a psychosocial temporomandibular joint disorder. In some cases, analgesic and anti-inflammatory and/or muscle relaxant medications are required to prevent chronic pain.
Electromedical measures such as transcutaneous electrical nerve stimulation (TENS) can also contribute to muscle relaxation and pain reduction. In addition, trigger point therapy to eliminate myofascial hardening in the therapy of temporomandibular joint diseases is discussed.
Comprehensive and far-reaching surgical or orthodontic interventions (including grinding therapy for occlusion disorders, arthroplasty or resection of the joint head for arthrosis deformans, locking surgery for dislocations), on the other hand, should only be considered if there are strict indications for temporomandibular joint disorders.
Outlook & Forecast
The prognosis of TMJ disorders depends on many factors. These include the age of those affected and the degree of severity of the clinical picture. Patient cooperation is also important. An example: A malocclusion is often the result of diseases of the jaw joint and the patient is given a bite splint or similar form of correction to wear. These can only work properly if they are placed in the mouth regularly. The therapy is therefore closely linked to the prognosis.
The same applies to CMD (Craniomandibular Dysfunction), in which misalignment of the jaw can trigger other complaints such as back pain and headaches, neck tension and grinding your teeth at night. A bad bite can cause bad posture, which can make muscular training necessary. Here not only regular visits to the physiotherapist by the patient are necessary, but also cooperation in regularly practicing what has been learned at home in order to make the training as successful as possible. Here, too, the prognosis is clearly dependent on the regularity and quality of the treatment.
Since many temporomandibular joint diseases develop in childhood and adolescence, the prognosis also depends on seeing the dentist early and regularly. The pediatric dentist can refer you to an orthodontist if necessary. Early treatment when the jaw is still growing is promising and associated with a good prognosis.
Prevention
Jaw joint diseases can be prevented, for example, by using bite splints or crunching splints, as these reduce abrasive wear (loss of tooth substance). In addition, relaxation techniques and improved handling of psychosocial stress protect against bruxism (teeth grinding). Likewise, rheumatic diseases or diseases caused by wear and tear as well as body static malpositions should be treated early and consistently to prevent temporomandibular joint diseases.
Aftercare
In most cases, the aftercare measures for temporomandibular joint diseases are severely limited, so that a doctor must be consulted quickly in the first place for these diseases. An early diagnosis usually always has a very positive effect on the further course of this disease and can also prevent further complications and other symptoms.
As a rule, self-healing cannot occur in the case of temporomandibular joint diseases, so those affected by this disease should definitely consult a doctor. In most cases, patients with temporomandibular joint diseases are dependent on a surgical procedure, which can permanently relieve the symptoms. The person concerned should definitely rest after the procedure and take care of their body.
Efforts and other stressful or physical activities should be avoided. When taking antibiotics, care should be taken that they should not be taken together with alcohol. In general, many relaxation exercises can also alleviate temporomandibular joint disorders and thus significantly increase the quality of life of those affected. Life expectancy is also usually not reduced by these complaints.
You can do that yourself
Temporomandibular joint diseases cover a wide range of possible complaints, so that the possibilities for alleviation vary in individual cases. Basically, temporomandibular joint diseases often lead to tension and pain, against which measures can be taken independently. Exercises to strengthen the muscles in the jaw area can be considered. The patient practices the exercises under the guidance of a physiotherapist and is then able to integrate them into his everyday life at home. This sometimes reduces pain or the temporomandibular joint disease worsens less quickly.
It is also important to deal with stress adequately in everyday life, as mental tension is often reflected in tenseness of the jaw and, in some people, is expressed in nightly grinding of teeth. If such a crunching is unavoidable, appropriate splints should be worn as a preventive measure according to a doctor’s prescription.
Those affected by jaw joint diseases can relieve pain and reduce tension in the jaw area through external and internal applications. Ointments can be used for application, for example with warming or cooling effects. Warm tea and drinking it slowly relaxes the jaw and has a positive effect on the perception of pain, at best in the short term. Even if the teeth are not affected by the jaw joint disease, thorough oral hygiene is particularly important for patients to prevent inflammation in the jaw area.
