Temporomandibular joint dysfunction: symptoms and treatment
The dysfunction of the temporomandibular joint in medicine has several names: arthrosis of the VLF joint, arthritis, subluxation of the mandible of the chronic character, myofascial syndrome and so on. The first who examined this pathology was the American otolaryngologist Kosten. It was he who revealed the connection between ear pains and impaired functions of the temporomandibular joint. As a result, the disease acquired another name: Kosten's syndrome. It is worth noting that this pathology is considered to be the most painful and complicated, since it is difficult not only to diagnose it, but also to treat it.
Features of the joint
The temporomandibular joint( TMJ) is located in front of the ear. He plays an important role. The joint consists of the bones of the lower jaw and the temporal bone. At the same time, his muscles perform many functions: speech, swallowing, chewing and so on. In addition, they connect the skull with the lower jaw. Muscles and joints allow a person to open and close their mouths. Also the device is responsible for the movement of the lower jaw to the right, left, forward, down and up.
What is dysfunction of the TMJ
Dysfunction of the temporomandibular joint, the treatment of which has its own peculiarities, manifests itself in the case of symmetry breaking. The device works correctly until both the right and left move the same. If there is a failure in the operation of one joint, then symmetry breaking occurs, which leads to violations of the functions of the second joint. Pathology begins to develop in those cases when the lower jaw is displaced when closing and opening the mouth, and then when moving in other directions.
The main causes of the pathology
The syndrome of dysfunction of the temporomandibular joint is found in patients of different age groups. As statistics show, about 70% of the population suffers from such violations. The reasons for the development of pathology abound. Among them are:
- bite disorder;
- sudden muscle strain when rubbing coarse and solid foods;
- increased abrasion of dental tissues;
- physical activity and training, in which the tension of a certain group of muscles occurs;
- errors of dentists, surgeons, therapists, orthodontists, orthopedists: filling, denture prosthetics;
- injuries of the joints of the lower jaw.
When filling or prosthetics, a specialist can install an overpriced crown or a seal. As a result, symmetry breaking occurs. And this, as is known, leads to the development of dysfunction of the temporomandibular joints. In addition, with such an incorrect treatment, the load is only on one side of the teeth when chewing food, which leads not only to the dislocation of the discs, but also to painful sensations.
Noise and clicks
How is dysfunction of the temporomandibular joint manifested? Symptoms of this pathology are very diverse. The most common sign of a similar pathology is the clicks that are heard in the area of the joints of the lower jaw. Such sounds can be loud enough. They can be heard by people who are with the patient nearby, when he just opens his mouth, yawns or chews food. In this case, pain may not occur.
As a rule, when the discs are displaced, muscle overstrain occurs when the patient hears a click. This happens usually when chewing food. At such moments, the patient can feel pain due to stress in the neck, head, face.
The syndrome of painful dysfunction of the temporomandibular joint is often manifested by pain in different areas of the head. This is another common sign of pathology. Usually, the headache in the development of dysfunction of the TMJ is localized in the occiput and temples. But often unpleasant sensations the patient can feel and in the area of scapula.
The cause of the headache in this case may be muscle pain that occurs when you grind your teeth and clench your jaw. Also, unpleasant sensations can disturb the patient due to the dislocation of the discs of the joint itself. In this case, the pain senses radiates to the neck, forehead or whiskey. It is worth noting that such unpleasant phenomena can be quite strong. In some cases, the doctor mistakenly diagnoses the pathology of the brain or migraine.
Locking, joint grip: locking
Painful dysfunction of the temporomandibular joint often causes uneven movement of the lower jaw caused by certain disorders. Blockage can be seen when the mouth is opened. There is a feeling that the patient is trying to "catch" something with the lower jaw.
In some cases, people with a blocked joint to open their mouths wider should move the device to the left and right. But there are other situations. Sometimes the patient is forced to open his mouth until a peculiar click is heard in the area of the joint with impaired functions.
Since the TMJ is located very close to the auricles, certain ear symptoms may occur. Some of them are quite unpleasant. The signs of dysfunction in this case are:
- painful sensations;
- feeling of ear congestion;
- is muffled in the ears, causing hearing loss.
It is because of these signs that many patients who have dysfunction of the temporomandibular joint seek help from a local GP or an ENT doctor.
Dysfunction of the joints of the lower jaw can lead to a change in bite or dental occlusion. This is often due to the displacement of the disks. The bones and their joints do not correspond to the norm, which leads to a change in the occlusion.
In addition to this problem, the patient can become very sensitive teeth. Most often this is due to the grinding of teeth and clenching jaws. Often people with this pathology turn to dentists with complaints of pain in the teeth. Not always specialists can determine the main cause of the appearance of unpleasant sensations. Because of this, the patient can remove the tooth or carry out his depilation. And this does not save us from dysfunction of the TMJ.
Other signs of
Dysfunction of the temporomandibular joint in certain situations is accompanied by inflammatory processes that occur as a result of synovitis or arthritis in the joint itself. In this case, a person can complain about the swelling of the tissues, painful sensations. Often this leads to general malaise, weakness and a rise in temperature.
In addition to the above symptoms, the patient may be troubled by:
- pain in the back and shoulder area caused by muscle spasm;
- impaired appetite and sleep;
- depression, which often develops due to feelings and misunderstanding of the problem that caused unpleasant sensations;
- with painful sensations that are chronic, there may be changes in the chemical structure of the brain.
Initial stage of diagnosis
The dysfunction of the temporomandibular joint has many symptoms. However, the diagnosis of such pathology is a multistage, long-term, complex and complex process. It is not always possible to put a correct diagnosis, only based on the patient's complaints. First of all, functional diagnostics are performed, which allows to determine the causes of pathology development.
At the same time a set of procedures is performed:
- data collection of medical;
- identification of all complaints;
- study of muscle tissue in the neck and head;
- X-ray diagnostics: magnetic resonance and cone-beam tomography;
- neurological examination, lateral teleradiography;
- cephalometric analysis;
- detection of parafunctions;
In some clinics, a small functional dental analysis is often performed to determine the diagnosis. This is also considered a primary diagnosis. In this case, the patient removes the impression, and then the model is manufactured. Also for the diagnosis, special drops are used, which can reveal bruxism. The dentist should evaluate the bite during the examination, as well as the quality of the interdental contacts and so on.
The most complex is considered a large functional analysis, not only in implementation, but also in the interpretation of data. In this case, the specialist must have special skills and knowledge. To carry out such a diagnosis, additional equipment is required.
All of the above tests are necessary to diagnose and identify the causes of dysfunction of the TMJ.The correctness of the studies carried out depends on the experience of specialists and equipment. After the diagnosis is made, the patient is given adequate therapy. It, in turn, can be surgical, reconstructive or conservative.
To whom to contact
This pathology is difficult to diagnose. Even experienced dentists rarely make such a diagnosis as painful dysfunction of the temporomandibular joint. Treatment in many cases is assigned incorrectly and does not give results. In most cases, patients do not get qualified help from dentists and start visiting other specialists: psychotherapist, neurologist, therapist, otolaryngologist, chiropractor, osteopath and so on. In fact, dentists should be engaged in the treatment of dysfunction.
Temporomandibular joint dysfunction: how to treat
To receive a positive result, complex therapy should be performed. It includes orthopedic treatment of temporomandibular joint dysfunction, which is aimed at correcting the occlusion. In certain situations, surgical intervention, acupuncture, physiotherapeutic procedures, dental prosthetics or the removal and installation of a new seal are performed.
In addition to the above, a doctor can prescribe wearing a trainer at night. This is a kind of articular bus, which allows you to remove pain myofascial syndrome. It is also used for diagnosis, to prevent abrasion of dental tissues in bruxism.
Can dysfunction of the temporomandibular joint cause complications? Treatment of such a pathology must be carried out necessarily. In some cases, dysfunction leads to dislocation of the discs. As a result, the surfaces of the joints can be reshaped - arthrosis. In the cavity begins to expand connective tissue, which itself is rough. As a result, the joint stops moving. This pathology is called ankylosis.
How to provide first aid
If the patient is fully confident that he has dysfunction of the temporomandibular joint, then if necessary, you can help the patient, reducing pain, and also improving the chewing function. This requires warmth, but only a damp one. In this case, a compress can be applied to the sore spot: a bottle previously filled with hot water. To avoid burns, it is recommended to wrap the container slightly moist, but not with a wet towel.
To reduce the intensity of pain and reduce inflammation, it is recommended to use ice. In this case, you can use a package or a bottle. However, you should not apply such a compress directly to the skin. Pack or bottle it is necessary to wrap a towel. Do not use it longer than 15 minutes. In this case, the break between the procedures should be at least 60 minutes. Relieve pain for a while with analgesics.
How to relax the joint
To joint often does not strain, you should follow several rules. The food should be wiped or soft, and also mixed. It is worth giving up chewing, rough, hard and hard foods. Nibble is in small pieces. With such a violation, it is not recommended to open your mouth wide.
Complete relaxation of the body also helps reduce pain. To do this, any relaxation technique is suitable.
Painful dysfunction of the temporomandibular joint: ICD-10
According to the international classification of diseases, dysfunction of the temporomandibular joint is indicated by code K07.6.In this case, violations can manifest themselves in different ways. This includes: a complex of either Kosten's syndrome, dilatation of the TMJ, "clicking jaw", the syndrome of the partial dysfunction of the TMJ.
Exceptions are stretching and dislocation of the jaw.