Temporomandibular Joint (TMJ) Pain-Dysfunction Syndrome
Anatomy
The TMJ is the joint where the mandible (lower jaw) joins the temporal bone of the skull, immediately in the front of the ear on each side of the head. A small disc of cartilage separates the bones, much like the knee joint, so that the mandible may slide easily each time you open or chew. The TMJ also moves every time you talk and swallow, making it one of the most frequently used and most complex joints in the body.
Function
When you bite down hard, you put force on the object between your teeth and on the joint. In terms of physics, the jaw is the lever and the TMJ is the fulcrum. To accommodate such forces and prevent too much wear, the cartilage between the mandible and skull normally provides a smooth surface, over which the joint can freely slide with minimal friction.
Symptoms
The discomfort associated with TMJ Syndrome may be sharp and searing, occurring each time you swallow, yawn, talk and chew. It may be dull and constant, immediately in front of the ear, but can also radiate at the side of the head (temple), the cheek, the lower jaw, and the teeth. Because the common focus of the pain is in the ear, many patients are convinced their pain is due to an ear infection, when in fact it is due to TMJ dysfunction. Other symptoms beside pain can include popping, clicking, and ringing.
Treatment
Proper treatment begins with a detailed exam and careful assessment of the teeth occlusion and functions of the jaw joints and muscles. Remedies may include: resting the muscles and joints, muscle relaxants, non-steroidal anti-inflammatory medications, and fabrication of an occlusal guard or splint to prevent the wear on the joint. The occlusal guard can also prevent damage and wear on the teeth, as well as conform the TMJ to a comfortable and repeatable position, alleviating the tension placed upon it.
