Dysfunction of the temporomandibular joint in medicine has several names: arthrosis of the TMJ joint, arthritis, chronic subluxation of the lower jaw , myofascial syndrome, and so on. The first who investigated a similar pathology was the American otolaryngologist Kosten. It was he who revealed the connection between ear pains and dysfunctions of the temporomandibular joint. As a result, the disease acquired another name: Kosten syndrome. It is worth noting that such a pathology is considered the most painful and difficult, since it is difficult not only to diagnose, but also to treat.
Joint features
The temporomandibular joint (TMJ) is located in front of the ear. He plays an important role. The joint consists of bones of the lower jaw and 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 apparatus is responsible for the movement of the lower jaw to the right, left, forward, down and up.
What is TMJ dysfunction
Dysfunction of the temporomandibular joint, the treatment of which has its own characteristics, manifests itself in violation of symmetry. The device works correctly until everything moves the same on the right and left. If a failure occurs during the operation of one joint, then a symmetry breaking occurs, which leads to impaired functions of the second joint. Pathology begins to develop in cases where the lower jaw shifts when closing and opening the mouth, and then when moving in other directions.
The main causes of pathology
Temporomandibular joint dysfunction syndrome occurs in patients of various age groups. According to statistics, approximately 70% of the population suffers from such violations. There are plenty of reasons for the development of pathology. Among them are:
- stress;
- malocclusion;
- sudden muscle strain during grinding of coarse and solid foods;
- increased abrasion of dental tissues;
- physical activity and training, in which there is a tension of a certain muscle group;
- mistakes of dentists, surgeons, therapists, orthodontists, orthopedists: filling, prosthetics;
- injuries of the joints of the lower jaw.
When filling or prosthetics, a specialist can install an overestimated crown or seal. As a result, symmetry breaking occurs. And this, as you know, leads to the development of dysfunction of the temporomandibular joints. Moreover, with such improper treatment, the load falls on only one side of the teeth when chewing food, which leads not only to displacement of the discs, but also to pain.
Noise and clicks
How is dysfunction of the temporomandibular joint? Symptoms of this pathology are very diverse. The most common sign of such a pathology is the clicks that are heard in the joints of the lower jaw. Such sounds can be quite loud. They can be heard by people who are close to the patient, when he simply opens his mouth, yawns or chews food. In this case, pain may not occur.
As a rule, when disks are displaced, muscle strain occurs when the patient hears a click. This usually happens when chewing food. At such moments, the patient due to stress can feel pain in the neck, head, face.
Headache
Pain syndrome of the temporomandibular joint is often manifested by pain in different areas of the head. This is another common symptom of pathology. Usually a headache with the development of TMJ dysfunction is localized in the neck and temples. But often the patient may experience unpleasant sensations in the area of the shoulder blades.
The cause of a headache in this case may be muscle pain that occurs when grinding your teeth and clenching your jaw. Also, discomfort can disturb the patient due to displacement of the disks of the joint itself. In this case, pain radiates to the neck, forehead or temples. It is worth noting that such unpleasant phenomena can be quite strong. In some cases, the doctor erroneously diagnoses a brain pathology or migraine.
Locking, grip joint: blocking
Pain dysfunction of the temporomandibular joint often causes an uneven movement of the lower jaw, due to certain disorders. Blockage can be seen when opening the mouth. There is a feeling that the patient is trying to “catch” something with his lower jaw.
In some cases, people with a blocked joint need to move the device left and right to open their mouth wider. 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.
Ear symptoms
Since the TMJ is very close to the auricles, certain ear symptoms may occur. Some of them are rather unpleasant. Signs of dysfunction in this case include:
- pain
- a feeling of stuffiness in the ear;
- muffled ears, causing hearing loss.
It is because of these signs that many patients who have a dysfunction of the temporomandibular joint seek help from a local physician or ENT doctor.
Tooth problems
Disruption of the joints of the lower jaw can lead to a change in occlusion or dental occlusion. This is often due to displacement of the disks. The bones and their joints do not correspond to the norm, which leads to a change in the bite.
In addition to this problem, the patient can become very sensitive teeth. Most often this happens due to gnashing of teeth and clenching of the jaws. Often people with a similar pathology turn to dentists with complaints of pain in the teeth. Not always specialists are able to determine the main cause of the discomfort. Because of this, the patient can be removed a tooth or carry out its depilation. And this does not save from TMJ dysfunction.
Other signs
Dysfunction of the temporomandibular joint in certain situations is accompanied by inflammatory processes resulting from synovitis or arthritis in the joint itself. In this case, a person may complain of swelling of the tissues, pain. Often this leads to general malaise, weakness and an increase in temperature.
In addition to the above symptoms, the patient may be disturbed by:
- pain in the back and shoulder blades caused by muscle spasm;
- impaired appetite and sleep;
- dizziness;
- depression, which often develops due to feelings and misunderstanding of the problem that caused the discomfort;
- with painful sensations of a chronic nature, changes in the chemical structure of the brain may occur.
The initial stage of diagnosis
Temporomandibular joint dysfunction has many symptoms. However, the diagnosis of such a pathology is a multi-stage, long, complex and complex process. It is not always possible to make the correct diagnosis, only on the basis of patient complaints. First of all, a functional diagnosis is performed, which allows you to determine the causes of the development of pathology.
In this case, a set of procedures is carried out:
- medical data collection;
- identification of all complaints;
- study of muscle tissue of the neck and head;
- X-ray diagnostics: magnetic resonance and cone beam tomography;
- neurological examination, lateral teleentgenography;
- cephalometric analysis;
- identification of parafunctions;
- occlusography.
Dental examination
In some clinics, a small functional dental analysis is often performed to determine the diagnosis. It is also considered a primary diagnosis. In this case, the impression is taken from the patient, and then a model is made. Also for diagnosis, special drops are used that can detect bruxism. During the examination, the dentist must evaluate the bite, as well as the quality of the interdental contacts and so on.
The most complex is considered a large functional analysis not only in the implementation, but also in the interpretation of the data. In this case, the specialist must have special skills and knowledge. For such diagnostics, additional equipment is required.
All of the above tests are necessary for making a diagnosis and identifying the causes of TMJ dysfunction. The accuracy of the research depends on the experience of specialists and equipment. After diagnosis, the patient is prescribed adequate therapy. She, in turn, can be surgical, reconstructive or conservative.
Who to contact
Such a pathology is quite difficult to diagnose. Even experienced dentists rarely make a diagnosis of pain dysfunction of the temporomandibular joint. In many cases, treatment is prescribed incorrectly and does not produce results. In most cases, patients do not receive qualified help from dentists and start visiting other specialists: a psychotherapist, a neurologist, a therapist, an otolaryngologist, a manual therapist, an osteopath, and so on. In fact, dentists should deal with the treatment of dysfunction.
Temporomandibular joint dysfunction: how to treat
To obtain a positive result, complex therapy should be carried out. It includes orthopedic treatment of dysfunctions of the temporomandibular joint, which is aimed at correcting the bite. In certain situations, surgery, acupuncture, physiotherapy, prosthetics or removal and installation of a new filling are performed.
In addition to the above, the doctor may prescribe wearing a trainer at night. This is a kind of articular splint, which allows you to remove myofascial pain syndrome. It is also used for diagnostics, to prevent abrasion of dental tissues with bruxism.
Can a temporomandibular joint dysfunction cause complications? Treatment of such a pathology must be carried out necessarily. In some cases, dysfunction leads to displacement of the discs. As a result of this, the surfaces of the joints lend themselves to restructuring - arthrosis. In the cavity, connective tissue begins to grow, which in itself is coarse. 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 a dysfunction of the temporomandibular joint, then if necessary, the patient can be helped by reducing pain and also improving chewing function. To do this, you need heat, but only moist. In this case, a compress can be applied to the sore spot: a bottle pre-filled with hot water. To avoid burns, it is recommended to wrap the container with a slightly damp but not wet towel.
To reduce the intensity of pain, as well as reduce inflammation, it is recommended to use ice. In this case, you can use a bag or a bottle. However, you should not apply such a compress directly to the skin. A package or a bottle should be wrapped with a towel. It is not recommended to use it for longer than 15 minutes. In this case, a break between procedures should be at least 60 minutes. Analgesics allow you to relieve pain for a while.
How to relax a joint
To the joint often does not strain, you should adhere to several rules. The food should be mashed or soft, as well as mixed. It is worth abandoning chewing, coarse, tough and solid foods. It is worth biting off in small pieces. With such a violation, it is not recommended to open your mouth wide.
Complete body relaxation also helps reduce pain. Any relaxation technique is suitable for this.
Pain of the temporomandibular joint: ICD-10
According to the international classification of diseases, temporomandibular joint dysfunctions are indicated by code K07.6. In this case, violations can manifest themselves in different ways. These include: a complex or Kosten's syndrome, TMJ looseness, “snapping jaw”, TMJ lobar dysfunction syndrome.
Exceptions are sprains and dislocations of the jaw.