Temporomandibular disorders are problems of the jaw joint and chewing muscles. Usually these problems are related to tooth grinding (bruxism). The most common complaints are clicking joints, tooth grinding, painful mouth opening, restricted mouth opening, and pain in the temple area; however, many other signs may appear. The etiology of these disorders is complex, often necessitating thorough investigation, instrumental examination and imaging tests. Patients with joint disorders may need magnetic resonance imaging (MRI), which allows the visualization or non-bony structures (such as the articular disc).
Treatment of these conditions depends on their nature. Several types of treatment are available: physiotherapy, rigid acrylic night guards, tooth prosthetics, etc. During and after treatment patients are advised to follow a specific diet. These measures are usually effective and invasive treatment is often unnecessary. In difficult cases, additional help of a neurologist, surgeon or sleep specialist, and even surgery may be needed. Other diseases, such as rheumatoid arthritis, etc, may also cause temporomandibular disorders.
IMPORTANT! There are cases where pathological processes (be it sinusitis, migraine, trigeminal neuralgia, etc.) in the adjacent areas cause pain which radiates to the area of the joints and teeth. In these cases, the patient may think he has pain in the tooth of the joint, but it is important not to begin dental treatment if the cause of pain is elsewhere. Determining the exact cause is often difficult and sometimes impossible, as the nature of some headaches is unknown.
Questions regarding temporomandibular disorders are handled by our highly qualified prosthodontists.
Fig. 1. View of the mandibular articular condyles in a CT scan
Fig. 2. MRI exam: anterior disc position and its reduction (the return of the disc onto the condyle). That is the cause of clicking in the joint.