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Often
heard among the general public are complaints of people who have
trouble chewing, suffer headaches and earaches, lack the ability
to open their mouths widely, and have muscle tenderness and spasm
throughout their face and neck. A majority of the time the person
doesn't seek help or is bounced from doctor to doctor in an attempt
to determine the reason for their affliction prior to seeking consultation
with their dentist. When these complaints are of a persistent nature,
they frequently coincide with disorders of the tempromandibular
joint (TMJ)'s and their associated structures. These problems are
known collectively as tempromandibular disorders(TMD).
The TMJ's play a major role in the daily activities of all people.
Since these joints enables us to chew, speak, and swallow, a disruption
in this system can lead to multiple disorders. The TMJ's are very
unique. They are essentially "ball and socket" joints.
The "socket" being a part of the skull bone and the "ball"
being the heads of the mandibular (lower) jaw bone. Sandwiched between
the two is the articular cartilage or shock absorber. This structure
provides for the gliding action of the joint. The joints (right
and left) sit in front of the carcanals and below the cheek bones.
Intimately associated with these joints are a host of muscles, ligaments
and tendons which act in synchrony when the joints are properly
functioning.
Signs and symptoms which may be isolated or
combined of TMD may include:
1-difficulty
with chewing foods
2-clicking,
popping, and locking of jaw joints
3-stiffness
of jaw muscles
4-earaches
5-limited
mouth opening
If
these signs and symptoms are of a persistent nature, a consultation
with your dentist would be most appropriate. Your dentist will be
able to perform a history and clinical examination take radiographs
if necessary and determine whether the origin of these symptoms
stem from the TMJ.
Early detection and intervention is important in the overall treatment
scheme. If recognized early, conservative therapy such as diet modification,
anti-inflammatory medication, physical therapy and the wearing of
an oral appliance can be utilized in an effort to reverse the process.
Without early treatment or patients not responding to conservative
therapy, surgery may be necessary if it is determined that its a
joint problem rather than muscular in origin. A first line surgical
technique is tempromandibular joint arthroscopy. Similar to a scope
used for treating ailments of the knee, the arthroscope is introduced
into the joint and maneuvered to visualize the anatomy and condition
of the joint. Advanced arthroscopic techniques can be performed
if necessary to re-establish and climinate pathologic processes.
Arthroscopy is usually performed by Oral and Maxillofacial Surgeon
in the hospital under general anesthesia.
Tempromandibular disease once a mystery for the general public can
now be more easily comprehended and treated with the help of your
dentist and related healthcare professionals.
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