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Temporomandibular-Joint-Disorder-(-TMD-)-Causes-And-Remedies-in-2023

Temporomandibular Joint Disorder (TMD) Causes And Remedies In 2023

Table of Contents

The temporomandibular joint (TMJ) is a gliding joint that connects the jawbone to the skull. You have a joint on each side of your jaw. 

The temporomandibular joint syndrome can lead to pain in the jaw joint and the muscles that control the movement of the jaw . Diagnosing the exact cause of the temporomandibular joint syndrome is usually challenging.

Your pain can be due to various factors such as genetics, arthritis, or jaw injury. Some people with jaw pain tend to clench or grind their teeth (bruxism), although many people without temporomandibular joint syndrome usually have a habit of clenching their teeth.

Related: “Bad Breath Like Rotten Eggs ( Causes And Remedies )

In most cases, the pain and discomfort caused by the temporomandibular joint syndrome are temporary and can be relieved with home care or non-surgical treatments.
In this article, you can learn about the symptoms, causes, diagnosis, and treatment of temporomandibular joint syndrome.

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Temporomandibular joint disorder syndrome symptoms

Signs and symptoms of temporomandibular joint syndrome may include the following:

  • Jaw pain or tenderness
  • Pain in one or both temporomandibular joints
  • Pain in and around the ear
  • Difficulty chewing or pain when chewing
  • facial joint pain
  • Joint locking makes it challenging to open or close the mouth.
  • Temporomandibular joint disorder syndrome can also cause clicking or discomfort when opening the mouth or chewing.

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Related: “Top 10 Root Causes Of Dental Pain

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What are the causes of TMJ disorder, and are there any risk factors?

Causes of temporomandibular joint syndrome disorder:

In the temporomandibular joint, joint movement is combined with sliding movements. The parts of the bones that meet at the joint are lidded with cartilage and are separated by a small shock-absorbing disc that usually keeps the movement smooth.

Related: “Gingivitis Treatment And Symptoms / With Or Without Gum Pain

In the event of the following problems, a person may suffer from temporomandibular joint pain disorder syndrome:

  • Disc erosion or out-of-balance
  • Joint cartilage damage due to arthritis
  • Damage to the joint due to impact

However, in many cases, the cause of temporomandibular joint syndrome is unknown.

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Related: “How Do I Know What Kind Of Toothache I Have?”

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How is TMJ disorder diagnosed, and what are the treatment options available?

Temporomandibular joint syndrome risk factors:

Factors that may increase the risk of temporomandibular joint disorder syndrome include:

  • Different types of arthritis, such as rheumatoid arthritis and osteoarthritis
  • jaw injury
  • Long-term (chronic) grinding or clenching of the teeth
  • Some connective tissue diseases cause problems that can affect the temporomandibular joint.
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Related: “Rheumatoid Arthritis Diagnosis/ Timely Action

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Diagnosis of temporomandibular joint disorder syndrome:

Please pay attention to the sound and position of your mouth when you open and close it.

Pay attention to the range of motion of your jaw.

Press on the areas around your jaw to identify points of pain or discomfort.

If your doctor or dentist determines that you have suspected temporomandibular joint syndrome, you may need the following tests:

  1. Dental X-rays to check the teeth and jaw
  2. CT scan to give detailed images of the bones involved in the joint
  3. MRI to identify problems with the joint disc or the soft tissue around it

Sometimes, temporomandibular joint arthroscopy is used to diagnose the temporomandibular joint syndrome. During temporomandibular joint arthroscopy, the doctor inserts a thin and small tube (cannula) into the joint space. Then, a small camera (arthroscope) is inserted to view the desired area and help diagnose the problem.

Related: “Does Root Canal Swelling Go Away on Its Own?

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Take action before it gets worse.

The Diagnostic Criteria for RA

Can a blood test confirm rheumatoid arthritis?

Blood tests are used to help diagnose rheumatoid arthritis, monitor the effectiveness of treatment, and track disease activity.

Although blood tests are valuable diagnostic tools, they need higher accuracy.

In order to accurately recognize the disease, in addition to testing and imaging, the patient’s medical history must also be evaluated, including current symptoms, especially pain, swelling, and stiffness, their location, duration, and severity.

After examining the medical history, specialists will make a “differential diagnosis,” which attempts to rule out other similar and autoimmune diseases such as lupus, psoriatic arthritis, gout, or osteoarthritis.

Related: “How Adaptive Immune System Works?

In the examination of the medical history for early detection of rheumatoid arthritis, they will also ask questions about the family history because, according to the research, people who have a family member with this disease will be more than two times more exposed to this disease than other people.

Related: “What Are The Red Flags Of Rheumatoid Arthritis?

Treatment of temporomandibular joint disorder syndrome:

In some cases, temporomandibular joint syndrome symptoms disappear without treatment. However, if the symptoms persist, the doctor can recommend different treatment options; more than one should often be done simultaneously.

  • medicines

Along with other non-surgical treatments, some drugs can help relieve the pain caused by temporomandibular joint syndrome, which includes:

  1. Painkillers and anti-inflammatory drugs If over-the-counter pain relievers help relieve pain, your doctor or dentist may prescribe more potent pain relievers, such as ibuprofen, for a limited time.

  2. Tricyclic antidepressants.These drugs, including amitriptyline, are mainly used for depression, but low doses are sometimes used to relieve pain and control teeth grinding and insomnia.

  3. Muscle relaxants In some cases, these types of drugs are prescribed for a few days to reduce the pain caused by temporomandibular joint disorder syndrome caused by muscle spasms.

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  • Acupuncture

Acupuncture is increasingly being used to treat temporomandibular joint syndrome. Treatment sessions usually last 15 to 30 minutes, and the average number of sessions is six to eight. 

Acupuncture is an appropriate adjunctive treatment for short-term pain relief in patients with temporomandibular joint disorder syndrome symptoms. 

In this method, an expert trained in acupuncture treats your chronic pain by placing wonderful needles in certain body parts.

  • Relaxation techniques

Consciously reducing breath holding and taking deep and regular breaths can relax tight muscles and thus reduce pain in the jaw hinge.

  • Biofeedback

Cognitive behavioral therapy and biofeedback can effectively control short-term and long-term pain for patients with temporomandibular joint syndrome. 

Patients should be counseled on behavioral modifications such as stress reduction, sleep hygiene, elimination of dysfunctional habits (such as teeth grinding, chewing on pencils or ice, clenching teeth) and avoiding excessive mandibular movements (such as excessive opening during yawning, brushing and flossing) be consulted. Electronic devices that monitor the stiffness of specific muscles can help you practice relaxation techniques.

  • Non-pharmacological treatments

Non-pharmacological treatments for temporomandibular joint disorder syndrome include:

    • Splints or mouth guards (occlusal devices)

Usually, using a soft or hard device placed on the teeth is helpful for patients with jaw pain, but the reason for its benefit has yet to be determined.

Related: “What Is More Painful, Braces Or Invisalign?

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    • Surgery or other treatment methods

If other treatment methods do not help to improve your pain, the doctor may suggest other methods, which include:

      • ArthrocentesisArthrocentesis is a minimally invasive method in which fine needles are inserted into the joint. 

This causes fluid to exit through the joint, and as a result, waste and inflammatory substances are eliminated.

      • Injections Corticosteroid injections into the joint can be useful for some patients. 

In some rare cases, botulinum toxin type A (Botox, etc.) is injected into the jaw muscles involved during chewing and may relieve the pain caused by the temporomandibular joint syndrome.

      • Temporomandibular articulation arthroscopy .In some cases, arthroscopic surgery can be as effective as open joint surgery for treating various types of temporomandibular joint syndrome. 

A fine and small tube (cannula) is placed in the joint space, the arthroscope is inserted, and a fine instrument is used for surgery. Temporomandibular joint arthroscopy has fewer risks and complications than open joint surgery but also has limitations.

      • Modified condylomaModified condyloma indirectly corrects the temporomandibular joint, not in the joint itself, through mandibular joint surgery. This method can be helpful for pain relief and jaw joint locking.
      • Open joint surgery. Suppose jaw pain does not go away with non-invasive treatments and is probably caused by a structural problem in the joint. 

In that case, the doctor or dentist may recommend open joint surgery (arthrotomy) to repair or replace the joint.

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Can TMJ disorder be prevented, and if so, how?

Being more aware of habits that lead to tension, jaw clenching, teeth grinding, or pencil chewing will help you avoid doing these things. You can reduce or prevent the symptoms of temporomandibular joint disorder syndrome by observing the following points:

  • Avoid overuse of jaw muscles:
  • Eat soft foods.
  • Cut the food into small pieces.
  • Avoid sticky or chewy foods.
  • Avoid chewing gum.
  • Stretching and massage: Your dentist, doctor, or physical therapist can teach you how to do exercises that strengthen your jaw muscles and how to massage the muscles.
  • Heat or cold: Applying a warm, moist compress or ice to the side of the face may help reduce pain.
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Is TMJ disorder a lifelong condition, and can it be cured completely?

Treatment of temporomandibular joint disorder syndrome depends on the cause of this disease. 

Sometimes, the temporomandibular joint syndrome can be successfully cured with home remedies like changing posture or reducing stress. 

If your problem is caused by a chronic (long-term) disease such as arthritis, lifestyle changes alone are not enough to cure it.

Arthritis can destroy the joint over time and increase pain. However, there are many treatments for arthritis symptoms. 

Most cases of temporomandibular joint disorder syndrome require changes in life habits, which may be accompanied by medication to help reduce pain and discomfort. In rare cases, it is necessary to use aggressive treatments. 

It would help if you talked to your doctor to determine your suitable treatment options.

Temporomandibular joint can be caused by various reasons, such as trauma or chronic stress, so treating symptoms is directly related to treating or reducing the condition that caused them. 

However, many patients find that home remedies improve TMJ symptoms within weeks or months. In some cases, these symptoms even resolve on their own.

Related: “How Do You Slow Down Arthritis?

conclusion

In temporomandibular joint disorder syndrome, some conditions increase the pain, and no treatment can reduce it. 

Nerve blocks, some medicines and home remedies can be promising treatments for this type of pain. If non-invasive treatments are not effective, surgery is the last resort. 

For treating temporomandibular joint disorder syndrome, you should see a skilled and experienced doctor because he knows the treatments and how to control the side effects correctly; this also reduces the risks, side effects and recovery time after the treatment.

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Author and specialist

Dr. Majid Zahrabi,

Neurosurgeon

  • Board Certified Neurosurgeon
  • DHA certificate holder
  • Plantation certificate holder, France
  • Certified holder of Discogol, France
  • A pioneer in the non-surgical treatment of disc herniation in the Middle East and CIS countries.
  • Under the training and coaching of Professor Jacques Theron (founder of Discogel Therapy) since 2008
  • More than 400 successful cervical and 1300 lumbar discogel injections
  • Trained and certified several neurosurgeons and spine surgeons in the Middle East and CIS countries for the treatment of Discogel
  • Strong belief in patient-centered care planning and participation
  • Neurosurgeon and spine surgeon at Imam Khomeini and Amir Mazandarani Hospital, Sari, Iran, with more than 430 surgeries annually, 2000-2011
  • Neurosurgeon and spine surgeon at Farmaniyeh, Nikan and Yas Sepid Hospital, Tehran, Iran, with more than 400 surgeries annually, 2011-2012
  • Neurosurgeon at Iranian Hospital, Dubai, 2022-2023
  • Since 2015, he has been working as a reference doctor for the treatment of intervertebral disc herniation with Discogel and has trained many doctors of spine-related specialties in various countries of the Middle East and CIS in person/practically and online.

.

Education:

  • Individual training sessions under the direct supervision of Professor Jacques Theron in Discogel treatment, 2008-2020
  • Training sessions under the supervision of Professor Thierry Boye on spinal implants, 2007
  • Participation and presentation in several national and international medical and neuro-spinal conferences
  • Board certificate by Iran Neurosurgery Board, 2001
  • Neurosurgery assistant training course, Isfahan University of Medical Sciences, Isfahan, Iran, 1996-2001 (In 2001, he graduated from Isfahan University of Medical Sciences with the first rank in the country.
  • His thesis the titled:The Application of human amniotic membrane in repair of dura matter in dogs.” ( It was happening for the first time in the world. )
  • General medical education, Tabriz University of Medical Sciences, Tabriz, Iran, 1984-1993

.

Published books:

  • CT scan of the brain for doctors
  • Etiology and treatment of painful spine disorders
  • Atlas of diagnosis, prevention, and treatment of spine disorders
  • The most common mistakes in the treatment of spinal disorders
  • Reading brain CT scan in simple language (3rd place in the book of the year)
  • Treatment of head and spine injuries

Publications and articles:

  • Bacteriostatic and bactericidal effects of DISCOGEL® (https://www.researchgate.net/)
  • Muscle recovery, reduction of pain, and improvement of movement strategies in patients with lumbar discopathy after injection of Discogel.
  • The article on the initial results of the treatment of intervertebral disc herniation with discogel injection, which won the second-best poster rank at the Pan Arab International Congress of Interventional Radiology (March 14-16, 2015) and was accepted for presentation at the Chicago Pain Congress.
  • The use of human amniotic membrane in dura mater repair in dogs, a study for the first time in the world.

.

Lectures:

  • Annual Congress of Physiotherapists of Iran, 2019
  • Chicago International Pain Congress, 2019
  • Iran International Pain Management Congress, 2018
  • Annual Congress of Physiotherapists of Iran, 2018
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Armenia for orthopedic specialists and neurosurgeons, 2017
  • First Live Workshop and Seminar on Minimally Invasive Disc Therapy (DISCON), 2017
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Azerbaijan for orthopedic specialists and neurosurgeons, 2016
  • Seminar of Iranian official managers, 2016
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Tajikistan for orthopedic specialists and neurosurgeons, 2016
  • International Neurological Intervention Congress in Iran, 2014
  • Educational seminar for nurses on treatment approaches for head and spine trauma, 2014
  • Educational seminar for general practitioners on treatment approaches for head and spine trauma, 2014
  • Speech at the Retraining Seminar for General Practitioners and Specialists in Dubai (Discon) in 2017
  • Speech in the internal retraining courses of Irani Hospital, Dubai
  • Holding lecture sessions and practical workshops on the treatment of intervertebral disc herniation with discogel injection in Azerbaijan, Tajikistan, Ukraine, Oman, and Armenia during the years 2015 to 2021.
  • Giving a lecture and holding a practical workshop for neurosurgeons in Vietnam at Ho Chi Minh City University in 2023

Dr. Majid Zohrabi started treating his patients in Dubai in 2022 and continues his activities in private medical centers in the UAE.