27.10.2015 08:25

The state of the dental system as a whole and the state of its individual elements directly depends on the functioning of its components, namely the jaw bones, tongue, teeth, masticatory muscles, joints, ligaments, nerves, TMJ (temporomandibular joint). When the work of all organs of the masticatory apparatus interacts harmoniously, the patient does not experience any discomfort when opening and closing the mouth, eating, chewing, talking, yawning, etc. In case of dysfunction, pain and discomfort appear in the oral cavity, muscles, joints, and in addition, dental diseases develop, including numerous caries. The appearance of unpleasant sensations is the initial signal about the presence of malfunctions in the masticatory apparatus, and here it is very important to consult a doctor in a timely manner, conduct a diagnosis and begin treatment. From this article you will learn:

TMJ and what impact dysfunction has.

It is necessary to understand that the dental system is a complex functional apparatus that performs such important tasks for humans as ensuring free mobility of the jaws, eating, talking, etc. The harmonious interaction of all its elements influences comprehensive work chewing apparatus. The temporomandibular joint (TMJ) is one of the components of the dental system, the proper functioning of which determines the condition of the masticatory apparatus. The TMJ is a joint consisting of two parts through which the lower jaw is attached to the bones of the skull and ensures the physiological functioning of the lower jaw. TMJ diseases make it difficult correct execution functions, causing the patient not only significant discomfort, but also painful sensations. Painful syndrome at muscularly- joint disorders are a fairly common phenomenon, and many patients, when muscle pain occurs, do not consult a doctor because they do not associate the pain with the teeth. However, it is TMJ dysfunction that causes muscle pain. With TMJ disorders, characteristic clicking sounds occur in the joint when opening and closing the mouth, frequent headaches, muscle pain in the neck and shoulder area, pain and tinnitus. Muscular joint dysfunction can also manifest itself as pain in other areas of the body, since the TMJ is directly related to the spine, posture, etc. Muscular painful syndrome can be relieved with compresses, but for full treatment it is necessary to undergo thorough examination at the gnathologist.

Occurs by various reasons, this may be a genetic factor, or the influence bad habits, incorrectly formed bite, abnormal development jaws, and also have a significant impact on the proper functioning of the TMJ nervous stress. When a patient experiences frequent stress, he involuntarily tenses masticatory muscles, which is why the latter are in constant tone. This leads to increased wear of teeth, displacement of the articular head, loosening of teeth, infringement of the neurovascular bundle and other problems. When the slightest deviation from the norm appears in the dental system, this inevitably affects the functioning of the temporomandibular joint, malfunctions appear, which entails a number of internal diseases. Muscular joint dysfunction can even appear due to poorly performed dental treatment, especially with improper prosthetics. The occurrence of toothache without visible reasons is the main signal of dysfunction. A full examination by a neuromuscular dentist or gnathologist will identify the cause and eliminate muscularly painful syndrome and restore TMJ function. It is necessary to understand that a disease such as TMJ dysfunction requires a competent approach: careful computer diagnostics and professional treatment at the gnathologist.

A gnathologist or neuromuscular dentist prescribes an examination that visually demonstrates the condition of the jaws and TMJ, and also uses computer equipment to simulate the necessary physiological closure of the teeth for a particular patient. Using a number of devices, the entire dental system of the patient is diagnosed and removed. muscularly painful syndrome and the optimal one is selected treatment.

What signs should you see a doctor for?

Temporomandibular joint dysfunction manifests itself individually. Since there are many symptoms of the disorder and many are similar to other diseases, it is necessary to consult with your doctor if you experience the slightest discomfort. To determine the disease, an examination by a dentist is prescribed, and if TMJ dysfunction is suspected, a diagnosis is carried out by a gnathologist.

The lower jaw, when disorders occur in the temporomandibular joint, takes incorrect position(the one at which it can function) and gets used to it. However, incorrect jaw position causes malfunction of the temporomandibular joint, which manifests itself as pain, muscle spasms, headaches and neck pain, tinnitus, limited mouth opening, etc. In addition, with dysfunction, when the jaw is not in a physiological position, tooth wear increases, dental structures (if any) quickly wear out, chips and cracks appear on the teeth, teeth shift, gum diseases occur, etc. Since muscle dysfunction causes significant discomfort to the patient, the doctor first relieves the symptoms and then eliminates the causes. The correct functioning of the dental system is possible only when the function is restored, and this implies a thorough diagnosis, treatment from a gnathologist, as well as a complex of therapeutic procedures. It is necessary to understand that when removing muscularly pain syndrome, the function is not restored, i.e. must be brought lower jaw to the correct physiological position. For this purpose they are used modern methods recovery, treatment be carried out based on individual characteristics patient and general clinical picture the entire dental system.

It is worth noting that the correct, physiological position of the jaw is determined using special computer technology, which diagnoses the current position of the jaw, joints and muscles, and models the type of teeth closure required for a particular patient. Thanks to modern technologies, you can clearly see all the processes in the masticatory apparatus, identify and eliminate the cause of dysfunction, carry out high-quality and effective treatment bite, as well as achieve the best aesthetic result.

Which doctor should I contact for TMJ dysfunction?

Treatment dental problems and periodontal diseases must be carried out comprehensively, taking into account not only the specific source of discomfort, but also the entire dental system of the patient. This approach allows for the most effective treatment without subsequent relapses. Complex treatment allows you to eliminate visible and hidden diseases oral cavity, restore disturbances in the functioning of the masticatory apparatus and create beautiful smiles. Similar is correct treatment is carried out by a gnathologist and a neuromuscular dentist, who, for effective result, often attract specialists from other fields. This approach ensures high-quality treatment the entire dental system of the patient. It is important to understand that the slightest bump on the surface of a tooth or a crooked tooth can affect the functioning of the masticatory apparatus, so treatment of dental problems should be carried out comprehensively, using modern methods of diagnosis and restoration of function.

Removal muscularly pain syndrome is carried out using various methods, including applications and compresses, but in most cases it is necessary complex therapy. In addition, to consolidate the result and guarantee the absence of relapse, it is necessary to undergo diagnostics and restore function. Diagnostics allows you to see disorders in the temporomandibular joint and determine the physiological type of teeth closure. Based on the diagnostic results, it is prescribed complex treatment bite, the purpose of which is to bring the lower jaw into the correct position and improve the functioning of the TMJ. With this approach, harmonious interaction of all components of the dental system can be ensured and, as a result, correct work chewing apparatus.

This is a pathology of the joint (temporomandibular), which is caused by spatial and occlusal muscle changes. Most often it is accompanied by serious pain in the neck, radiating to the temples, and a migraine is formed. When moving the jaw, clicks appear, mouth opening (amplitude) noticeably worsens. Ringing and noise in the ears are also typical. In a dream, a person with such disorders snores.

Features of the disease

Dysfunction of the temporomandibular joint is due to the fact that the lower jaw is under a certain influence various factors can change its position - distalize, that is, move back, or turn around, but only within the capsule. In such a situation, the interarticular type disc is exposed to quite significant pressure from the lower jaw (head). This often provokes its displacement forward, which leads to dislocation.

Such negative manifestations can form every time there is active movement of the jaw, which will provoke chronic changes and more serious pathologies.

The main symptom of the disease is the appearance of a peculiar crunch, often clicks. Also arises unpleasant feeling in the ear area. The element of the lower jaw, namely the head, can move deeper into the cavity on one or both sides. This, in turn, provokes compression of the bilaminated zone, in which a significant number of nerves and various vessels are located. Since the zone does not have necessary protection due to dislocation, pressure is provoked on it, which creates very noticeable pain.

At the moments of swallowing or eating, the temporomandibular joint begins to move; with dysfunction, it is formed each time dislocation. Over the years, the disc wears out, and the ligament that holds it in place also breaks and becomes thinner. After which, enough happens active process destruction of the surface (since the head will move without shock absorption).

Reasons

1. Temporomandibular joint dysfunction (TMJ) is often caused by nervous irritations and stress.
2. Arthrosis, various types arthritis become the basis for the occurrence of this pathology, and the manifestation begins with the onset of a minor pain syndrome and gradually develops into the pathology in question.
3. Scoliosis of the spine, as well as various pathologies pelvis They seriously affect muscle tone and posture. Against the background of these changes, the development of compensatory dysfunctions of the skull is formed.
4. Any injuries can become an indisputable basis for serious side effects, including TMJ. Serious immediately arises pain syndrome, after which the dislocation can appear instantly, often accompanied by swelling and significant changes in the bite.
5. Various bite pathologies that may be associated with a violation of the position of the jaw, in the absence of chewing teeth.
6. Not correct treatment dental diseases, prosthetics, etc. Difficulties in adaptation often arise, which provokes pathologies of the jaw.
7. Increased stress, which can occur during various activities, in particular when playing athletic sports.

Symptoms

Temporomandibular joint dysfunction is characterized by the following symptoms:

• Severe pain when eating or swallowing. The symptom appears gradually. Immediately the symptoms are minor, but as the disease progresses they become more pronounced.
• Formation of extraneous sounds when moving the jaw. Most often, clicking and a certain crackling sound appears. In certain cases, the clicks can be extremely loud and can be heard strangers. At the same time, the sound phenomenon is not always combined with the manifestation of pain.
• Headache and slight dizziness. If the pathology is not treated, then these symptoms appear more often and more vividly.
• “Locking”, a kind of “jamming”. That is, uneven movement appears when opening the mouth. In certain cases, the patient cannot turn the jaw from side to side when opening.
• The disease often manifests itself as pain in the ears, and carved toothache, is formed high blood pressure in the eyes. Against the background of pathology, otitis media, arthritis, and osteochondrosis may develop.
• Pathologies also appear in the form of bruxism, depression, there are situations of sleep disturbance, photophobia, paresthesia, and snoring are formed.

Diagnostics

Diagnosis of the disease is quite complex, and without special examinations impossible to get by:

1. An examination by a therapist, neurologist, dentist, or rheumatologist is recommended.
2. After a visual examination, as well as studying the symptoms, an examination is prescribed.
3. X-rays are required.
4. Computed tomography and ultrasound examinations are also used.
5. Orthopantomography is used.
6. In certain cases, a number of clinical tests are prescribed.

First aid

If injuries occur, you should immediately contact a specialist to reduce the load by mechanical methods. You can also use cold to relieve swelling. If a crunching sound, extraneous sounds and significant pain occur, you can take a painkiller and consult a doctor for a diagnosis. Self-medication in this situation is unacceptable.

Features of treatment

• For the period of treatment in mandatory the load on the temporomandibular joint is reduced. It is recommended to eat soft foods and reduce speech load.
• Depending on what caused the development of the disease, it is prescribed symptomatic treatment. Non-steroidal anti-inflammatory drugs and agents that restore cartilage tissue are prescribed special drugs relieving muscle spasms.
• To eliminate pain, sedatives can be prescribed, special blockades and intra-articular injections can be made, painkillers can be prescribed, and glucocorticosteroid injections can be performed.
• Physiotherapy is used for recovery (laser and ultrasound are most often recommended).
• Psychotherapy, as well as dental treatment(if it became the basis for the occurrence of pathology).
• In certain cases it may be necessary surgery.

Prevention

1. Elimination of excess loads on the joint.
2. Reducing the manifestation of stress and depression.
3. Correction of bite and other dental diseases.
4. Posture correction.

What is temporomandibular joint dysfunction? This question interests many people. Problems with teeth are not uncommon for humans, problems with joints are also common, but there is a disease that combines these two types - temporomandibular joint dysfunction. This diagnosis is one of the most unstable, and treatment depends on the symptoms. More than half of all dental visitors complain about this disease, and this is not surprising, since according to recent studies, approximately 58% of people suffer from one form or another.

Moreover, dysfunction is common in children, affecting approximately 23% of people under 18 years of age.

There are a lot of clinical manifestations of this disease, and treatment is complicated by the fact that the disease is polyetilogical, that is, it can be caused by either one or a number of factors.

Features of the disease

Diagnosis is quite complex, as is treatment, which can take several months. But the sooner you start treatment, the easier it is to stop pathological changes joint of the lower jaw and it is easier to find the main causes, so in no case should you delay.
Oddly enough, the most popular reason that can cause dysfunction of the TMJ joint is stress.
The second most popular reason for the development of TMJ dysfunction is the negligence or lack of experience of the dentist. The disease can be caused by unsuccessful dental treatment, but in most cases the dentist is not to blame; the blame goes to the patient, who did not accurately follow the procedures and restrictions prescribed to him during the rehabilitation period after any intervention.
If we consider the doctor’s mistakes, then they include incorrect installation of the filling. chewing tooth What causes asymmetry? Of course, it may be a couple of millimeters, but from that time on the joint is affected during chewing. increased load, due to which it is destroyed or displaced faster, and only after this does TMJ dysfunction begin.
In addition, there is a list of popular reasons:

1. Injury to the joint, such as a strong side impact that can dislodge a disc.
2. In cases where a session with a dentist lasts more than 3 hours without breaks. A constantly wide-open mouth compresses the discs.
3. If teeth have been lost and not replaced with implants. Thus, a person’s bite is reduced. To survive food, you have to do a lot of rotational movements, which is why the discs are quickly developed.
4. Teeth grinding or clenching.
5. Clenching of teeth and cheekbones when lifting heavy weights.
6. Hormonal and contraception may negatively affect discs and joints, including the TMJ.

The list can be continued indefinitely, since each person also has individual problems, but in any case they are interconnected with those listed above.
Dentists, therapists, neurologists and other doctors try to avoid treating such patients, and if they provide care, it is not of high quality, and the patient has to go from one doctor to another, from one treatment room to another, but the problem does not go away.
The USA has the most money insurance companies They pay specifically for the treatment of jaw joint dysfunction, and the number of patient requests is simply colossal.

Symptoms that appear with temporomandibular joint dysfunction:

1. With a disease of the temporomandibular joint, sounds may be heard different sounds and clicks. This is the most common symptom, which with 100% accuracy indicates a violation of the TMJ. These sounds can be either insignificant or so loud that they can be heard nearby. standing people. Clicking occurs during wide opening of the jaw, excessive clenching of teeth, and while eating. This all means that the disc has shifted and during the click it returns to its place, but at the same time the muscles are overly tense, as a result of which headaches and toothaches appear.
2. Headaches. Of course, they happen to everyone and for different reasons, but it can also be a symptom of TMJ. In this case, the headache will be localized in the temples, back of the head and in rare cases in the neck and shoulder blades. To test what a headache indicates, it will be enough to clench your jaw tightly, and if the pain intensifies at this moment, then the chance of TMJ increases significantly. But often, along with this symptom, teeth grinding appears, especially during sleep. The pain can be either mild or very severe, which doctors often confuse with migraine.
3. Pain dysfunction. This means that the disc flew out while the jaw was closed or wide open, and the muscles cannot put it back in place; in this position, the person cannot move the jaw due to severe pain.
4. TMJ locking. During the disease, jaw movements may cease to be smooth and there is a feeling that the movement is happening as if on rusty gears. That is, in jerks, and with each jerk there is a click.
5. A person's bite changes. This happens because, as the disc itself displaces, it also displaces the bone.
6. Infringement facial nerve, which can cause both severe pain, and paralysis of the facial area until the nerve can be released.
7. Symptoms can also radiate to the ears. Since the joint is located in close proximity to the ears, dysfunction in it can cause problems with the ears, ranging from ordinary pain to hearing loss, but if you consult an ENT specialist in time, these symptoms can be quickly eliminated.
8. Inflammatory processes. Swelling may begin at the site of the lesion, body temperature rises and malaise is felt.

Treatment of the disease

There is no treatment as such, so first there is long period, during which the patient is tested for the presence of all possible factors that caused the disease.
If symptoms are detected, they should be removed immediately. This period may last a couple of months.
The joint itself is treated with a rather primitive method and only during the period of its maximum inflammation, since at this time the disc has come out, the muscles are relaxed, as a result of which everything can quickly be put in its place.
After the doctor inserts the jaw into place, it must be secured with a special bandage to prevent it from falling out again. In the coming days, eating any solid food is prohibited, you need to talk less, and these bandages will prevent you from yawning and the like.

The temporomandibular joint is located in front of the ear and includes the lower jaw and temporal bone. It is he who makes it possible to talk, swallow, chew, move the jaw in different sides. TMJ dysfunction is a pathology of the coordination of this joint as a result of improper placement of its components, malocclusion, or problems with muscle function.

Diagnosing the disease is difficult. This is due to the multiplicity of symptoms and a large number changes occurring against the background of the disease. All this complicates the diagnosis and treatment process.

TMJ dysfunction: signs

TMJ dysfunction syndrome is characterized by symptoms:

• Pain in the jaw, face, shoulders and neck.
• Discomfort when opening the mouth, talking, eating.
• Inability to open mouth wide.
• Problems with the jaw returning to its place when opening.
• Clicking and other sounds when the mouth moves in different directions.
• Difficulty chewing.
• Fatigue of facial muscles.
• The appearance of swelling on one side of the face.

TMJ dysfunction - causes of the disease

A common cause of TMJ dysfunction is stress. TO possible factors that led to the development of the disease include:

1. Illiterate placement of the filling. As a result, the symmetry in the functioning of this joint is disrupted, one side of the jaw experiences overload, the discs are displaced, and this syndrome occurs.
2. Long-term dental treatment at the dentist.
3. Joint injury.
4. Increased stress during sports.
5. Grinding of teeth.
6. Loss of teeth and changes in bite due to this reason.
7. Taking certain oral contraceptives.

A common symptom is headache. The patient feels discomfort in the temples, back of the head and even shoulder blades. The headache can be so severe that doctors suspect migraine and brain disease.

The proximity of the joint to the ears leads to the appearance painful sensations in the ear, congestion and even hearing loss. Ringing is also an alarming symptom.

Diagnosis of TMJ dysfunction

Given the variety of symptoms, diagnostic difficulties arise. Therefore, patients go from office to office to find out accurate diagnosis and are examined for a long time by several specialists: a therapist, a neurologist, an ENT doctor, a rheumatologist. In fact, the definition of the disease and its further effective treatment depends on the coordinated work of two doctors: a dentist and a neurologist.

The symptoms of this anomaly are similar to other diseases. In this regard, the doctor needs to study the anamnesis and conduct a series of studies. The doctor will check the joint for pain, listen to the sounds made when the jaw moves, note how much limitation of movement and blocking the jaw has as it moves up and down, and check the bite.

Conducted panoramic shot to exclude other diseases. To assess the condition of soft tissues, computed tomography or magnetic resonance imaging is performed. After the examination, the doctor decides on treatment or refers the patient to a maxillofacial surgeon.

Treatment of TMJ dysfunction

The treatment strategy for TMJ dysfunction is to reduce the load on the affected area. It is necessary to limit conversations, eat soft foods and perform other gentle actions. To get rid of pathology, specialists are involved: dentists, osteopaths, neurologists, psychologists.

Considering that TMJ dysfunction syndrome forces the patient to experience pain, pain therapy is carried out.

1. Taking sedatives and antidepressants.
2. Massage, myogymnastics, and various physiotherapeutic methods (electrophoresis, laser, ultrasound) are indicated.
3. Psychosomatics and visiting a psychologist.

At a dentist's appointment, treatment of this pathology is carried out primarily with the aim of returning the bite to the place of the bite for proper closure of the teeth, correcting fillings that rise above the surface of the crown, and high-quality prosthetics. To correct the bite, braces are used. Recovery is facilitated by the use of orthopedic mouth guards and splints.

If therapeutic treatment did not bring the desired results, is being carried out conservative therapy. In this case, surgical intervention is performed. It includes following procedures: myotomy of the lateral pterygoid muscle, arthroplasty, condylotomy of the head of the jaw located below.

For successful treatment a complex of medical actions is shown. This includes treatment by an orthodontist, replacement of fillings, surgery, proper prosthetics, physiotherapy and acupuncture.

Treatment of such an anomaly is extremely important. If you neglect this problem, complications will arise: arthrosis, joint immobilization. Only combined treatment will give a positive result.

It is possible to prevent the disease, it is necessary to avoid stress, excess pressure on the joint, carry out high-quality dental prosthetics, correct the bite, if necessary, and solve problems with posture.

TMJ dysfunction is associated with changes occurring in the human jaw. The jaw joint and the muscles located around it are affected. Because of this, the jaws move incorrectly, the process of chewing food is disrupted, and a painful sensation occurs.

Causes of the problem

Dysfunction of the temporomandibular joint can be caused by several factors, the main one being trauma. The injury may affect not only the jaw, but also the jaw joint or the muscles around it, as well as muscle fibers head and neck.

There are other reasons causing the problem with chewing function:

Characteristic symptoms

The first thing patients complain about with temporomandibular joint dysfunction is a sharp attack of pain and discomfort in the area of ​​the joint. The pain may be temporary or accompany the person for a long time. It affects mainly people of working age, most often women aged 20 to 40 years.

The following main symptoms can be identified, according to which it is not difficult to classify the disease:

1. When you try to open your mouth wide, pain occurs.
2. Pain in the face and neck, jaw joints. When chewing food, pain occurs in the area auricle. Even during communication, a person may experience a feeling of discomfort.
3. Sometimes the jaw gets stuck in some position.
4. Another manifestation is noticeable swelling of the face on the side where the joint mobility was impaired.
5. Malocclusion.
6. Audible clicks and crackles in the joint when a person talks or chews. Sometimes the grinding is accompanied by pain.
7. The patient quickly experiences fatigue in the jaw facial apparatus. The patient cannot chew food or talk for a long time.

Additional symptoms of temporomandibular joint dysfunction that you need to pay attention to:

1. Headache accompanied by toothache. A person cannot even determine exactly what hurts: his jaw, tooth or head.
2. Painful sensations spread to the ear. This may cause hearing problems. A common complaint is ringing in the ears.
3. Dizziness.
4. The pain may radiate to the neck muscles and move to the shoulder.

How to diagnose a disorder?

If the function of the temporomandibular joint is impaired, you should consult a doctor. After all, the manifestations characteristic of this disease can be signs of completely different pathologies: toothache can radiate to the ear and head, inflammation of the paranasal sinuses can lead to the same unpleasant sensations.

First of all, the specialist must examine the patient and determine whether there is dysfunction of the temporomandibular joint. To do this, he carries out a series of manipulations: asks the patient to open and close his mouth, listens to the sounds accompanying the movement of the joint. If a person cannot open his mouth wide enough or jamming occurs when trying to do so, it can be assumed that a pathology of the temporomandibular joint has occurred.

The specialist will evaluate the bite, determine if there are any deviations, and whether they perform their functions facial muscles. Temporomandibular joint dysfunction can be diagnosed after receiving x-ray. It should be panoramic, only in this way the doctor can easily examine the jaws, the joint connecting them, and absolutely all the teeth. An X-ray of the entire face allows the doctor to exclude other pathologies whose symptoms may be similar to this disease.

But not only x-rays can help in diagnosis. For TMJ dysfunction, the doctor sometimes prescribes magnetic resonance imaging, the purpose of which is to obtain images of soft tissues. In this case, the specialist sees whether the disc is located correctly inside the temporomandibular joint. It will be possible to talk about the condition of the bones and their structure based on the results of a computed tomography scan.

After conducting the above studies, the doctor will confirm or refute the diagnosis of TMJ dysfunction. Further management of the patient will be carried out by a surgeon specializing in operations of the facial part of the body and the oral cavity.

Treatment methods

All patients who have been diagnosed with TMJ dysfunction are interested in the question of how to get rid of pain faster and what is being done to treat temporomandibular joint dysfunction? After all, a feeling of discomfort and pain dysfunction changes a person’s usual way of life. Several treatment methods are used.

When diagnosing disorders TMJ treatment could be as follows:

Only the doctor decides how to treat the pathology of the temporomandibular joint; self-medication can lead to the joint hurting for a long time.

But the patient himself can alleviate the condition. Correct posture will eliminate pain in the neck. A set of exercises selected by a physical therapy specialist will strengthen the ligaments. Massage relieves pain well. With any deviations in the functioning of the jaw, you should consult a doctor in a timely manner to prevent the occurrence of any complications.