Temporomandibular joint
Temporomandibular joint disorders, also known as craniomandibular dysfunction (CMD), are caused by malfunctions of the temporomandibular joint and masticatory muscles. They often manifest as pain, clicking or restrictions in jaw mobility. The causes can be teeth grinding, misalignment or muscular tension.
Depending on the cause, various measures are used for treatment, including bite splints, physiotherapeutic treatments or orthodontic corrections. The aim is to improve jaw function and alleviate discomfort in the long term.
What are temporomandibular joint problems?
TMJ disorder, also known as temporomandibular dysfunction (TMD), refers to pain or dysfunction in the area of the temporomandibular joint and surrounding muscles. The temporomandibular joint connects the lower jaw to the skull and is responsible for basic movements such as chewing, speaking and swallowing. If this joint or the associated muscles are impaired, this can lead to considerable discomfort.
Typical temporomandibular joint complaints
Painin the temporomandibular joint:
- Pain directly in the area of the temporomandibular joint, especially when opening or closing the mouth, chewing or speaking. Sometimes the pain also radiates to the neck, ears or head.
Jaw cracking or rubbing:
- An audible cracking or rubbing in the temporomandibular joint when opening or closing the mouth is a common symptom. This sound can indicate a misalignment or problems with the joint disk (disc).
Jaw tension or blockages:
- Those affected may have the feeling that their jaw is "tense" or "blocked", which makes it difficult to open and close their mouth.
Jaw pain when chewing:
- Pain occurs particularly when chewing hard or tough foods, which may indicate overuse or inflammation of the temporomandibular joint.
Earache and tinnitus:
- As the temporomandibular joint is located close to the ear, pain can often radiate into the ears. Some sufferers also report tinnitus (ringing in the ears).
Headache:
- Tension headaches, particularly in the temporal region, are often associated with temporomandibular joint problems. These are caused by tension in the jaw muscles or stress in the temporomandibular joint.
Dizziness:
- In some cases, jaw problems can also lead to dizziness, as the organ of balance in the inner ear can be affected by the pressure of the jaw joint.
Typical triggers or situations in which temporomandibular joint problems occur
Stress and tension:
- Stress can cause those affected to unconsciously clench or grind their teeth (bruxism). This overloads the temporomandibular joint and the masticatory muscles and can lead to discomfort.
Teeth grinding (bruxism):
- Teeth grinding, often during sleep, is a common trigger of TMJ pain. It causes excessive pressure on the temporomandibular joint and the muscles.
Misalignment of the teeth or jaw:
- Misaligned teeth or misaligned jaws can lead to an uneven load on the temporomandibular joint. This leads to pain and functional disorders.
Excessive chewing:
- Frequent chewing of gum or eating hard foods can overload the temporomandibular joint and lead to discomfort.
Dental treatment or operations:
- Temporary temporomandibular joint pain can occur after dental procedures, especially after opening the mouth for a long time during treatment.
Injuries to the temporomandibular joint:
- Traumatic impacts, such as blows to the jaw or falls, can damage the temporomandibular joint and lead to pain or dysfunction.
Arthritis in the temporomandibular joint:
- Arthritic changes (e.g. osteoarthritis) can also affect the temporomandibular joint, leading to chronic pain and restricted movement.
Effects of temporomandibular joint disorders on everyday life
Pain and discomfort:
- Chronic pain affecting the jaw, head, neck and sometimes even the shoulders can have a significant impact on quality of life. Sufferers often experience pain when chewing, speaking or even at rest, which interferes with daily activities.
Eating habits:
- TMJ disorder can make chewing painful, especially with hard or chewy foods. Many sufferers have to change their diet, preferring soft or pureed foods to avoid pain.
Communication:
- Speaking can be uncomfortable or painful, especially during lengthy conversations. This can lead to people holding back or speaking less in a social context.
Sleep problems:
- Teeth grinding or night-time clenching can lead to disturbed sleep. The pain can also get worse at night, making it difficult to fall asleep and stay asleep.
Occupational restrictions:
- People who work in professions where there is a lot of talking (e.g. teachers, call center employees) or professions that cause high stress can be limited due to the discomfort. Chronic pain can also have a negative impact on concentration and work performance.
Mental stress:
- Constant pain and restrictions in everyday life can lead to stress, irritability, anxiety or even depression. People who suffer from temporomandibular joint problems are often inhibited in social situations, which further impairs their quality of life.
Physical complaints:
- Tension in the jaw area can also lead to headaches and neck pain. This tension sometimes spreads to other muscle groups, which reduces general physical well-being.
Changes in posture and movement:
- In some cases, sufferers compensate for the pain by changing their posture, which can lead to additional discomfort in the back and neck area.
How are temporomandibular joint problems treated?
TMJ problems are usually comprehensively diagnosed and treated by an oral and maxillofacial surgeon (OMF). The first step is a detailed examination of the temporomandibular joint, the masticatory muscles and the teeth. Imaging procedures such as X-ray, MRI or CT can be used to identify the exact cause of the symptoms.
Treatment depends on the diagnosis and can include various approaches:
- Conservative therapy: This includes physiotherapy, special exercises, bite splints to relieve pressure on the temporomandibular joint and medication such as painkillers or muscle relaxants.
- Minimally invasive procedures: In cases of acute inflammation or fluid accumulation, a temporomandibular joint puncture or irrigation (arthrocentesis) can be performed to alleviate symptoms.
- Surgical interventions: In severe cases where conservative methods do not help, surgical correction may be necessary. This can involve repairing or replacing structures in the joint.
The aim of the treatment is to relieve pain, improve the mobility of the jaw and restore functionality.
What are the possible consequences of not treating TMJ pain?
1. chronic pain
- Increased pain: Untreated temporomandibular joint pain can worsen over time. What was initially an occasional pulling or pinching sensation can become chronic, permanent pain that does not subside even during periods of rest.
- Radiation of pain: The pain can spread to other areas of the face, neck, shoulders and even the back. Patients may experience persistent muscle tension and pain in these regions.
2. limited jaw mobility
- Restricted movement: Chronic temporomandibular joint pain can lead to restricted jaw mobility. Opening the mouth, chewing or speaking can become painful and difficult. In severe cases, a complete blockage of the temporomandibular joint can occur, which considerably restricts everyday functions.
- Difficulty chewing and speaking: Pain and movement problems can make it difficult to chew food, especially harder or tougher foods. Speaking can also be uncomfortable or painful, making communication difficult.
3. dental damage and problems
- Teeth grinding (bruxism): Jaw joint pain can cause those affected to unconsciously grind their teeth or clench them hard. These uncontrolled movements lead to tooth damage such as abrasion, cracks or teeth breaking, which require additional treatment.
- Incorrect loading of the teeth: Due to the constant misalignment of the jaw joint, the bite may be altered in such a way that individual teeth are overloaded, which can lead to dental problems in the long term.
4. muscle tension and headaches
- Tension in the masticatory muscles: Untreated temporomandibular joint pain often leads to chronic tension in the masticatory muscles and the adjacent muscles in the neck and shoulders. This can lead to muscle stiffness and restricted mobility.
- Headaches: A frequent companion of TMJ pain is tension headaches or migraines, which are caused by excessive tension in the chewing muscles and malfunction of the temporomandibular joint.
5. temporomandibular joint arthrosis (degenerative changes)
- Wear and tear of the temporomandibular joint: Chronic temporomandibular joint pain that is left untreated can lead to wear and tear of the joint cartilage, which is known as temporomandibular joint arthrosis. These degenerative changes lead to permanent joint damage, which becomes more painful and difficult to treat with age.
- Misaligned jaws: Long-term incorrect loading of the temporomandibular joint can lead to a change in the position of the jaw, causing an incorrect bite position. This can further increase the pressure on the joint and exacerbate other symptoms.
6. psychological stress
- Stress and anxiety: Chronic pain and the associated limitations can lead to emotional stress, anxiety and even depression. People who suffer from TMJ pain often experience a reduced quality of life and feel frustrated or helpless.
- Sleep disorders: Pain in the temporomandibular joint can also affect sleep. Many sufferers have difficulty lying comfortably or relaxing their head, which leads to insomnia or restless sleep.
7. reduced quality of life
- Social isolation: Chronic TMJ pain can lead to social isolation as sufferers avoid activities such as talking, laughing or eating together to avoid pain. This can have a significant impact on social life.
- Occupational restrictions: When TMJ pain leads to limited jaw mobility or chronic headaches, it can also affect professional activities, especially when communication, meetings or even physical labor is required.
8. long-term joint damage
- Temporomandibular joint degeneration: Without treatment, joint damage can worsen and lead to complete destruction of the joint cartilage. In extreme cases, this may require surgical intervention to preserve the function of the temporomandibular joint.