Temporomandibular joint disorders are poorly understood and often difficult to manage. Disorders of this joint are common and are not associated with age. Popping, clicking, locking and pain are some of the most common complaints, and can be managed if diagnosed properly. Other, more subtle issues include asymmetrical growth, a chin moving to one direction or a retrusive jaw/chin. These conditions can be insidious or they can be the result of a traumatic injury. Thanks to advancements and miniaturisation of technology, the joint space can now be visually inspected and arthroscopic surgery performed.
Most TMJ disorders are self-resolving, requiring routine pain relief, a soft diet, massage of the associated muscles and habit avoidance. Your dentist, orthodontist, medical general practitioner or an Oral Medicine specialist, such as Anita Nolan, are a good first point of call before exploring surgical options. Progressive or persistent issues do require further investigation.
An MRI is frequently used to assess the soft tissues and cartilage and to accurately visualise the disc, a conebeam CT or medical CT is used to assess the bone quality for any evidence of pathology or arthritis. Nuclear medicine scans (bone scan, Single Photon Emission Computed Tomography or positron emission tomograpy) are used to objectively measure active growth within the joint space. Investigations will frequently include a blood test.
Treatment options for common conditions include injection of medications into the joint, joint arthroscopy or arthrocentesis, open joint surgery, orthognathic surgery or total replacement of the joint itself.
The management for temporomandibular joint dysfunction has progressed significantly over the past 10 years due to the advances in technology. Historically, patients and clinicians have been frustrated by poorly supported treatment modalities and technologies resulting in avoidance of active treatment. As with any joint issue, the anatomy of the temporomandibular joint is the cornerstone to understanding therapeutic options, their applications and, importantly, their limitations.
