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Temporomandibular Joint Dysfunction

TMJ = Temporomandibular Joint

It is the joint on each side between the condyle of the lower jaw (mandible) and the fossa within the base of the skull (temporal bone).  There is a disc made of cartilage between the condyle and the fossa.  The TMJ allows the lower jaw to function by opening and closing and moving forwards (protruding).

TMJ problems range from a minor click to more significant pain, locking and limitation of jaw movement.  Many people have minor clicks in their TMJ's without significant problems and without requiring specific management.  Professional help may be required where clicking, pain and limitation of jaw movement causes a problem.

A commonly used term where such symptoms occur is TMJ dysfunction but many terms are used.  It may result from problems in the joint itself (inflammation, arthritis, and problems with the disc) or the associated muscles or a combination of a joint and muscle problem.

The cause is not always clear cut but may result from overloading the joint from trauma, or clenching and grinding teeth.  General factors such as tiredness and stress may also have a role.

Other problems in the TMJ which occur more rarely include other pathology (eg tumours) and dislocation.

MANAGEMENT

Management is commonly conservative (without surgery) but surgery may be required in some cases.  Conservative management may include heat application, massage, a soft diet, a bite raising appliance and simple analgesics (pain killers).  A patient may be referred to an Oral and Maxillofacial Surgeon commonly from their dentist or doctor for their expertise in the diagnosis and management in TMJ problems.  At our practice we aim to help patients with diagnosis, advice, simple surgical procedures (eg arthrocentesis and steroid injection) and medical treatment and referral as required to other health professionals.  Management is often multidisciplinary and may include the surgeon (s), doctor, dentist, oral medicine specialist, physiotherapist, medical specialists, and other health professionals.