Temporomandibular Joint
Patients want to know more about their jaw joints. We have quite a bit of information for you below. You can be better informed so you can feel better like Neil, Sally, Gary and Pamela did.
They had symptoms of temporomandibular-joint ranging from jaw pain, head and neck aches, tmj popping, grating or clicking. At Eternal Smiles we use treatments that can include night guards to muscle relaxers.
Dr Singh has been trained to understand the temporomandibular-joint problems after studying in Florida, America. A thorough joint examination reveals the problem.
Ligaments of the temporomandibular joint
There are three extracapsular ligaments. They act to stablise the temporomandibular joint.
- Lateral ligament – runs from the beginning of the articular tubule to the mandibular neck. It is a thickening of the joint capsule, and acts to prevent posterior dislocation of the joint.
- Sphenomandibular ligament – originates from the sphenoid spine, and attaches to the mandible.
- Stylomandibular ligament – a thickening of the fascia of the parotid gland. Along with the facial muscles, it supports the weight of the jaw.
Articulating Surfaces
The temporomandibular joint consists of articulations between three surfaces; the mandibular fossa and articular tubercle (from the squamous part of the temporal bone), and the head of mandible.
This joint has a unique mechanism; the articular surfaces of the bones never come into contact with each other – they are separated by an articular disk. The presence of such a disk splits the joint into two synovial joint cavities, each lined by a synovial membrane. The articular surface of the bones are covered by fibrocartilage, not hyaline cartilage.
Movements of the temporomandibular joint
Movements at the temporomandibular joint are produced by the muscles of mastication, and the hyoid muscles. The two divisions of the temporomandibular joint have different functions.
Moving the temporomandibular joint forward and backward (Protrusion and Retraction)
The upper part of the joint allows protrusion and retraction of the mandible – the anterior and posterior movements of the jaw.
The lateral pterygoid muscle is responsible for protrusion (assisted by the medial pterygoid), and the posterior fibres of the temporalis perform retraction. A lateral movement (i.e. for chewing and grinding) is achieved by alternately protruding and retracting the mandible on each side.
Elevation and Depression
The lower part of the joint permits elevation and depression of the mandible; opening and closing the mouth. Depression is mostly caused by gravity. However, if there is resistance, the digastric, geniohyoid, and mylohyoid muscles assist. Elevation is very strong movement, caused by the contraction of the temporalis, masseter, and medial pterygoid muscles.
Clinical Relevance: Temporomandibular Joint Dislocation
A dislocation of the temporomandibular joint can occur via a blow to the side of the face, yawning, or taking a large bite. The head of the mandible ‘slips’ out of the mandibular fossa, and is pulled anteriorly.
The patient becomes unable to close their mouth. The facial and auriculotemporal nerves run close to the joint, and can be damaged if the injury is high-energy.
Posterior dislocations of the TMJ are possible, but very rare, requiring a large amount of force to overcome the postglenoid tubercle and strong intrinsic lateral ligament.
Ann had problems with a dentist not understanding her bite. After placing many crowns and fillings he did not understand her bite was not in the proper place. Then after 3 visits with Dr Singh she recovered and now able to enjoy her foods.
“I had headaches and sore shoulders for years. The night guard has helped wonders and for the first time in years. I no longer wake up with a headache or discomfort in my front teeth. I am really impressed with the time and attention Dr Singh took to make it comfortable and the after care given to ensure it remains correct and comfortable.” Sally Holgate
Jaw Joint Conditon
Dr Singh has extensive training in treating problems associated with the jaw joint and bite, or what we call ‘Temporo-mandibular joint (TMJ) disorders’. These come in many forms and the symptoms can include:
- Painful clicking, popping or grating in the jaw joint when opening or closing the mouth.
- Pain in the chewing muscles or jaw joint, especially first thing in the morning or in the evening after a stressful day.
- Soreness in the jaw.
- Difficulty opening or closing the mouth or locking of the jaw.
- Jaw muscle stiffness.
- Headaches or radiating pain in the face, shoulders and neck.
- Ringing in the ears.
- A change in the way the upper and lower teeth fit together.
- Can be mistaken for chronic toothache.
What causes it?
These problems have many contributing factors such as stress and grinding of teeth. Trauma to the jaw plays a role in some TMJ disorders. But for most jaw joint and muscle problems, scientists don’t know the cause. For many people, symptoms seem to start without an obvious reason. Research disputes the popular belief that a bad bite can trigger TMJ disorders. Because the condition is more common in women than in men, scientists are now exploring a possible link between female hormones and TMJ disorders.
How is it treated?
Dr Singh is fully trained to diagnose these problems and treat them –He uses ‘TMJ therapy’ and bite adjustment. The therapy involves wearing a specialised (Hard Night guard) stabilisation splint. This is carefully fabricated and adjusted to relax the chewing muscles and place the jaw joint in a comfortable position to allow it to heal properly.
Once the pain has been resolved over a period of 3-6 months, certain restorative treatment may be required to correct the bite.
“My jaw joints were sore and the side of my face were painful the last few months. Dr Singh advised that I wear a night guard to protect my teeth from wearing down due to my grinding and help my jaw joints recover. The treatment and care was great. Thank you for helping sore jaw better.”
Gary Dickenson
In summary, careful planning and analysis will allow the treatment to be designed around your individual needs.
The facial muscles and jaw joints are all part of a system that is controlled by the brain. Because Dr Singh has a detailed understanding of this system, he can detect specific reasons that cause harmful bite pattern and head and neck pain.
When muscles and joints do not work properly, the muscles will often tire. The tiredness can become part of a cycle that results in tissue damage, pain, muscle tenderness and spasm.
Although accidents involving injuries to the jaw, head, or neck, or diseases such as arthritis may result in some bite problems, Using detailed bite evaluation we can diagnose any discrepancies with your bite. We also use it to get the accuracy of newly fitted restorations 100% correct to make your restorations last longer.
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