Temporomandibular Joint Disorders

PRESENTATION

Pre-auricular pain
  • Clicking noises on movement
  • Joint locking
  • Restriction in jaw opening

The patient may give a history of bruxism (grinding teeth) and may be suffering with stress disorders. Symptoms are often exacerbated by eating.

TREATMENT

Plain radiographs are usually unhelpful.

Patients who do not respond to conservative management are usually those who have started with a clicking joint, often painless and then progressed to a painful condition with no clicking and restricted movement. This signals irreversible derangement of the meniscus and these patients need a diagnostic arthrogram to assess the value of surgery.

Below is the exercise sheet given to patients by the department for temporomandibular joint dysfunction syndrome:

EXERCISES TO PREVENT CLICKING OF THE JAW JOINT

The exercise should be carried out sitting in an erect posture in front of the mirror. The exercise should be performed before meals and at bedtime, i.e. four times a day. Once you are used to the exercise you can stop using the mirror and carry out the exercise as often as possible.

With your mouth closed and the teeth lightly touching, place your tongue on the roof of your mouth as far back as possible. A sensation of tension will be noted in the muscles at the base of the tongue and below the chin, and in front of your ears, i.e. over the jaw joints.

Open your jaw keeping your tongue touching the roof of your mouth as far back as is comfortable. Open the jaw to a comfortable distance without moving the tongue.

You will notice in the mirror that your jaw moves like a hinge going neither to the right or to the left. Also it does not move forward. If the jaw does not move like a hinge you are not doing the exercise properly.

You will probably find that you are moving the tongue away from the roof of the mouth. Keep practising, it does get easier.

Gradually increase the extent to which the mouth opens until it can be moved to a normal extent without producing a click.

Do not be tempted to make the jaw click by doing any 'funny movements'.

During this initial training time be careful with your diet, i.e. take soft foods that require little chewing, cut up apples, etc.

You will be asked to carry out these exercises for approximately six weeks and then will be reassessed in clinic.

Download this document. MS Word.

 

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