SURGERY FOR COMMON JAW JOINT PROBLEMS

Its quite common to develop a problem with the jaw joint, known medically as the temporomandibular joint (TMJ). This joint, one of the smallest in the body, allows the bottom jaw to hinge with the top and enables us to eat and speak. We actually have two TMJ; the joints on the right and left of the face move together because the lower jaw links them together.


http://spencerhodges.co.uk/wp-content/uploads/2016/04/Spencer-Hodges-in-Theatre.jpg

Around 25% of people have problems with the jaw joint at some point in life. The vast majority of problems are not related to cancer and most arise due to a build up of several contributing factors.

“The challenge that I face when treating jaw joint problems is to discover the underlying causes and then to put together a management plan to remove them from the patient’s life. This may involve lifestyle changes, self-help, relaxation, painkillers, physiotherapy, jaw joint infections or, rarely, surgery. Each case is individual,” explains Mr Hodges.

Temporomandibular dysfunction syndrome

This is a ‘catch-all’ term that can be used to describe all jaw joint problems. We tend to use it as a diagnostic term if the symptoms can be described pretty accurately, but we do not know precisely what is causing them.

TMJ problems can be divided into 3 common types. There are also a few rare conditions that affect the jaw joint: find out more about uncommon jaw joint problems

  • Internal derangement
  • Myofascial pain
  • Degenerative joint disease

Find out more about how jaw joint problems are treated and managed by Mr Hodges.

Internal derangement

Inside the jaw joint is a thin layer of fibrous cartilage that divides the joint into two compartments: the upper joint space and the lower joint space. This layer is called the intra-articular disc or meniscus.

The meniscus usually fits on the rounded end of the jaw bone like a cap but it can shift out of position and cause problems such as:

  • Clicking of the jaw
  • Pain
  • Locking of the jaw

If you have an internal derangement, the meniscus doesn’t stay in position on the rounded part of the jaw joint. Instead it becomes loose and is crumpled up at the top of the bone. As the jaw moves back the other way, the cap clicks back into place, causing a clicking or popping sound.

If the meniscus doesn’t pop back onto the jaw bone, it can act like a wedge and stop the jaw opening fully.

All of these problems can cause pain as the cushioning effect of the meniscus is being lost. It’s more likely that the bones move together, causing inflammation or direct damage to local nerve endings.

Myofascial pain

This condition is caused by structures around the jaw joint such as the muscles, tendons, ligaments, joint capsule and associated nerves.  The underlying cause of this condition can range from over-activity in the muscles, repetitive habits, or stressful life events.

Degenerative jaw joint disease

Just like other joints in the body, the TMJ can be affected by synovial joint diseases such as osteoarthritis, rheumatoid arthritis and juvenile arthritis. These are collectively called degenerative diseases, but they don’t always affect just older people. The name reflects the fact that bone within a joint is damaged due to loss of cushioning as soft tissue disappears.

This can happen due to several disease processes, but degenerative jaw joint disease is most often caused by osteoarthritis.

The most common symptoms are pain in the face and jaw, joint noises (known as crepitus), and trouble opening your mouth fully.

Treatment depends on many factors and can range from advice on lifestyle changes, such as reducing stress, to steroid injections directly into the joint, or even to a complete surgical jaw joint replacement.