When opening mouth clicking jaw: causes and treatment joint
If the patient when opening the mouth pain in the jaw, this symptom often indicates dysfunction vysochaishego joint (TMJ). Sick can also manifest pain around the ear, neck and teeth of the upper or lower jaw. The treatment is determined by severity of lesions of the temporomandibular joint.
Causes discomfort occurs when chewing food
The etiology of the disease is in a functional overload of the masticatory muscles, which causes nonuniform blurring of the articular disc. As a result, when the opening of the mouth the articular head extends beyond the cartilage of the bag and the person feels a specific crunch.
Why pain in the jaw? The following factors may cause this symptom:
- Prolonged and excessive use of chewing gum.
- Chronic emotional stress.
- Dental malocclusions. It can be congenital or acquired pathology. The nature of the clamping jaws are frequently broken after a poor prosthetic or setting disproportionate seals.
- Atypical eruption of wisdom teeth.
- Inflammatory or traumatic injuries of the maxillofacial region.
- Chronic inflammation of the parotid salivary gland and lesions of the spine in the cervical region.
- Pain in the jaw while opening the mouth often after numerous surgeries on tissues of the facial area.
Symptoms of TMJ disorder
Diagnosis of the disease is complicated by the lack of direct signs of disorder of the joint. Also in this area no nerve endings. Uneven work of the joint heads causes painful sensations in the temporal part of the head, the lower and upper jaw.
Clinical picture of the disease form such symptoms:
- Muscle pain in the facial muscles of the face.
- Periodic dislocation or subluxation of the temporomandibular joint.
- The destruction of the articular disc.
- Jaw clicks when opening.
- Mouth open with pain.
- The sensation of tinnitus.
- Increased erosion of enamel.
- Chronic osteoarthritis of the TMJ.
If you open the mouth of the patient pain in the jaw, which is accompanied by bouts of severe pain during mouth opening, chewing, talking or yawning, then this is the occasion to provide immediate medical assistance.
Diagnosis of TMJ pathologies
The establishment of the final diagnosis is based on the following manipulations:
- The medical history of the disease. The doctor listens to the subjective complaints of the patient and makes a preliminary conclusion about the causes of pain in the jaw.
- Visual examination in which particular attention is paid to the proportionality and symmetry of the facial area.
- Instrumental examination of the oral cavity organs and the determination of the nature of occlusal contact (occlusion), when the jaw when chewing should be closed in the correct bite.
- X-ray examination of the temporomandibular joint. On the x-ray specialist studies the structure of the joint and the integrity of its component parts.
- In some cases, the surgeon may resort to computed tomography. Digital x-ray scanning of soft and hard tissues of the face allows one to determine the smallest changes in joint tissues.
Differential diagnosis of
Signs of joint dysfunction should be distinguished from such diseases:
- Pulpitis. Acute inflammation of the tooth pulp often is manifested by pain in the temporal region. A distinctive feature of pulpitis is considered a pain syndrome that mainly bothers the patient at night. Discomfort felt when eating cold food.
- Periodontitis. Purulent inflammation of the ligamentous apparatus of the tooth is accompanied by intense pain, which are localized in a specific area of the oral cavity.
- Periostitis. Suppurative inflammation of the upper and lower jaws in addition to pain syndrome causes swelling of the soft tissues.
- Acute otitis media. Inflammation of the middle ear in the early stages reminiscent of dysfunction of the temporomandibular joint. Further progression of otitis media provokes intense pain of a permanent nature on the one hand.
- Neuralgia. Neurological lesions of the trigeminal nerve is often reminiscent of osteoarthritis of the TMJ. In such cases, slight pain can disturb the person for a long time.
The main treatment methods
Therapy of diseases of the temporomandibular joint starts with eliminating the primary causes of dysfunction. This may be the correction of malocclusion, replacement of the badly made prosthetics and rehabilitation of the oral cavity.
How to heal TMJ lesions:
- Conservative therapy, which is considered the main method to eliminate disturbed functions of the joint. Only with the failure of this treatment the dentist can offer the patient a more radical treatment. Only in 5% of patients surgical intervention is considered a necessary procedure. The conservative effect is to use special Nakonechnyj tires, anti-inflammatory drugs, use of analgesics, periodic therapeutic exercises, thisprocedure in the form of heating of the joint and the regulation of diet. The duration of this treatment is several months.
- Minimally-invasive surgery. Persistent disruption of the joint require a more effective method of treatment. The patient performed MRI to clarify the exact structure of the pathological region. After this the patient is under local anesthesia is carried out puncture of the joint capsule and with a needle, the doctor washes the intra-articular surface. The procedure aims to eliminate surgery all scarring, protein, and inflammatory cells. If the TMJ rinsing disinfecting fluid does not bring the patient relief, experts recommend to proceed to the next stage.
- Arthroscopy articular cavity. This methodology also refers to minimally invasive surgical procedures and involves inserting into the joint cavity micro-cameras and minimally invasive instruments. All manipulations are carried out through a pinhole aperture, and the control operation is performed on the monitor screen. In the process of radical intervention, the surgeon can smooth the joint surfaces to restore the alignment of the blade and to remove scar tissue.
- An open surgery. The classic indications for surgery are: severe TMJ trauma, malignant tumors and chronic dysfunction of the joint. The patient is under General anesthesia. Access to the operative field may be behind the ear (retroauricular method) or by person (preauricular method). The purpose of the operation is the radical change in the structure of the joint. Upon completion of surgical procedures, the wound sutured cosmetic seam, which provides a positive aesthetic effect. Open methods of operation aim to stimulate tissue repair of the temporomandibular joint.
Very often the surgeon during radical intervention conducts correction of the articular disc or a complete replacement. In cases of chronic loss of head joint beyond the joint, doctors recommend the patient to carry out laminectomy. This operation involves the removal of the front hill of the temporomandibular joint, which facilitates the return of the articular head to its original position.
- Prosthetics the individual components of the temporomandibular joint. Most deformans of TMJ require condylectomy (surgical removal of the articular head). The indication for this treatment are: significant traumatic destruction of the hard tissues in the temporal region, complete immobility of the joint (ankylosis) resulting from the splicing of the bony parts of the TMJ, restricted movement of the mandible due to numerous surgeries. Upon failure of such radical measures, experts have resorted to the implantation of an artificial joint, which is developed individually for each patient. In contemporary oral and maxillofacial hospitals these implants are chosen according to the results of computer tomography of the temporal region.
- The treatment of fractures of the temporomandibular joint. Treatment of traumatic injuries of the joints is performed after careful x-ray examination. Classic methods of treatment foresees the fixation of the tire. At the end of such therapy is not always possible to achieve a positive cosmetic and functional effect.
Today for treatment of fractures of the TMJ specialists perform the surgery with retroauricular access. In such cases, the fixation of bone fragments is carried out by special screws. The advantage of this technique is believed to be accurate repositioning of damaged particles and the full restoration of the functional activity of the joint.
What to do after surgical treatment of pathologies of the temporomandibular joint
For full recovery of the patient after surgery required 1-6 months. During this period, depending on the complexity of carrying out of medical procedures the patient is recommended to stick to a special diet, enriched with trace elements and vitamins. Daily diet should exclude foods of solid consistency.
Early rehabilitation of the patient contribute to regular physiotherapy sessions and thisprocedure. These activities improve the microcirculation and stimulate the regeneration of damaged tissues.
At the end of the recovery period doctors prescribe the patient a radiological study of the TMJ, the results of which indicate the status of bone tissue.
Therapeutic exercises to eliminate the sensation the crunch during chewing
After removing pain attacks the doctor recommends to apply to the temporal area a warm compress to improve microcirculation. At home patients must complete a set of exercises:
- In the mouth opening to hold the movement of the lower jaw in the vertical direction 3-4 cm
- The maximum displacement of the jaw to the right and to the left.
- To stabilize the hand on the chin and under moderate pressure to raise the lower jaw.
- To move the jaw in the horizontal direction, overcoming the resistance of hands.
All exercises must be done up to 10 times. The frequency of repetition is once a day.
Prevention of dysfunction of the temporomandibular joint
To prevent the development of pathology of the TMJ you can use these events:
- Timely examination and treatment of dental diseases.
- Conduct orthopedic treatment with the features of the malocclusion.
- Passage of routine inspection at least twice a year.
What to expect after frequent sensation of clicking during mastication
Clicking sound in the temporomandibular joint can lead to the following complications:
- Increased erosion of enamel, which is accompanied by hypersensitivity.
- Constant pain in the facial muscles.
- Osteoarthritis is inflammation of the joint, accompanied by bouts of pain and limitation of function.
- A sharp reduction of mobility of the mandible.
- Arthropathy in the form of irreversible changes of structural elements of the TMJ. The treatment of this pathology requires a rather complicated surgical intervention.
- Chronic joint dislocation. Over time, patients quickens the removal of the articular head outside TMJ. To eliminate the dislocation, the patient should consult the oral surgeon for reposition dislocation.
Prognosis dysfunction of the temporomandibular joint
At the initial stages of dysfunction of the joint lends itself to conservative treatment. In such cases, to eliminate the pathology can medical way and medical gymnastics. Disease in the later stages requires complex therapy. Depending on the severity of the articular surfaces, the doctors can perform minimally invasive surgeries and complex surgery for implantation of the TMJ.