Possible Temporo Mandibular Disorder


Q: I have no idea how to classify this. Anyways, possibly a few months ago everytime i would chew, i could hear something being "squished" between my jaw and cranium. Like a vain is being pinched and squirting blood. But It's only on my right side and doesn't hurt. Side note unrelated: everytime i click on one of the fields to input information, the help box completely covers the box and makes it almost impossible to write


A:    Temporo-mandibular disorder(s) (TMD), or temporomandibular joint syndrome, is the most common cause of facial pain after toothache. Temporomandibular disorder is a commonly seen condition in primary care and dentistry practice, as many as 75% of the people in the United States population will at some time have some of the signs and symptoms of TMD. Problems in this area can cause head and neck pain, a jaw that is locked in position or difficult to open, problems biting, and popping sounds when you bite. The causes are various: grinding the teeth (bruxism), clenching the jaw, punch to the jaw, osteoarthritis or degenerative joint diseases, and other joint diseases. Most temporomandibular disorders (TMDs) are self-limiting and do not get worse. Simple treatment, involving self-care practices, rehabilitation aimed at eliminating muscle spasms, and restoring correct coordination, is all that is required. In the case that you have pain, then Nonsteroidal anti-inflammatory analgesics (NSAIDs) should be used on a short-term, regular basis and not on an as needed basis, eat soft food, apply warm compresses on the area of pain. Home therapy includes mandible (lower jaw) movements, such as opening and closing the jaw from side to side. Try this after a warm compress is applied for 20 minutes. The lower jaw movements should be repeated three to five times a day, five minutes continuously each time, for about two to four weeks. On the other hand, treatment of chronic TMD can be difficult and the condition is best managed by a team approach; a primary care physician, a dentist, a physiotherapist, a psychologist, a pharmacologist, and in small number of cases, a surgeon. The different modalities include patient education and self-care practices, medication, physical therapy, splints, psychological counseling, relaxation techniques, biofeedback, hypnotherapy, acupuncture, and arthrocentesis. Arthroscopic surgery is indicated in the following: internal derangements, adhesions, fibrosis, and degenerative joint diseases.

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