Jaw Joint Disorders
Disorders of the jaw joint often cause facial pain, difficulty opening the mouth and clicking or grating noises. Dr Gillman has extensive specialist training and experience in diagnosing and treating these problems
The Jaw Joint
The jaw joint, also known as the Temporomandibular Joint or TMJ is where the bottom jaw (mandible) meets the temporal bone in the side of the skull. The TMJ is one of the smallest but most used joints in the body as it enables us to chew, speak, sing, shout and yawn. The TMJ is a fairly unique joint as it not only allows movement from side to side but also allows the mandible to roll and glide smoothly forwards and backwards in the socket. This smooth movement is enabled by a disc within the joint which acts as a shock absorber. Muscles that are attached to and surround the TMJ control jaw movement.
Jaw Joint (TMJ) Disorders
Pain of the jaw joint can be a symptom of several jaw joint disorders, including:
Rheumatoid arthritis and other inflammatory arthritides, which refers to a large group of disorders that cause pain, inflammation, and stiffness in the joints, muscles, and bone and can also affect the jaw joint.
Jaw clicking, which occurs when the disc is moved out of position
Dislocation of the jaw which occurs when the condyle (the part of the mandible within the joint) moves out of the socket
Closed lock of the jaw occurs when the disc doesn’t move back into the correct position
Bruxism (teeth grinding) and overuse of the muscles which control the jaw joint, causing a cramping pain
Osteoarthritis, a disease in which the cartilage within a joint begins to break down and the underlying bone begins to change, can also affect the jaw joint
What Is the Treatment for TMJ Disorders?
Dr. Gillman will take a thorough history of your symptoms to determine the likely cause of the pain. This may be supplemented with X-rays, a CT scan or an MRI.
The majority of jaw joint pain or muscular pain can be significantly improved by the use of simple pain medications and a bite splint with or without physiotherapy.
Muscle pain which does not improve following these non-invasive measures can be improved by the injection of Botox into the affected sites.
Pain localised over the jaw joint that does not improve with non-invasive treatment may require arthrocentesis - this is a relatively short procedure carried out in the clinic which involves inserting 2 needles into the joint and washing out inflammatory cells with sterile water. However, some cases require arthroscopy with arthrocentesis. Arthroscopy involves inserting a small diameter camera into the joint - this allows a detailed examination of the joint and may identify scars or areas of diseased tissue that need specific treatment. Whilst many problems can be identified during arthroscopy, it may not be possible to treat all problems of the joint without open joint surgery.
Open joint surgery is performed via a small incision in front of the ear. Dr Gillman treats a range of joint problems via this approach; an eminectomy may be performed for persistent dislocations and a disc anchorage procedure for troublesome clicking. In extremely rare circumstances, it may be necessary to replace the entire jaw joint with a custom-made prosthesis, a procedure which Dr Gillman was among the first to carry out in Israel.