TMJ Disorders
As our dentist explains, to better understand TMJ disorders, we need a little bit of a basic understanding of this joint. TMJ stands for “Temporo-Mandibular Joint”. The temporomandibular joints (TMJ for short) along with the associated jaw muscles make it possible for us to open and close our mouths. Located on each side of the head, our joints work together when we chew, speak, or swallow. They also control the lower jaw as it moves forward, backward, and side to side. Each TMJ has a disc between the two bony components. The disc cushions the load while enabling the jaw to move, rotate and glide smoothly. Any problem that affects this intricate system of muscles, ligaments, discs, and bones from working properly can result in a painful TMJ disorder.
Jaw Joints – Anatomy
Let’s look at the components of this delicate joint and see how it compares and contrasts with other joints in our body (e.g. elbows, knees, etc.). All the joints in the body (including the TMJ) allow for movement between 2 bony components by a “hinging” mechanism. What sets the jaw joints apart from other joints in our body is that the joint itself moves and slides up and down against the base of the skull (e.g. temporal bone) allowing for a full opening of the mouth. The disc that is positioned between the 2 bony neighbors is attached to the lower jaw bone by tendon-like connective tissue. These tendons allow for swiveling of the disc as the lower jaw bone moves underneath. Ligaments from certain jaw muscles also attach to the disc and jaw bone to aid in the movement and positioning of the jaw and the disc. TMJ disorders can be due to a problem with any of these components. In nearly every case when there is a problem, the patient has (or has had in the past) “noisy” joints. These joint sounds vary in their quality and sound. Some are quite audible whereas others are very faint. Some you can only feel and not hear at all.
TMJ Sounds – Clicking – Popping – Locking
Joint sounds are due to displacement or dislocation of the disc from its normal position in relation to the lower jaw bone. Huh?
The jaw joint allows for 2 separate movements as we talked about earlier. The disc can slip out of its healthy position during any part of these 2 movements. This slipping or displacement causes a sound and a tactile feeling as well. When this problem first starts the sound may be quite audible. It may also be very palpable. But as time goes on the sound may diminish in intensity and one day may even completely disappear. But now, the patient can only open a fraction of what they could when the problem first started. Why is that?
As it turns out joint sounds (or lack thereof) can tell us a lot about the stage of TMJ disorders. When the problem first starts the bony components have not had any changes to their original shape. But, as this problem persists the shape of the jaw bone starts changing. This is attributed to the bone-to-bone rubbing that occurs when the disc is displaced in the jaw joint during movement. When the bony components of the joint undergo physical changes, there is a change in the quality and intensity of the sound associated with the disc displacement. Over the years what happens is that the displacement of the disc becomes more frequent, easier, and sometimes even permanent. That is the reason why the joint no longer makes a sound. That is also the reason why the patient can’t open wide anymore. It’s like a door that is off of one of its hinges. It cannot open or close normally.
For a more in-depth look, check out this helpful article on our blog.
Dr. Sonny Eslampour has years of experience and extensive training in treating patients with TMJ disorders. Contact us now to set up your consultation.