What is TMJ?

QUESTION: What is TMJ? Would you please discuss it and its treatment?
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ANSWER: "TMJ" stands for "temporomandibular joint" and usually refers to
problems with that joint. The joint is the one that allows your jaw to open,
shut and slide your chin forward. It's a joint that takes a lot of stress,
even under the best of conditions. Its proper alignment and function depends
on many factors, including your teeth, the muscles of your face and mouth, and
your ways of coping with stress.
The range of problems with TMJ is broad, but any disruption of its
function usually results in a misalignment of the teeth and jaw and gradual
deterioration of the joint.
The causes of TMJ problems are varied; I'll discuss a few of them. Mouth
or jaw injuries, such as those occurring in auto accidents or sports injuries
often start the TMJ problems. The jaw becomes misaligned due to the injury,
and the joint wears unevenly due to the misalignment. The TMJ problems may
develop slowly, over a period of years after the injury. Personal habits such
as chewing pencils or ice, grinding teeth, or clenching the jaw from tension
can also create a TMJ problem.
What are the symptoms of TMJ? Face or jaw pain, noises such as a
clicking when the jaw is opened, or difficulty in opening the jaw are all
symptoms. Some people report that the jaw pain travels to the head, neck,
ears, shoulders and arms. TMJ should be suspected in anyone who suffers from
frequent headaches that have no known cause. The symptoms worsen over the
years unless the problem is treated.
Accurate diagnosis of TMJ is important before treatment can be begun.
Specialized x-rays, especially a process called video arthrography, are part
of the diagnostic workup. Determining exactly how the different parts of the
temporomandibular joint function in relation to one another is crucial to
treating the problem with success.
The problem may not be in the joint itself; it may be located in the
powerful muscles of the jaw. If this is the case, muscle relaxation is the
goal. This may be accomplished by learning to control stress, using physical
therapy to exercise the jaw muscles, or using local anesthetic pain control.
Sometimes, muscle relaxants are prescribed to help the jaw muscles relax and
heal. In some cases, a special mouthpiece is designed to realign the mouth
and ease the pressure on the jaw joint.
If the problem is severe and does not respond to less permanent
treatment, the alignment of the jaw and mouth must be altered. This can be
accomplished in a variety of ways, but should only be undertaken when other
methods fail, because the treatment is permanent and cannot be reversed.
Changing the alignment of the teeth and jaw should only be attempted by
someone who is well-experienced in successful treatment of TMJ. Sometimes the
alignment of teeth is altered by grinding the surfaces so that the upper and
lower teeth meet more harmoniously. In more severe cases, surgery is
performed to repair the temporomandibular joint. If the jaw joint is found to
be deteriorated beyond repair, an artificial joint can be used to replace it.
In some parts of the country, arthroscopes are being utilized to diagnose
and treat some forms of TMJ disorder. This shows great promise, because the
physician can see directly into the joint with only a minimal incision, and he
can treat the problem without extensive surgery.