Disorders of the temporomandibular joint and complaints of the masticatory muscles can have different causes. Frequently, pain is caused by a malfunction of the temporomandibular joint. These malfunctions can be caused by a disorder of the muscles moving the lower jaw, but also by lesions of the complex cartilage and ligamentous apparatus of the temporomandibular joint itself and, last but not least, by damage to the bone in the joint area. The clinical picture is also called craniomandibular dysfunction (CMD).
Not every cracking sound when opening the mouth or chewing requires treatment. Approximately 70% of the population exhibit such symptoms without there being a disease value. But if there is pain when opening the mouth or dysfunction when chewing, a specialized doctor should be consulted.
Temporomandibular joint complaints that require diagnostic clarification are:
Cracking or rubbing sounds in the temporomandibular joints with pain when chewing or speaking.
A painful restricted mouth opening or mouth closure and deviation of the mandible to one side when opening the mouth.
Swelling and redness of the soft tissues in the cheeks and temple.
Pain in the temporomandibular joints with radiation to the ears, temple, neck, back of the head, or shoulders.
After a detailed clinical assessment and a basic radiological diagnosis, a significant improvement in findings is achieved in most cases with short-term physiotherapy. In some cases, however, further diagnostics (e.g. magnetic resonance imaging - MRI) are necessary. Often, splint therapy also leads to an improvement in symptoms. This involves a transparent plastic splint that must be specially adapted to the patient's requirements and is usually worn at night. The aim of this splint therapy is to relax the chewing muscles and relieve the jaw joint. In addition, the splint protects the teeth at night in case of unconscious teeth grinding.
If conservative measures have not been successful, additional surgical therapy may be necessary.
In oral and maxillofacial surgery, minimally invasive procedures such as arthrocentesis or arthroscopy are available in addition to open surgical measures, in which the temporomandibular joint is opened via small surgical access routes in front of or behind the ear. In severe and advanced degenerative diseases with destruction of the bones in the joint process area, the insertion of artificial temporomandibular joint prostheses may also be necessary.
If you have any complaints or would like a consultation on the subject, please make an appointment to see a maxillofacial surgeon.
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