After insertion of complete denture, Pt came complaining from pain in TMJ and tenderness of muscle with difficulty in swallowing, this could be due to:
a- High vertical dimension.***
b- Low vertical dimension.
c- Thick denture base.
d- Over extended denture base.
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Temporomandibular joint and muscle disorders, often called TMJ disorders (or TMJ), are a group of conditions that cause pain and dysfunction in the jaw joint and in the muscles that control the jaw movement
Researchers generally agree that these disorders fall into three main categories:
1- Myofascial pain involves discomfort or pain in the muscles that control the function of the jaw.
2- The internal disarray of the joint is related to a displaced disc, a dislocation of the jaw or a lesion of the condyle.
3- Arthritis refers to a group of degenerative or inflammatory disorders of the joints that can affect the temporomandibular joint.
It is possible to have more than one of these disorders at the same time.
Some calculations indicate that TMJ disorders affect more than 10 million Americans. These disorders appear to be more frequent in women than in men.
Causes:
Trauma to the jaw or temporomandibular joint has a role in some TMJ disorders, but in most cases, the exact cause of the disorder is unclear. For many people, the symptoms seem to start without an obvious reason.
Since TMJ disorders occur more frequently in women than in men, scientists explore the possible link between female hormones and TMJ disorders.
Symptom:
There are several symptoms that may be related to TMJ disorders. The most frequent symptom is pain in the chewing muscles or in the jaw joint. Other symptoms include:
- pain radiating to the face, jaw or neck;
- stiffness in the jaw muscles;
- limited movement or "blocking" of the jaw (when the jaw is locked);
- noises such as clicking, thundering or shrieking accompanied by pain in the jaw joint when opening or closing the mouth;
- a change in the way in which the upper and lower teeth fit together.
Diagnosis:
At present there is no standard test that is widely accepted to correctly diagnose TMJ disorders. Since the exact causes and symptoms are not clear, it can be difficult and confusing to identify these disorders.
The doctor will take note of the symptoms, get a detailed medical history and examine the problem areas, including the head, neck, face and jaw to determine if they cause pain, or if there are clicks, thunders or difficulty moving them. The doctor may also recommend doing imaging studies, such as x-rays.
You may want to ask your doctor about other possible causes of pain. Facial pain can be a symptom of many other disorders, such as sinus infections (sinusitis) or ear infections, various types of headaches and facial neuralgia (pain related to facial nerves). Discarding these problems first helps identify TMJ disorders.
a- High vertical dimension.***
b- Low vertical dimension.
c- Thick denture base.
d- Over extended denture base.
--------------------------------
Temporomandibular joint and muscle disorders, often called TMJ disorders (or TMJ), are a group of conditions that cause pain and dysfunction in the jaw joint and in the muscles that control the jaw movement
Researchers generally agree that these disorders fall into three main categories:
1- Myofascial pain involves discomfort or pain in the muscles that control the function of the jaw.
2- The internal disarray of the joint is related to a displaced disc, a dislocation of the jaw or a lesion of the condyle.
3- Arthritis refers to a group of degenerative or inflammatory disorders of the joints that can affect the temporomandibular joint.
It is possible to have more than one of these disorders at the same time.
Some calculations indicate that TMJ disorders affect more than 10 million Americans. These disorders appear to be more frequent in women than in men.
Causes:
Trauma to the jaw or temporomandibular joint has a role in some TMJ disorders, but in most cases, the exact cause of the disorder is unclear. For many people, the symptoms seem to start without an obvious reason.
Since TMJ disorders occur more frequently in women than in men, scientists explore the possible link between female hormones and TMJ disorders.
Symptom:
There are several symptoms that may be related to TMJ disorders. The most frequent symptom is pain in the chewing muscles or in the jaw joint. Other symptoms include:
- pain radiating to the face, jaw or neck;
- stiffness in the jaw muscles;
- limited movement or "blocking" of the jaw (when the jaw is locked);
- noises such as clicking, thundering or shrieking accompanied by pain in the jaw joint when opening or closing the mouth;
- a change in the way in which the upper and lower teeth fit together.
Diagnosis:
At present there is no standard test that is widely accepted to correctly diagnose TMJ disorders. Since the exact causes and symptoms are not clear, it can be difficult and confusing to identify these disorders.
The doctor will take note of the symptoms, get a detailed medical history and examine the problem areas, including the head, neck, face and jaw to determine if they cause pain, or if there are clicks, thunders or difficulty moving them. The doctor may also recommend doing imaging studies, such as x-rays.
You may want to ask your doctor about other possible causes of pain. Facial pain can be a symptom of many other disorders, such as sinus infections (sinusitis) or ear infections, various types of headaches and facial neuralgia (pain related to facial nerves). Discarding these problems first helps identify TMJ disorders.
Treatment:
Since more studies are needed on the safety and effectiveness of most treatments for disorders of the joint and jaw muscles, experts recommend that the most conservative and reversible treatments possible be used. Conservative treatments do not invade tissues of the face, jaw or joint or require surgery. Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth. Even when TMJ disorders are persistent, most patients do not need aggressive treatments.
Conservative treatments:
Since the most common joint and jaw muscle problems are transient and do not get worse, a simple treatment may be enough to relieve discomfort. Relief can be obtained with short-term use of pain medications or non-steroidal anti-inflammatory drugs or NSAIDs that do not require a prescription, such as ibuprofen, or with the use of a stabilizing splint or bite protector, which fits the upper or lower teeth. If a stabilization splint is recommended, it should only be used for a short time and should not cause permanent bite changes. Studies on its effectiveness in relieving pain have not been conclusive.
Irreversible treatments:
Surgical treatments are controversial, often irreversible, and should be avoided whenever possible. There have been no long-term clinical studies to analyze the safety and effectiveness of surgical treatments for TMJ disorders. In addition, surgical replacement of the mandibular joints with artificial implants can cause severe pain and permanent damage to the jaw. It is possible that some of these devices may not work properly or may break in the jaw over time.
Helpful tips:
The following personal care habits can help relieve the symptoms of TMJ disorders:
- eat soft foods;
- apply ice packs;
- avoid extreme jaw movements, such as yawning with your mouth wide open, singing loudly and chewing gum;
- learn relaxation techniques and stress reduction;
- practice gentle stretching of the jaw and relaxation exercises that can help increase jaw movement. Your health care provider or physical therapist may recommend exercises if they are appropriate for your particular situation.
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