Temporomandibular
Joint Disorders

What is the temporomandibular joint (TMJ) ?

This is the jaw joint between the jaw and the skull just in front of the ears.

What causes temporomandibular joint disorders?

These may be caused by injury or arthritic changes affecting the joint. Pain and stiffness of the joint may also be caused by stress which may increase the tendency to grind the teeth, often at night.

What are the symptoms of temporomandibular joint dysfunction (TMD)?

Temporomandibular joint disorders often manifest as the following symptoms –

Pain. This is often situated in front of the ears but may involve the cheeks, lower jaw and temple region bilaterally. This pain is often worsened by eating and opening the mouth wide. Often pain of the neck and shoulders is also present.

• Difficulty opening the mouth wide
• Clicking of the jaw
• Locking of the jaw
• Grating noises of the jaw

How is the condition diagnosed?

TMD is diagnosed by a full history of the symptoms and by performing an examination. In particular it is essential to rule out other causes of facial and jaw pain. Investigations may be indicated including radiographs (xrays) and sometimes an MRI scan to exclude abnormalities of the disc within the joint. Blood tests may occasionally be indicated.

How may TMD be managed?

There are several treatment modalities which may be helpful in the management of TMD. Often a multi-disciplinary team approach is required. Treatments available include -

Splint therapy

This is especially useful when a tooth grinding habit is suspected.

Physiotherapy

This is often particularly helpful when there is associated muscle pain.

Drugs

Many drugs may be useful in the management of TMD including analgesic drugs (which may be used topically), muscle relaxants and sometimes other chronic pain drugs.

Psychological therapy

This may be helpful when associated with considerable stress or psychological problems.

Surgery

This may be indicated in some situations.

Dr Poate and Temporomandibular joint disorders

Dr Poate is a member of the multi-disciplinary Temporomandibular Joint clinic at The Lister Hospital, Chelsea. This team is able to offer medical and surgical management and physiotherapy. Dr Poate has considerable experience in the diagnosis and management of patients with temporomandibular joint disorders.

TMJ study day

Dr Poate and the TMJ multi-disciplinary team of which he is a member hold a TMJ study day at King's College Hospital, London for the education of surgeons, dentists, doctors, physiotherapists, nurses and other health care professionals involved in the management of patients with temporomandibular joint disorders.

TMJ presentations

The TMJ multi-disciplinary team have been involved in many national and international presentations over the last 3 years in which the results of the clinic have been presented.

TMJ publications

The TMJ multi-disciplinary team have a peer-reviewed publication on the results of the multi-disciplinary TMJ clinic being published in a national journal in 2014.