transmandibular joint dislocation

Michelle Arney

Temporo-Mandibular Dislocation

Definition

Temporo-mandibular joints (TMJ) are just forward of the ears and connect the jaw with the skull. With dislocation the jaw slides backwards into the skull, and at this time the mouth cannot be closed. Symptoms include inability to close mouth, pain and swelling in jaw and can also include numbness in chin and lower lip (Jaw Dislocation).

Patients also describe TMJ as a tightness, sticking, or catching of the jaw. (Walling, Anne D.)

TMJ is also associated with people who grind their teeth (Soothe Away Jaw Pain). This makes the person’s jaw incredibly sore. It also causes headaches and insomnia. (Walling, Anne D.)

Causes

Major causes of TMJ dislocations are that the muscles inside a person’s mouth just aren’t strong enough to hold the jaw, the joint space being too big, and osteoarthrosis. A new study is also showing that TMJ dislocations could have a connection to female hormones (Lensch, Chad D.D.S.).

TMJ happens randomly but it does also happen after accidents to the skull. These accidents include a car accident or just being hit hardly in the jaw.

Treatment

Doctors try to do very conservative things to treat TMJ disorders. One of these includes listening to relaxation tapes for 30 minutes a day (Soothe Away Jaw Pain). Listening to the relaxation tapes is good for people whose TMJ disorders are concurring with people who grind their teeth or clench their teeth tightly. It is also suggested that a person open their mouth 10 – 15 times, 3 times a day as wide as they can without causing pain. Then hold the mouth open for 5 seconds and slowly close it. It is also suggested that if a person has pain in front of their ear or hear a noise in their jaw that they talk with their doctor before trying this exercise (Soothe Away Jaw Pain).

Chad Lensch D.D.S. also said that he reduces the symptoms by using medication such as anti depressants since they are a form of muscle relaxant. Dr. Lensch said that physical therapy and wearing soft mouth guards at night are good for people who grind their teeth. He also uses anti-inflammatory drugs to flush out the joint space. This procedure is called arthrocentesis.

Just recently the FDA approved a TMJ prosthesis. This prosthesis replaces all the joints and connects to the mandible and skull (Heeney, Jane E. M.D.). This can either be an outpatient surgery or you could get admitted into a hospital. Over 300 people have received this implant but it is suppose to be used as a last resort and only if all other kinds of treatment failed (Lensch, Chad D.D.S.). It has also been stated that the prosthesis sometimes do not fit right. (Heeney, Jane E. M.D.).

Prevention

There are many ways to control dislocations. One way is when a person is yawning they should hold their jaw to not let it open all the way. Another way is to not take big bites of food. Also a person should be aware of how wide they open their mouth when they are excited and yelling and screaming. By doing these things it will have a persons jaw not ever lock open and require medical attention.

Since TMJ also happens because of a person has been in an accident the best way to protect yourself is to always wear your seat belt and to wear protective gear while playing sports. It is understood that a person can’t always wear protective gear, such as a helmet while swimming, but a person should always be careful of their skull.

Overall

I would recommend not getting the surgery. After all the research I did it would seem like a waste to spend money on a surgery that has a very good possibility of not even being successful.

Since there are ways to prevent a persons jaw from being locked open I would just rather choose to always trying to hold my jaw rather then getting a surgery. Also, it would seem hard to remember to always hold your jaw. Through my own life it is somewhat hard but after having it get locked open once a person would remember to hold it.

Works Cited

Henney, Jane E. M.D. Approval of TMJ Prosthesis. 8 September 1999. 28 September 2000 http://jama.ama-assn.org/issues/v282n10/ffull/jfd90007-3.html.

Jaw Dislocation (Temporo-Mandibular Joint Dislocation)

Lensch, Chad D.D.S. Personal interview. 6 October