Arthritis – Temporomandibular joint disorder
Arthritis is an inflammatory condition that affects the joints, and its symptoms include pain, stiffness and swelling of the joints. This condition can affect any joint in the body, including the temporomandibular joint (TMD), which lies between the lower jaw and the temporal bone of the skull.
Temporomandibular arthritis (TMD) can be caused by several factors, such as trauma, stress or autoimmune diseases.
In this article, we explore the causes, symptoms and treatments available for TMD arthritis.
The temporomandibular joint joins the mandible to the rest of the canine via the articular disc.
Thanks to this structure, vertical and lateral movements of the mouth are possible.
In various local or general conditions, the TMD may undergo transient or even permanent pathological changes, always accompanied by pain and functional limitation, which affect the patient’s quality of life.
Thus, by affecting the TMD, the following functions may be altered:
Chewing – normally, during chewing, the movements made by the perioral muscles are ample to help efficiently grind food. In the case of joint damage, jaw movements are reduced in amplitude and the quality of the masticatory action decreases, with consequences for the entire digestive tract.
Swallowing – incomplete mastication leads to swallowing larger pieces of food. Thus, the quality of the food bowl formed is lower and swallowing will be significantly hampered.
Phonation – speech also suffers by limiting the opening of the oral cavity.
Swallowing, being an involuntary act, will be very painful and almost impossible.
Arthritis is inflammation of the temporomandibular joint. It can result from a direct cause, for example local inflammation or trauma, or it can be the consequence of a general condition.
Arthritis due to infection
Occurs through the bloodstream of a general infection or directly, through damage with a local starting point.
The area around the temporomandibular joint is inflamed and jaw movements are limited and painful.
In the initial stages, X-rays show no changes but over time, untreated pathology can cause destruction of bone tissue.
Treatment must be instituted from the outset because untreated joint damage leads to irreversible changes in the dynamics of the jaw.
The therapeutic approach includes the administration of antibiotics to treat the infectious focus. Excessive mobilization of the mandible should also be avoided. Resumption of movements should be carried out gradually to prevent the onset of ankylosis.
Very rarely, acute trauma can cause arthritis. For example, following difficult extractions involving a longer sitting, inflammation of the joint capsule may occur.
A soft food diet, anti-inflammatory drugs and warm compresses can reduce inflammation and restore function to the TMD.
It affects a high percentage of the world’s population but the TMD is one of the last sites of interest. Common manifestations include pain and limitation of functional movements.
A complication of rheumatoid arthritis is ankylosis which manifests itself by the deposition of a bony block around the temporomandibular joint.
In its early stages, rheumatoid arthritis is treated with anti-inflammatory drugs. It is also important to mobilize it, so mouth opening exercises are useful.
Whether it’s interbody objects or extraoral devices to mechanically produce mouth opening, stimulating this function is essential to prevent ankylosis.
If the latter pathology sets in and mechanical treatments have not worked, surgery is resorted to.
If the opening of the oral cavity is restricted, the mouthpiece, placed between the arches and maintained during the night and between meals, is also of real help. It can relieve pain, relax the masticatory muscles and thus reduce stress transmitted to the temporomandibular joint.
Causes of temporomandibular arthritis
TMD arthritis can be caused by several factors, such as trauma to the TMD, dental or jaw problems, or autoimmune diseases such as systemic lupus erythematosus or rheumatoid arthritis. Sometimes the cause cannot be identified.
Symptoms of temporomandibular arthritis
Symptoms of temporomandibular arthritis include pain in the TMD area, difficulty opening the mouth, noises during joint movements, and pain in the ear, head and neck.
These symptoms can be exacerbated by unhealthy habits, such as teeth grinding or excessive gum chewing.
Diagnosing temporomandibular arthritis
Diagnosing TMD arthritis usually involves a physical examination and discussion with your specialist.
X-rays or magnetic resonance imaging may be used to determine the condition of the joint.
Treatment of temporomandibular arthritis
The treatment of TMD arthritis may be different depending on the cause and severity of the symptoms. Treatments may include the use of non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy or cognitive-behavioral therapy to manage stress and unhealthy habits.
In more severe cases, surgery, such as arthroscopy, may be used to repair or replace the joint.
Preventing temporomandibular arthritis
Preventing TMD can include avoiding unhealthy habits such as excessive gum chewing, avoiding hard or splintery foods and reducing stress.
Regular dental checkups are also recommended to prevent dental or jaw problems.
TMD can be a painful and uncomfortable condition, but there are many treatment options available to help manage symptoms.
It’s important to talk to your GP to identify the cause and choose the right treatment for your case.
In addition, avoiding unhealthy habits and maintaining good dental hygiene can help prevent problems with your TMD.
With proper attention and care, people with TMD can reduce their symptoms and improve their quality of life.