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TEMPOROMANDIBULAR DISORDER

(TEMPOROMANDIBULAR JOINT DISORDER, NOS)
Temporomandibular Disorder

WHAT YOU NEED TO KNOW:

What is temporomandibular disorder? Temporomandibular disorder is a condition that causes pain in your jaw. The disorder affects the joint between your temporal bone and your mandible (jawbone). The muscles and nerves around the joint are also affected.

What causes temporomandibular disorder?

  • Dislocation of the cartilage disc in the joint

  • Deformities of the jaw

  • Inflammation, infection, arthritis, muscle problems, or tumors in the jaw area

  • Injury to or fracture of the jawbone

  • Muscle strain from chewing or teeth clenching or grinding

What are the signs and symptoms of temporomandibular disorder?

  • Popping or grating sound when you open or close your mouth

  • Headache or pain in your jaw, ear, neck, or face

  • Pain or swelling of the jaw muscles

  • Tingling or numbness in the jaw or face

  • Trouble opening or closing your mouth, or your jaw locks

How is temporomandibular disorder diagnosed? Your healthcare provider will examine your jaw, face, and neck. He will ask you about your health conditions or injuries. You may also need the following tests:

  • X-rays: You may need to have x-rays of your skull, jaw, or teeth.

  • Arthrogram: This is an x-ray that uses contrast dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your jaw. You may be given contrast dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

  • Bone scan: This is a test done to look at the bones in your body. The bone scan shows areas where your bone is diseased or damaged. You will get a radioactive liquid, called a tracer, through a vein in your arm. The tracer collects in your bones. Pictures will then be taken to look for problems. Examples of bone problems include fractures (breaks) and infection.

How is temporomandibular disorder treated?

  • Medicines:
    • NSAIDs: These medicines decrease swelling and pain. You can buy NSAIDs without a doctor's order. Ask your healthcare provider which medicine is right for you, and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.

    • Botulinum toxin: This may be injected into the muscles of your jaw to decrease pain.

    • Steroid medicine: These may be injected into the joint to decrease pain and swelling.

    • Muscle relaxers help decrease pain and muscle spasms.

  • Surgery: You may need surgery to fix your teeth, jawbone, or the joint.

What are the risks of temporomandibular disorder? You may bleed or get an infection if you have surgery. If left untreated, your condition may get worse. You may have trouble breathing, eating, drinking, talking, or opening your mouth. If not treated early, temporomandibular disorder may lead to permanent injury, such as nerve damage, deformity, or paralysis.

How can I manage my symptoms?

  • Eat soft foods: Your healthcare provider may suggest that you eat only soft foods for several days. A dietitian may work with you to find foods that are easier to bite, chew, or swallow. Examples are soup, applesauce, cottage cheese, pudding, yogurt, and soft fruits.

  • Use jaw supporting devices: Splints may be used to support your jaw or keep it from moving. You may need to wear a mouth guard to keep you from clenching or grinding your teeth while you are sleeping.

  • Use ice and heat: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on your jaw for 15 to 20 minutes every hour or as directed. After the first 24 to 48 hours, use heat to decrease pain, swelling, and muscle spasms. Apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed.

  • Go to physical therapy: A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain in your jaw. A speech therapist may help you with swallowing and speech exercises.

When should I contact my healthcare provider?

  • You have a fever.

  • Your splint or mouth guard is loose.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have nausea, are vomiting, or cannot keep liquids down.

  • You have pain that does not go away even after you take your pain medicine.

  • You have problems breathing, talking, drinking, eating, or swallowing.

  • Your splint or mouth guard gets damaged or broken.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.