DE   EN   ES   FR   IT   PT Stomatology Dysfunction of a temporal and mandibular joint

Dysfunction of a temporal and mandibular joint


Dysfunction of a temporal and mandibular joint (VChNS) is connected with changes in a jaw, a maxillary joint and the surrounding facial muscles participating in process of chewing and the movements of a jaw.

Анатомия височно-нижнечелюстного сустава

Anatomy of a temporal and mandibular joint

Reasons of dysfunction of a temporal and mandibular joint:

The reasons of dysfunction of a temporal and mandibular joint are up to the end not found out, however stomatologists assume that this problem is connected with disturbances from maxillary muscles or elements of the joint.

Dysfunction of a temporal and mandibular joint can be a consequence of an injury of a jaw, temporal and mandibular joint or muscles of the head and neck – for example, as a result of strong blow or "a hlystovy injury". Treat other possible reasons:
The bruxism or stiskivaniye of teeth leading to an overload of a temporal and mandibular joint;
Shift of the intra joint cartilaginous disk located between a head of a joint and a socket;
Damage of a temporal and mandibular joint owing to an osteoarthritis or a pseudorheumatism;
Stress which consequence is tendency to tension of facial or maxillary muscles or a stiskivaniya of teeth.

Symptoms of dysfunction of a temporal and mandibular joint:

Sharp pain and discomfort which can be temporary or remain for many years can be symptoms of dysfunction of a temporal and mandibular joint. Dysfunction of a temporal and mandibular joint is most often observed in an age group from 20 to 40 years (women are ill more often than men).

Typical symptoms of dysfunction of VNChS are:
Pain or morbidity in a face, maxillary joints, a neck and shoulders, in or near an ear during the chewing, a conversation or broad opening of a mouth
Restriction of amplitude of opening of a mouth
Blocking ("jamming") of a jaw in an open or closed position
Clicks, crash or gnashing in a maxillary joint when opening and closing a mouth (sometimes followed by pain).
Fatigue of facial muscles
Difficulties when chewing or suddenly arising "inconvenience" of a bite (feeling that upper and lower teeth are not closed correctly).
Puffiness on the one hand persons

Other common symptoms are tooth or a headache, dizzinesses, ear pain, hearing disorder, pain in an upper part of a shoulder, the ring in ears (tinnit).


Symptoms of dysfunction of a temporal and mandibular joint can remind symptoms of many other diseases (diseases of teeth or okolonosovy bosoms, arthritis, inflammatory diseases of gums) therefore the doctor will carefully study data of the anamnesis and will conduct clinical examination for specification of the reasons of the symptoms tested by you.

The doctor will check a temporal and mandibular joint for existence of pain or morbidity; will listen to sounds in a joint (whether there are no clicks, a crash or the gnashing sounds at the movements of a jaw); will pay attention to restriction of volume of movements or "jamming" of a jaw when opening or closing a mouth; will estimate type of a bite and function of facial muscles. Sometimes there is a need to make a panoramic x-ray film (a full-front picture in which the doctor can see at the same time both jaws, VNChS and all teeth that allows to exclude other reasons of observed symptoms). In certain cases carrying out magnetic and resonant (MRT) or computer tomography (CT) is required. By means of MRT it is possible to receive the image of soft tissues – for example, intra joint disk VNChS that allows to check correctness of its situation at the movements of a jaw. KT-scanning gives the chance to investigate bone structure of a joint.

By results of inspection the doctor can make the decision to direct you for further observation and treatment to the surgeon-stomatologist (the maxillofacial surgeon). This is the doctor of a narrow profile specializing in carrying out surgical interventions in a face, a jaw and an oral cavity.

Treatment of dysfunction of a temporal and mandibular joint:

Ways of treatment can vary from simple recommendations about care of area of a sore joint and use of conservative methods to injections and surgical intervention. Most of specialists consider that treatment should be begun with conservative (nonsurgical) measures, resorting to surgical intervention only in extreme cases. Many of the listed below methods give the best effect at the combined use.
Applying of wet heat or cold compresses. The cold compress is put for 10 min. to the relevant side of a face and area of a temple.

Then carry out several simple exercises for warm-up of the maxillary muscles recommended by the stomatologist or LFK specialist. After performance of exercises put a warm towel or a napkin to the struck side of a face. These procedures are repeated several times a day.
Exception of firm food. Include products with a soft consistence in food (yogurts, mashed potatoes, cottage cheese, soups, omelets, fish, porridges, boiled fruit, vegetables and bean). Products before the use cut small pieces to reduce need for a chewing. Exclude the firm and crackling products (rolls with a firm crust, drying, crude carrots), the products demanding long chewing (caramel, toffees) and also the large pieces of food and fruit which are bitten off by widely opened mouth.
Reception of medicines. For pain relief and puffiness it is possible to use non-steroidal anti-inflammatory drugs (NSPVP), for example, the aspirin or an ibuprofen (advit, motrit, olives) which are released without recipe. Perhaps, the doctor will recommend the raised doses of these or others to NSPVP or will appoint other medicine – for example, a narcotic analgetic. For removal of tension of maxillary muscles (in particular at a bruxism or a habit to grit teeth) muscle relaxants can be appointed. For reduction of a stress (which is in certain cases regarded as the aggravating factor at VNChS dysfunction) it is possible to use demulcents. Removal or pain relief are also promoted by reception of small doses of antidepressants. Muscle relaxants, demulcents and antidepressants are released only according to the recipe of the doctor.
Treatment by the low-frequency laser. It is used for pain relief and removal of an inflammation, and also for increase in volume of movements in cervical department and amplitudes of opening of a mouth.
Carrying the orthopedic tire (splint) or caps. Сплинт and a nazubny mouthpiece represent the plastic nozzles which are put on upper and lower teeth. They interfere with a smykaniye of teeth that reduces negative effects from a stiskivaniye or gnashing by teeth. Besides, they promote correction of a bite, holding teeth in the most correct and least travmatiziruyushchy situation. The main distinction between splinty and a mouthpiece is what a cap is put on only for the night, and сплинт rushes constantly. In need of carrying the doctor will discuss caps with you what type caps is required to you.
Orthopedic and orthodontic treatment. Replacement of the absent teeth, installation of crowns, bridges or breket-system for alignment of the cutting surfaces of teeth or correction of a bite.
Restriction of movements of a joint. It is recommended to yawn and minimize as seldom as possible the chewing movements (especially the use of chewing gum and ice cream), and also to avoid the maximum movements of a joint (as at shout and singing).
It is not recommended to prop up a chin a palm or to hold the receiver clamped between a shoulder and an ear. The correct posture promotes pain relief in cervical and front area.
For reduction of tension of a jaw it is necessary to hold whenever possible a mouth slightly slightly opened. In the afternoon the stiskivaniye of teeth or gnashing by them helps to prevent making of a tip of language between teeth.
Training in the equipment of a relaxation helps to reduce tension of maxillary muscles. Consult with the stomatologist concerning need of physiotherapy exercises or massage. Think of use of techniques of stress coping, for example a method of the biological feedback (BF).

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