Trigger Point Injections vs Dry Needling
Temporomandibular Joint: Anatomy, Movements & TMJ Dysfunction
The Temporomandibular joint (TMJ) is the jaw. The TMJ is the point where the jaw joins the skull; you can feel this joint directly when you place your fingers posterior to your cheek and anterior to your ear when your jaw is moving up and down, chewing. The TMJ is the articulation of the mandible with the mandibular fossa of the temporal bone.
The Temporomandibular joint has two main supporting ligaments; the lateral ligament, and the sphenomandibular ligament. The lateral ligament is responsible for keeping the lower jaw strong by preventing posterior displacement of the mandible. This ligament keeps your temporomandibular joint from becoming dislocating when you get receive a punch in the jaw or receive a hard blow. "The lateral ligament normally prevents the condylar process from being driven upward and fracturing the base of the skull," (Saladin, pg. 294). The sphenomandibular ligament extends from the sphenoid bone of the skull to the ramus of the mandible. The sphenomandibular ligament is on the medial side (closer to midline) of the temporomandibular joint.
The synovial cavity of the TMJ is separated into the superior and inferior chambers by an articular disk. The articular disk allows for a lateral and medial excursion (side to side movement) of the mandible.
The temporomandibular joint is combined with three elements of condylar, hinge, and plane joints. The TMJ consist of six movements; elevation, depression, protraction, retraction, lateral excursion, and medial excursion. During chewing the jaw is protracting (moving forward) and retracting (moving backward). When opening the mouth our mandible depresses, and our mandible elevates when closing our mouth. The side to side movement of the mandible when grinding food between the molars is performed by lateral, and medial excursions. The lateral excursion is the movement to the left and right of the zero position of the jaw. The medial excursion is the movement back to the zero position of the jaw, (Saladin, pg. 291).
The temporomandibular joint can become dislocated, where the condyle pops out of the fossa and slips forward. The TMJ can become dislocated from a deep yawn or having other strenuous depression of the mandible. The joint can be relocated by pressing down on your lower posterior molars while pushing the jaw posteriorly, (Saladin, pg. 295).
TMJ syndrome is experienced by some people, where their jaw causes them pain. Clicking or popping of the jaw is a symptom of TMJ syndrome, and difficulty opening the jaw all the way. TMJ syndrome can because by injury to teeth or the jaw joint, misalignment of the teeth or jaw, teeth grinding, gum chewing, or stress.
PREVENTION & TREATMENT
There are many different treatment options for a person who is suffering from TMJ. For temporary relief of the pain associated with TMJ, people can try to treat the pain and discomfort by eating soft foods, applying ice to the area, trying to avoid eating hard or tough foods that may aggravate their joints in their jaw. To be mindful of when they are yawning. However, there is Gentle jaw stretching and relaxation techniques they can practice that would help alleviate the pain and increase their jaws movement. People can use physical therapy or a more natural and holistic approach to Acupuncture. A health care provider like a chiropractor or a physical therapist can recommend exercises if appropriate for your particular condition.
They can also try over the counter medication for short term use such as an anti-inflammatory like ibuprofen. When necessary, the person’s dentist or physician can prescribe stronger pain or anti-inflammatory medications, muscle relaxants, or antidepressants to help ease symptoms. The dentist may recommend a mouth guard to protect the person teeth during night grinding. However, the physician or dentist may recommend an oral appliance, such as a stabilization splint or bite guard. Stabilization splints are the most widely used treatments for TMJ disorders. Studies of their effectiveness in providing pain relief, however, have been inconclusive. If a stabilization splint is recommended, it should be used only for a short time and should not cause permanent changes in the bite.
Saladin, K. S. (2012). Anatomy & physiology: the unity of form and function (7th ed.). New York: McGraw-Hill.
Pearson Education, HealthDent.com/tmj
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