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TM JOINT SURGERY

The TM joint acts sliding hinge, connects your jaw bone to your skull.

Symptoms:

    Signs and symptoms of TMJ disorders may include:
  • Pain or tenderness of your jaw
  • Pain in one or both of the TM joint.
  • Aching pain in and around your ear.
  • Difficulty chewing or pain while chewing.
  • Aching facial pain
  • Locking of the joint, difficult to open or close your mouth.

    TMJ disorders can also cause a clicking sound or grating sensation when you open your mouth or chew. Painful TMJ disorders can occur if:
  • The disk erodes or moves out of its proper alignment.
  • The joint’ s cartilage is damaged by arthritis.
  • The joint is damaged by a blow or other impact.

    Risk factors:
  • Various types of arthritis, such as rheumatoid arthritis and osteoarthritis.
  • Jaw surgery
  • Certain connective tissue diseases that cause problems that may affect the TM joint.

Care at Dr Balaji ‘s Hospital for TMJ disorders:

Team approach: For complicated problems , team members work together to address your TMJ disorder in a coordinated way.

    Diagnosis:
    Doctor will discuss your symptoms and examine your Jaw. He / she will probably,
  • Listen to and feel your jaw when you open and close your mouth.
  • Observe the range of motion in your jaw.
  • Press on areas around your jaw to identify sites of pain or discomfort.
  • If your doctor suspects a problem , you may need..
  • Dental x rays to examine your teeth and jaw.
  • CT scan to provide detailed images of the bones involved the joint.
  • MRI to reveal problems with the joint ‘ s risk or surroundings soft tissue

TMJ arthroscopy is sometimes used in the diagnosis of a TMJ disorder. During TMJ arthroscopy , your doctor inserts a small thin tube (cannula) in to the joint space, and a small camera (arthroscope) is then inserted to view the area and to help determine a diagnosis.

Treatment:

In some cases , the symptoms of TMJ disorders may go away without treatment. If your symptoms persists , your doctor may recommend a variety of treatment options, often more than one to be at the same time.

Medications:

Along with other non surgical treatments these medication options may help relieve the pain Associated with TMJ disorders:


  • Pain relievers and anti – inflammatories. If over- the- counter pain medications aren’t enough to relieve TMJ pain, your doctor or dentist may prescribe stronger pain relievers for a limited time, such as prescription strengthen ibuprofen.
  • Tricyclic antidepressents: These medications ,such as ampitriptyline, are used mostly for depression , but in low doses, they’re sometimes used for pain relief, bruxism control and sleeplessness.
  • Muscle relaxants: These types of drugs atre sometimes used for a few days or weks to help relieve pain caused by TMJ disorders created by muscle spasms.

Therapies:

    Non drug therapies for TMJ disorders include:
  • Oral splints or mouth guards (occlusal appliances). Often , people with jaw pain will benefit from wearing a soft or firm device inserted over their teeth, but the reasons why these devices are beneficial are not well- understood.
  • Physical therapy. Along with exercises to stretch and strengthen jaw muscles , treatments might include ultrasound, moist heat and ice.
  • Counseling. Education and counseling can help you understand the factors and behaviors that may aggravate your pain , so you can avoid them . Examples include teeth clenching or grinding, leaning on your chin, or biting fingernails.

Surgical or other procedures

    When other methods don’t help , your doctor might suggest procedures such as:
  • Arthrocentesis: Arthrocentesis ( ahr-throe-sen-TEE-sis) is a minimally invasive procedure that involves the insertion of small needles in to the joint so that fluid can be irrigated through the joint to remove debris and inflammatory byproducts.
  • Injections: in some people , corticosteroid injections in to the joint may be helpful. In frequently , injecting botulinum toxin type A (Botox, others) into the jaw muscles used for chewing may relieve pain associated with TMJ disorders.
  • TMJ arthroscopy: In some cases , arthroscopic surgery can be as effective for treating various types of TMJ disorders as open – joint surgery. A small thin tube (cannula) is placed in to the joint space, an arthroscope is then inserted and small surgical instruments are used for surgery. TMJ arthroscopy has fewer risks and complications than open – joint surgery does, but it has some limitations as well.
  • Modified Condylotomy: modified condylotomy (Kon-dih-LOT-uh-mee) addresses the TMJ indirectly, with surgery on the mandible, but not in the joint itself. It may be helpful for treatment of pain and if locking is experienced.
  • Open- joint surgery: If your jaw pain does not resolve with more – conservative treatments and it appears to be caused by a structural problem in the joint, your doctor or dentist may suggest open – joint surgery ( arthrotomy) to repair or replace the joint.

Life style and home remedies

Becoming more aware of tension – related habits - clenching your jaw, grinding your teeth or chewing pencils --- will help you reduce their frequency. The following tips may help you reduce symptoms of TMJ disorders: Avoid overuse of jaw muscles. Eat soft foods. Cut food in to small pieces. Steer clear of sticky or chewy food. Avoid chewing gum. Stretching and massage. Your doctor, dentist or physical therapist may show you how to do exercises that stretch and strengthen your jaw muscles and how to massage the muscles yourself. Heat or cold: Applying Warm, moist heat or ice to the side of your f ace may help alleviate pain.