Craniomandibular dysfunction includes all functional alterations related to the temporomandibular joint and to the muscles involved in its movement.
Its presentation is very varied: pains in the joint, opening or closing click clicks, headaches, muscular contractions of the face or neck, limitation of opening, including blockage of opening or closing; Ear pains, tinnitus (noise in the ears), constriction (wear) on the tooth enamel, etc.
They are diagnosed based on pathological changes in the muscular and articular tissues (contractures, arthritis ...), which are frequently related to stress episodes.
Pathologies of craniomandibular dysfunction
- At the joint level: osteoarthritis, arthritis or arthralgia (joint pain) of the TMJ. Different degrees of dislocation of the articular disc accompanied by blockages in the opening or closing.
- At muscle level: myalgias (myofascial syndrome) with or without opening limitation.
- At the dental level: chronic pulpitis or even pulp necrosis in the teeth that suffer from enamel overload and wear (bruxism). Inflammation of the dental ligament (periodontits) due to overload (bruxism).
These pathologies are manifested by various symptoms:
- Joint sounds, click when opening or closing the mouth or when chewing. It can be an initial symptom that starts intermittently and becomes continuous.
- Pain in the teeth when chewing or simply closing the mouth.
- Alterations in the mobility of the mandible, limitation in the opening. Excessive fatigue when chewing.
- Pain when opening or closing the mouth.
- Pain related to areas of the face.
- Earache, which is actually pain of the joint that by its proximity to the ear confuses the patient.
- Blockages in the opening with inability to close or with changes in the closing position and in the contact of the teeth.
Problems that may cause craniomandibular dysfunction
Craniomandibular dysfunction causes problems related to the mobility of the mandible, blockages and / or joint dislocation can occur causing difficulty in speaking and pain in chewing.
At muscle level, contractures are painful on the face spontaneously or on palpation, and sustained pain becomes headache, earache, pain, and cervical contracture.
Disorders of the TMJ
Malocclusion and psychological factors accompanied by stress are commonly accepted as the most involved etiological factors.
The patient usually goes to the dentist for any of the symptoms listed above; In its clinical history always appears the stress (emotional, labor ...) like element more habitual.
In addition, they are often accompanied by chewing habits (nails, chewing gum, pencils ...), or simply twitching tics and muscle tightening.
Treatment for TMJ disorders
The treatment should be directed to the symptoms that the patient presents, but also to the cause that produces them.
ATM physical mediated
- For joint pain it is useful to apply local dry heat on the sore joint. Ultrasounds provide it more deeply in chronic treatments.
- Massages in contractured muscles.
- There are also tables of muscular exercises.
- If there is a dislocation of the articular disc, the manipulation (reduction) must be done by a professional.
ATM pharmacological measures
- Anti-inflammatory, calming pain.
- Miorelajantes, used with caution because they usually produce sleep and create tolerance.
- Anxiolytics, help improve stress and are well tolerated.
- Antidepressants such as amitriptyline.
ATM Clinical Treatments
A clinical occlusal adjustment may be necessary to stabilize the mandille in a muscular position and articularly better tolerated.
Splints for the TMJ
Their use is very common, they do not have any adverse effect and almost always produce a clinical improvement. There are different types:
- Of relaxing.
- From Michigan.
In addition, they all protect the teeth from wear and soft tissue from the occlusal trauma that accompanies these pathologies.