Diagnosis and treatment of jaw joint problems .

The Jaw Joint is located between the lower jaw and the skull and is the only joint of the body in this form due to its double-headedness. The physiological movement of the joint causes many other functions, especially chewing and speaking, to be performed in a healthy way. The chewing forces on the teeth act directly on the joint. We can compare it to a nutcracker because of the way the chewing forces come on the joint. The situation in which the chewing forces on the joint go beyond the physiological limits and cause a condition that will cause destruction on the joint is called Tempromandibular Joint Disorder or shortly “TMJ Problem” in the dentistry literature.

Restorative treatments on the teeth are the most important reasons for the chewing forces occurring between the lower and upper teeth to go beyond physiological limits. These treatments can sometimes be a bridge, sometimes a prosthesis, sometimes even a filling or orthodontic treatment. Disruption of the order between the teeth will lead to the deterioration of the relationship between the upper and lower teeth and the jaw joint for years. While the relationship between these structures, which started from the developmental periods and developed for years, is a relationship accepted by the central nervous system of the person, its sudden deterioration with a treatment finds a response with the reaction of the nervous system. In order to remove this structure that disrupts harmony on the teeth, the nervous system first provides pressure on the teeth by contracting the muscles acting on that structure in order to put pressure on this structure. If this incompatible structure is eliminated by the contraction of the muscles and clenching of the teeth, the problem disappears. However, when the hard restorative material cannot be removed most of the time, this time it causes pain in the muscles that apply force to that area with the stimulation of the nerves. With the formation of pain in the muscles, this time the nervous system tries to avoid the cause of pain for protection. This time, the system breaks down in the direction of escaping from the area where the problem is. Unless the problem is eliminated, any therapeutic intervention will fail. Symptoms of TMJ disorder may be as follows;

1. Pain in the joint area,

2. Pain in the muscles (Masseter and/or Temporal) that lift the jaw joint,

3. A feeling of tiredness on the face when you wake up in the morning,

4. Limitation in mouth opening,

5. S-shaped movement during flaring,

6. Clicking or plopping sounds in the joint when opening the mouth,

7. Migraine-type headaches; often the patient wants to take painkillers as soon as he gets up in the morning,

8. Continuous grinding of teeth at night,

9. As a result of the long duration of the problem, abrasions in the areas where the teeth connect with the gingiva, while these abrasions are said to be the result of faulty tooth brushing for years, it has been revealed that in modern dentistry they occur as a result of faulty chewing forces.

10. Tinnitus (tinnitus),

11. Unilateral hearing loss with tinnitus

So what solutions can we use to solve the problem?

1. The most ideal solution is the T-Scan III Computerized Occlusion Analysis method, which is the only scientific solution today, and the point(s) that cause the incorrect chewing force on the tooth(s) are eliminated by performing occlusion analysis.

2. By attaching a plate to the patient, it is aimed to disrupt the stimulus pattern in order to eliminate the faulty point in the central nervous system; however, the solution is temporary, if the plate is permanently attached, the problem may arise on the other side this time. The problem will continue as before for a while after the plaque is removed.

2. It is wrong for the patient to use excessive pressure on the problem area in an effort to solve the problem by himself. For example, if there is a limitation in mouth opening, the patient should not force himself to open his mouth. This will further increase the muscle spasm.

3. There is no benefit in using anti-inflammatory drugs, these drugs only temporarily relieve the patient’s pain with their secondary analgesic properties.

4. Applying hot compresses on the muscles in the pain area may also cause the patient to relax.

5. The patient’s tinnitus and often the accompanying hearing loss can be eliminated as a result of correcting the occlusion disorder that occurs during chewing.

6. Elimination of the occlusion disorder between the lower and upper teeth is the most important issue for the normalization of the Bone-Muscle-Nerve combination that constitutes the problem, and for the complete disappearance of TMJ problems.

7. Even if the TMJ problem is observed as a result of extremely physically stressful tooth extraction operations, the problem can often disappear on its own, but if the tooth arrangement has changed, the problem may continue in different sizes and varieties. In this case, the removal of faulty points in natural teeth by occlusion analysis should be a radical treatment.

8. Surgical operations on the jaw joint are only temporary solutions and we do not recommend them to our patients.