Temporomandibular joint cracking
introduction
Diseases of Temporomandibular joint are not uncommon. Within Germany, disorders of the normal temporomandibular joint function belong alongside the occurrence of carious defects even among the most common abnormalities in the field of Oral cavity. According to extensive studies, suffer over 10 million Citizen with TMJ osteoarthritis. The number of patients who suffer from less noticeable TMJ disorders far exceeds this number.
In most cases, deficits in the temporomandibular joint function manifest themselves very early in the affected patient through the occurrence of Temporomandibular joint cracking, Tension and Pain at the Masticatory muscles, a headache and Earache or limitations of the Mouth opening. It is generally believed that such TMJ problems occur in most cases Incorrect loads and mechanical wear the articular surfaces consisting of cartilage.
However, there are also patients who develop such symptoms due to inflammatory or infectious causes. With increasing age, it has been proven that the risk of developing a disease of the jaw with clearly noticeable (and sometimes audible) jaw joint cracking also increases. In addition, a possible genetic predisposition or heavy physical work also seem to play a decisive role in the development of diseases of the TMJ.
anatomy
The Temporomandibular joint (lat. Temporo-mandibular articulation) provides a flexible connection between the bony upper jaw (lat. Maxilla) and the Lower jaw bone (lat. Mandible) where the so-called Mandibular fossa (lat. Mandibular fossa) direct contact with the Maxillary head (Caput mandibulae) is received.
While the maxillary bone den stare Forming part of the temporomandibular joint, the lower jaw, which is essential for opening the mouth, is free movable clamped in the joint. This bone connection is supported by numerous muscles (Masticatory muscles) and Tapes. So that the two bony structures of the temporomandibular joint do not rub against each other, the head of the maxilla and the pit of the mandible are made movable by one Cartilage (Articular disc) separated from each other. The Cartilage disc Functionally divides the jaw joint into two independent Portions, the upper and lower joint space.
Sliding movements are mainly performed in the area of the upper joint part (upper joint space). Turning movements on the other hand, run essentially in the lower joint space. For the Chew or Speak However, it is by no means sufficient to perform one of these two movements separately. In these processes, both ranges of motion must be skillfully combined with one another. From this fact it can be deduced that in the temporomandibular joint too Combination movements (so-called Rotating and sliding movements) can be executed.
Causes of temporomandibular joint cracking
Since the jaw joint cracking is only a symptom of various diseases of the joint, its causes can be of diverse nature. The long-term treatment of this symptom can therefore only be carried out with suitable therapy for the underlying problem. For this reason, it is extremely important to pay attention to when the temporomandibular joint cracking occurs and under what conditions it worsens or how it can be alleviated if necessary.
In addition, the affected patient should pay attention to whether other abnormalities occur in addition to the jaw joint crack. Accompanying symptoms of the temporomandibular joint cracking are, for example, tension or pain in the masticatory muscles, headache or earache. In particular, the accompanying symptoms that occur in the course of the underlying disease can provide an initial clue to the underlying problem and provide essential help in choosing the appropriate treatment measures.
In some patients, the eruption of the wisdom teeth appears to be the cause of the temporomandibular joint cracking. This phenomenon can be explained by the fact that the size of the human jaw has decreased significantly in the course of evolution and that it no longer has enough space to accommodate 32 teeth. After the wisdom teeth have erupted, the remaining teeth can be displaced and displaced from their original place in the jaw. As a result, there is often improper stress on the jaw joint, which can lead to signs of wear and tear and ultimately to jaw joint cracking.
Furthermore, some affected patients report that in mentally or physically triggered stressful situations they often tend to grind their teeth at night or to press the rows of teeth against one another with enormous pressure. It is precisely these patients who usually notice a cracking of the jaw joint and severe pain in the jaw joint, head and ears after getting up.
However, all of the causes just explained are comparatively rare reasons for the occurrence of the jaw joint cracking. By far the most common cause of this symptom is still the presence of a disease of the temporomandibular joint known as CMD syndrome (craniomandibular dysfunction). Craniomandibular dysfunction is a malfunction of one or more parts of the temporomandibular joint itself.
Read more on the topic: Craniomandibular dysfunction
Tooth misalignments that have not been treated or only inadequately treated are the most common cause of craniomandibular dysfunction, which can lead to the perception of temporomandibular joint cracks and, in some cases, severe pain. Typically, the pain that occurs as a result of this malfunction occurs in the area of the ears, head and back. In most patients, the neck is primarily affected. In addition, visual disturbances and tension in the masticatory muscles are typical accompanying symptoms of craniomandibular dysfunction.
In addition to the mechanically induced causes already described, bacterial or viral infections that lead to inflammatory processes in the area of the temporomandibular joint can promote the occurrence of jaw joint cracks or even trigger them themselves. Back, head and neck pain as well as general symptoms such as fever and fatigue are among the most common side effects of an infectious TMJ disease. In addition, one-sided stress while chewing is considered to be the cause of severe signs of wear and tear on the joint, which can be accompanied by cracking of the jaw joint.
A temporomandibular joint inflammation can also produce cracking noises.
Read more on the topic: TMJ inflammation
Temporomandibular joint cracking with or without pain - what are the causes?
The click of the temporomandibular joint can trigger an unpleasant noise, but it does not always have to be painful. Pain often occurs when the temporomandibular joint jumps completely out of the socket (luxation) and the muscles are overstretched. This jumping out doesn't have to be complete. So-called subluxations can occur, in which the joint head does not come out completely, but only partially. This subluxation can even take place almost unnoticed without the patient noticing anything.
If the symptoms occur through crunching and pressing, the patient often has strong tension in the head and neck area in the morning after getting up and in stressful phases of life, which can lead to increased pain.
diagnosis
Basically every resident dentist should be able to treat joint diseases that lead to temporomandibular joint cracking effectively and over the long term. However, there are also specialists who mainly deal with the therapy of TMJ diseases and their effects and should therefore be preferred in pronounced cases. For the patient concerned, the choice of the most suitable dentist is a crucial basis for the success of the treatment of temporomandibular joint cracking and its underlying disease.
In most cases, the dentist will be able to determine the cause of the jaw joint cracking after an extensive doctor-patient discussion and a few simple examinations. If, after the first diagnostic measures, it can be determined that the jaw joint cracking is due to a misalignment in the area of the jaw, a more extensive examination must usually be carried out. Both the palpation of the bony joint parts and the masticatory muscles as well as a detailed functional analysis belong to the usual examination measures for patients who suffer from temporomandibular joint cracks. In addition, it is advisable to take an X-ray that fully depicts the teeth, jawbones and jaw joints and clearly shows signs of wear.
Cracking of the temporomandibular joint when chewing
An uncomfortable crackling sound when chewing can occur when the joint apparatus is overloaded. The muscles are stiffened by grinding and pressing and the joint surfaces are overstrained. This can spread to such an extent that the jaw joint can no longer adapt while eating because it cannot use the muscles optimally. This can lead to a dislocation of the temporomandibular joint head, which results in an uncomfortable cracking sound. During the dislocation, the head jumps out of the joint pit, because for muscular or other reasons the healthy, normal joint path cannot be maintained. This dislocation can also cause discomfort and even occur while speaking.
What is the difference between one-sided and two-sided cracking?
Many sufferers only have symptoms on one side, but not on both sides. In general, this means that only one temporomandibular joint tends to pop out and the other remains in the normal joint path.It is entirely possible to feel these symptoms bilaterally. The causes can be varied.
A disturbed bite can wear out one side or both to such an extent that the temporomandibular joint cannot hold the normal joint guidance. In this case one speaks of TMJ arthrosis. If left untreated, crunching and pressing can also trigger osteoarthritis over a long period of time. Furthermore, a shock or impact can cause a fracture during trauma, which, if left untreated, can lead to popping out.
Therapy for jaw joint cracking
Since cracking of the temporomandibular joint can have various causes, the therapy must be adapted as far as possible to the treatment of the causal disease. This is the only way to remedy the temporomandibular joint cracking symptom in the long term and to keep the patient symptom-free. The correct treatment therefore depends on the diagnosis made by the dentist.
For patients who suffer from improper stress on the joint due to worn or incorrectly fitted dentures, which lead to jaw joint cracking, it is essential to replace or grind them in as soon as possible.
If the temporomandibular joint cracking is caused by inflammatory temporomandibular joint pain, the focus of which is caused by inflammation of the muscles or the joints themselves, both pain relievers (analgesics) and anti-inflammatory drugs (anti-inflammatory drugs) are generally used. Since severe tension often occurs in the course of the inflammatory processes, targeted massages and relaxation exercises are also carried out.
Orthodontic treatment is often the only way to relieve symptoms of patients who suffer from temporomandibular joint cracking caused by asymmetries in relation to the position of the teeth or crowding of the teeth. In addition, the production and regular wearing of an occlusal splint can help in most cases for patients who tend to grind their teeth in stressful life situations (bruxism) or who bite the halves of the jaw violently. By wearing the bite splint, further tooth abrasion is avoided and the remaining tooth substance is protected. In addition, the jawbone in the joint is more relaxed when using the bite splint. The result is a rapid reduction in the temporomandibular joint cracking.
Which exercises can help?
Exercises that can remedy the problem are massaging the overused muscles. The hardened muscle strands can be loosened by circular movements and light pressure so that the stiffening loosens. Knots can also be massaged in this way. Furthermore, the temporomandibular joint can be trained through targeted maximum opening of the mouth so that the head of the temporomandibular joint no longer pops out. The mouth may only be opened so wide without the patient feeling pain.
Relaxation exercises by moving sesame seeds or cherry stones in the mouth with the tongue and tissues is also advisable. If all these exercises do not relieve the symptoms, the attending dentist should be consulted, who may refer to an oral and maxillofacial surgeon, unless conservative therapy with special physiotherapy helps.
prevention
In the majority of cases, the occurrence of jaw joint cracks can be prevented by simple means. For one, are regular Dentist visits, in which the condition of the teeth and, if necessary, the Dentures is carefully examined, essential. On the other hand, it can be helpful as a patient to pay attention to the situations in which you are strengthen Tension tends. Heavily worn Dental fillings, Crown or bridges should be improved or completely replaced within a reasonable period of time. In addition, simple ones help Relaxation exercises thereby relieving the chewing muscles and thus also the jaw joint.
