How to treat temporomandibular joint

Temporomandibular joint dislocation, also known as jaw dislocation, is a fairly common disease in both children and adults. This condition is not dangerous, but if not treated in time, it can seriously affect your health.

Temporomandibular joint dislocation is an imbalance in the joint between the skull and the lower jaw. The temporomandibular joint plays an important role in the functioning of the masticatory system.
Temporomandibular joint dislocation usually occurs after this joint has been infected for a long time and is not detected and treated in time. This dislocation can occur in both children and adults.
Although dislocation is not a dangerous disease, it causes a lot of trouble in the process of eating, living and if not treated in time, it will seriously affect health.

Temporomandibular joint dislocation can be caused by some of the following reasons:
Stress, pressure at work, nervous tension. Infection, degenerative joint disease, or inflammation - secondary osteoarthritis of the temporomandibular joint, rheumatoid arthritis. Trauma from impact or sudden opening of the mouth too wide can dislocate the temporomandibular joint. Teeth grinding while sleeping or chewing gum too much can also cause TMJ dislocation. Teeth grinding or chewing gum tightens the jaw, will create too much force on the temporomandibular joint, the most dangerous is dislocating the bite. Dislocated disc or after tooth extraction, especially after tooth number 7, 8 or because teeth are misaligned, crowded, and misaligned, can dislocate the temporomandibular joint. In addition, there are other causes of temporomandibular joint dislocation such as tooth wear, gaping teeth, tooth loss, misaligned teeth, periodontal disease, gum disease, incomplete partial or complete dentures. Bad habits such as sucking on a pacifier and biting a pen can also cause a child to develop TMJ.

Symptoms of temporomandibular joint dislocation usually appear after an excessive opening of the mouth that causes the jaw to be crooked to one side (one side dislocation) or the lower jaw to drop forward (both sides), the mouth is open. can be closed and accompanied by other symptoms such as:
Salivation. Difficulty chewing, swallowing, joint pain, headache. If the temporomandibular joint is dislocated on one side, there will be the following symptoms: The chin is deviated to the healthy side. The healthy cheek will be sunken, while the dislocated cheek will be flattened. Small open mouth. Palpation of the condyle on the dislocated side shows slight convexity under the skin. If TMJ dislocation both sides will have the following manifestations: Chin protrudes anteriorly. Cheeks are sunken on both sides. Mouth wide open. When the department will see the condyle located in front of the cap of the ear cup.

Temporomandibular joint dislocation is usually diagnosed based on clinical symptoms. In some cases, to determine the type of dislocation or to check for condylar fractures, or to evaluate for associated injuries, the patient is usually ordered:
X-ray of the temporomandibular joint . Or a CT scan of the skull and face.

After definite diagnosis is unilateral/bilateral temporomandibular joint dislocation, the doctor needs to explain to the patient to cooperate in treatment, especially when a procedure is needed.
In rare cases, the doctor can use local anesthetic with 2% lidocaine with a dose of 2 - 5ml injected into the dislocated joint and surrounding areas where the lateral sphenoid muscle attaches to allow automatically return to the normal position.
Most cases of temporomandibular joint dislocation require manual manipulation. Manual temporomandibular joint manipulation is performed as follows:
The patient is given an analgesic or mild muscle relaxant before the procedure. Patient position: The patient is sitting, leaning back and head against a chair or hard wall, looking straight ahead. Position of the manipulator: The manipulator stands in front of the patient, uses two gauze pads on the chewing surface of the lower molars, then presses with two thumbs on the gauze, the remaining fingers hold the outer corner of the jaw. Use force to press the angle of the jaw downward, and at the same time push it back. Attention should be paid only to the dislocated joint, if both sides are dislocated, both sides should be adjusted at the same time. When there is a feeling that the joint "slips" at the tip of the hand and the patient closes his mouth normally, the joint has returned to its original position. If the first time the temporomandibular joint has not returned to the position, it can be straightened again. Patients with chronic dislocations are easier to correct than patients with first dislocations. Difficult cases such as: The patient is worried or uncooperative, has a lot of pain, the muscles can't be straightened... need anesthesia and a corrective procedure is performed in the operating room.
In case the patient has no lower teeth or has periodontal disease, the patient has too much muscle tone... the doctor can use the method of external convex convex straightening. With this method, the doctor will use his finger to feel the area in front of the ear flap to determine the position of the dislocated condyle, then use his hand to push the condyle to the position of the joint cavity behind. This method also works when applying the classical method does not work.
Once successfully straightened, the temporomandibular joint returns to its normal position, it is necessary to use an elastic bandage to cover the chin and head for 10-14 days to avoid recurrence and limit excessive impact on the temporomandibular joint. Patients should follow a soft diet, limit talking loudly, laugh loudly, open their mouth excessively...
In case the patient has a chronic dislocation and the old treatment methods no longer work, the The doctor can consult with a maxillofacial surgeon to conduct surgical treatment:
Surgery to tighten the ligaments around the temporomandibular joint by shortening them to better fix the joint. Surgery to lower the apex by cutting the apex. After the treatment of the temporomandibular joint dislocation, so that the disease does not return, you should eat soft foods, avoid foods that are too hard or too chewy. At the same time, you should give up bad habits such as grinding your teeth, biting your nails or biting other objects. In addition, you can practice gentle facial massage movements as well as participate in sports activities to relieve pressure and stress.
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