Jaw joint • Chewing muscles

A large part of the population do have problems with their jaw joints or chewing muscles. It is mostly young and teenagers who are affected by this kind of problems and more women than men are affected. Women between the ages of 20 and 40 are particularly vulnerable.

What does the jaw joint look like? 

The jaw joint generally consists of three parts: a articular head (a), a mandibular fossa (b) and a articular disc (disc) (c) (Figure 1). The articular disc is located between the joint head and the mandibular fossa and is surrounded by a joint capsule. When biting your teeth together, the articular disc is located midway between the articular head and the mandibular fossa, while the articular head (lower jaw) and the articular disc slide back and forth when the mouth is opened (Picture 2).

Jaw joint with closed mouth. Source: Tandlægeforeningen
Jaw joint with open mouth. Source: Tandlægeforeningen
Symptoms

The most common and easily detectable symptoms are kinks or other sounds from the jaw joint when talking and chewing or when opening the mouth. Others may have problems with the movement of the lower jaw, for which it may be difficult for to open the mouth completely. There may be pain at the jaw joint or at the ear, either in the form of transient pain arising from the movement and opening of the mouth, and in the case of chronic pain which does not disappear. Eventually, muscle pain or headache can be experienced.

Diseases and genes

Most genes that occur in the jaw joint are either a form of osteoarthritis or precursors to this. Here can be mentioned the displacement of the sheave, as well as other disorders where the joint structure changes.

Offset of the sheave

One of the most frequent problems in the jaw joint is the displacement of the sheave. When this occurs, you will experience crack sounds when the mouth is opened and closed, and when you chew. These mists occur when the joint head and sheave slide in place relative to each other as the mouth is opened and again displaced when the mouth is closed. The displaced sheave may be a long-lasting condition, but is not necessarily embarrassing or painful. However, the disk can get caught when opening the mouth, and if this happens, it will feel as if the jaw locks. This solves when the sheave slides back into place.

However, the disk does not always slide back into position and will remain staggered. If this is persistent and still occurs when opening your mouth, you will not experience the kinking sounds, but the yawning ability is likely to be reduced and the mouth will not open completely. Normally, one can gradually open the mouth more and more, even though the shin still does not slide in place, but this can take several months, and is therefore a slow process.

In some cases, the jaw may be dislocated and the mouth will remain open without the possibility of being completely closed. Often this will happen by a hit on the jaw or if you have hypermobile joints.

Under normal conditions, the disc is placed between the mandibular fossa and the articular head. Source: Tandlægeforeningen
Under abnormal conditions the discus may be incorrectly positioned. Source: Tandlægeforeningen
Osteoarthritis

Jaw joint osteoarthritis  often causes pain that worsens as the jaw moves. Reduced yawning abilities often follow. After a long time, the pain will often go away as the condition settles down. Typically, the capability will also be improved with this. In connection with joint pain, there will often also be pain and myoses in the chewing muscles. The rheumatism can cause changes in cartilage and bone in the jaw joint, and these can cause malaise and pain.

Diagnose
  • Osteoarthritis is often preceded by cracking and locking of the jaw joint because of an impalance of the reconstruction and break down of bone
  • It can be divided in a acute active fase with pain, swelling and stiffness of the jaw joint. In the chronic fase there is af reduced mobility.

Treatment

  • The acute fase the pain is reduced with painkillers
  • A stabilizing guard or exercise for the joint is used to relieve the joint.
The arthritis has caused changes on bone the cartilage and on the discus (Source: Tandlægeforeningen)

 

 

 

 

 

 
General joint disorders

In addition to jaw joints, general joint disorders and diseases, such as arthritis, can also cause problems. A variety of diseases that can cause problems in the joints throughout the body can cause jaw joint problems. If this happens, in addition to pain and reduced ability to habituate, it will also be possible to experience problems with the intercourse. Almost half that suffer from certain joint diseases will also be affected in the jaw joint.

Myoses

As mentioned, in the case of jaw joints, myoses may appear in the chewing muscles. Genes from these pose fatigue, stiffness and tenderness in cheeks and temples. The genes can either be localized to the chewing muscle itself, be associated with jaw joint problems, or appear to be pain and soreness in the neck and shoulders.

Causes of jaw joint problems

Previously, the suspicion of a wrong muddle has been linked to jaw joint trouble, but now one can safely say that it is not that simple. This also makes it difficult to prevent jaw joint problems. However, a combination of several long-lasting influences or conditions may have an influence:

  • Incorrect congestion or strain on chewing. Other types of dental defects
  • Stroke, shock, or other trauma to the jaw. In some cases, troublesome or prolonged dental treatment
  • Other body conditions, such as rheumatoid arthritis, loose joints (hypermobility), Parkinson’s disease, fibromyalgi

As with many other conditions, your mental condition also has something to say. Stress, depression and life crises can exacerbate your genes of jaw problems.

Treatment

During some periods you will experience slight symptoms symptoms of jaw joint difficulty. This will usually not require treatment, as only 5-15% of the population have symptoms that require real treatment.

The treatment will usually be a common effort, where you will receive good advice and instructions, as well as receive treatment by your own dentist or doctor if these have competencies in this field, as well as possible treatment from other professional groups.

Treatment for problems in the jaw joint can be long-lasting and one should not expect the problems to disappear immediately. Likewise, you have to adjust to the fact that the problems may not go away completely, just as you experience with back and knee injuries.

A nightguard may be a part of the treatment during jaw and muscle pain. 

The nightguard is used at night. Source: Tandlægeforeningen
Nightguard from above
Nightguard from below
What can you do yourself?

How much treatments help greatly depends on your own efforts. The first step is to help the dentist identify the problem. Therefore, try to note when and in what situations you have problems, and how long it has been going on, before you seek help.

It is important to follow the advice and instructions given by your dentist on exercises, medications and the use of bite bars.

In addition, it is recommended that you protect the jaw joint and follow these tips:

  • Avoid large chunks when eating
  • Avoid hard and tough foods
  • Cut the food into small chunks
  • Cook or grate raw vegetables
  • Never use the teeth as a tool