Personal Assistants;
Wendy Brent
Kathy McLaughlin
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Temporomandibular Joint (TMJ) Disease
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Facial Pain
TMJ disease can cause a huge range of symptoms. Broadly speaking it can be a functional issue with clicking or locking of the joint and this is common in people who clench or grind their teeth together (bruxism). TMJ dysfunction may be due to or result in muscle pain, internal derangements of the joint or degeneration of the joint.
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Later on in life the joint can show degenerative changes similar to those seen in other joints. This "wear and tear" of the joint can cause discomfort and a reduced range of movement of the jaw.
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The joint can be imaged using plain x-ray, CT or MRI scan depending on what changes we are looking for. Most strategies to manage TMJ disease are multi-faceted and may involve specialist physiotherapy, soft bite raising appliances, occasionally medication or joint arthrocentesis with steroid injection. Botulinum toxin can be used to relieve muscle spasm within the muscles of mastication.
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"the temporomandibular joint and associated muscles form a complex dynamic system. Correct diagnosis is the key to it's management.."
Facial pain can be due to multiple different causes. Our aim in these cases is to try and get to a diagnosis. This may require different tests to try and elucidate the cause. The management after a firm diagnosis is always more straightforward. If blood tests and scans rule out any serious structural pathology then a diagnosis of atypical facial pain may be given. I always see a few cases which are more difficult to diagnose and are sometimes treated as chronic migrainous neuralgia. Botulinum toxin treatment is effective for these patients.