What is the treatment for temporomandibular joint disorder?

Question

Hello doctor,

I have been having problems with my mouth or jaw. I get really bad headaches and pain throughout my head, neck, and shoulders. After visiting the doctor and dentist multiple times, I underwent X-rays in both open and closed mouth positions, which revealed the following findings.

Open and closed mouth lateral oblique views of the temporomandibular joints were obtained. The bilateral mandibular condyle heads are normal in appearance and well-positioned within the temporal mandibular fossa on closed mouth views.

Open mouth views demonstrate anterior dislocation of the bilateral mandibular condyles in relation to the articular eminences. No significant joint space loss or degenerative change. Anterior dislocation of the bilateral mandibular condyles in relation to the articular eminences with open mouth position.

I am still waiting to get an appointment with an oral surgeon. What do the X-ray findings mean, and what is the treatment for something like this? Does it require surgery?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

As you already have a previous history of TMJ (temporomandibular joint) problem, condyle's dislocation might appear as a huge problem, but do not worry.

Probable causes of the dislocation include trauma, sudden falls, or fractures in the condylar region or joint.

The differential diagnosis includes an acute condylar fracture, while the probable diagnosis is condyle dislocation, likely due to trauma and your history of TMJ disorder.

Your oral surgeon will try nonsurgical approaches first. Suppose you have not visited your local dentist for more than three weeks. In that case, I suggest that you consult in the clinic so that your dentist will try a conservative nonsurgical approach after seeing your radiograph.

A nonsurgical approach by your local dentist will include the manual fixation of the dislocated condyles. This is also called manual reduction. This will be done under local anesthesia, and you need not fear any surgical approach to this technique.

After treatment, you may also be put on muscle relaxants or painkillers for three to seven days. Unless this approach does not work, the surgical approach is not indicated. Please visit your maxillofacial surgeon as soon as possible. A follow-up visit is recommended after one week.

Take care.