TMJ is Explained by Shelby Township Dentist

This is Dr. Antolak from in Shelby Township, Michigan. 586-247-3500 is our phone number. And I want to just talk a little bit about what TMJ is. As everybody refers to as TMJ.

Well, TMJ is actually a jaw joint. It’s the joint as I’ll show you on the skull right here. It is the joint between the upper jaw here and the lower jaw here. Okay? And so, what happens is, people, if you get a clicking in your jaw, that has to do with the cartilage disc that lies between the lower jaw and the upper jaw that clicks. But also TMJ what people think too, is an issue where they not only have pain up in this area and a clicking but also headaches. So it’s a whole syndrome it’s called TMD which is called temporomandibular dysfunction which is more broadly defined. Right now what I want to do is basically go over some of the issues that you can have with your jaw and why it clicks when opening and closing why you have some pain in the jaw joint.

The temporomandibular joint is the most complex joint in the human body and the reason why that is, is, it has a couple of different functions. One function is it’s used to just rotate like this, just when you minimally rotate your jaw like this, it just acts like a hinge, like a normal hinge, like a normal joint down the body. But then here’s the special part about it, is when, we’ve been designed so that if we, you know? Obviously, we can’t get a whole lot in the mouth. If we can just do that much. But, if we need to open up real wide, what happens is, our lower jaw will start shifting forward, and I’m going to try showing you in this model here. As we open wide, our lower jaw will start shifting forward, as you can see right here. And right on here, how our jaws are designed, is there’s a disc that sits between them, that traverses and goes right. If everything is functioning normally, that disc itself will go right along with this lower jaw here with the joint. It’s called the condyle. And it will function smoothly as it goes up and down. And literally the jaw joint moves forward and backwards right with the disc itself.

Now what happens when it clicks is part of that disc literally, not the whole thing but some part of that disc will actually come off the joint. And it will shift forward. Then you close back and it shifts back on.

This disc is actually contained and supported by ligaments which are attached to muscles. So if you get a lot of stress in your muscles, or if you clench your teeth, then those muscles become activated and hyperactivated. And that hyperactivation makes these very sensitive. So they shorten up real fast and that can create this jaw clicking and so for example if this is your…

I’m going to show this is the lower jaw here. And this is the upper jaw which I just showed you so when you first start off your jaw rotates like this. Okay no problem, then after you open up wide, your jaw comes down like this, like I just demonstrated. If you start moving forward and that disc between it, part of it snaps forward. Then that’s the clicking you get. Then you start moving back a little bit as you close. Then it snaps back on. And so that goes back on and off and on and off. So that can become a problem. So what we need to do many times is to relax the muscles in there.

We do that by using bite spreads, or something called the NTI. Things that can prevent the stresses from going on within the joint itself, and within the muscles that support that jaw joint, that support that disk. As we relax those muscles and they perform more normally, as long as there is not too many problems that have taken place.

With that being said, there are some people who have some more issues, or problems with their jaw joint internally. That’s at the internal joint. So what I do is I have here just a patient that we had seen before in the past. What I want to do is show you a CAT scan that’s made of the joint a little bit more close up. What it will do is, it will show you the space that’s in there is where the disc will actually be. So right now within this CAT scan we’ve got 3 different planes. Right now this is the view which is looking, if you took a section like this, we just took a section, cut through here you can see the jaw joint here and the jaw joint here, and if you look right here, this is that part here which is called the condyle which is the top of it here, that’s what this is and that’s what this is right here. Now, as we as we move up and down.

Up and down, as we move this angle like this up and down, we can see how this is changing. So, as we do that, you can see how its changing it’s shape. Okay, so now as we go up further, now it’s getting into the jaw space right in there. Now, let me show you something right in here. This view here is showing a section like this. Now this section is showing this, which is more of what I was just describing.

This is the part of the jaw joint from side to side, from the right side to the left side here. And now, as we move it forward and backwards we can see the position of this. What this does, this actually allows us to see if there’s arthritis in this space here, or if there are any bony attachments and things like that, that can create pain in the jaw joint itself. And so, as we go through it we can see in this patient, at least in this joint, it looks pretty healthy.

There’s a nice space as we can see here. Let me make this a little bit larger as we look right here. There’s a space between here so this is the space where the jaw joint is actually sitting, that’s why you can’t see it and it continues as we go through here as you see that, you can see there’s a space between the whole thing alright.

Now, on this view here, which interesting now.

We’re looking at it from this view here. So, on the scan. This part right here is actually this. Okay? And this part right here is this part right here at the top part of the, it’s called the maxilla. So you have the superior part and the inferior part and this is where the jaw, this person here, normally this jaw sits up in this region here but to take this, to take this scan he had to move his jaw forward a little bit and you can kind of see right now where this is positioned. This jaw was fitting here, now it’s slide, it’s starting to come forward a little bit.

If this is unhealthy, this disk is going to slide forward. And this space is going to get closer and closer and even grind into, even be bone to bone here. So this is the anatomy of the jaw joint. And a CAT scan like this is really nice because it gives us some abilities to see the health of the joint itself. So if there are problems that can’t be resolved easily, we do a scan like this so we can figure out there might be an anatomical reason for that. Surgery is usually the last thing that anybody wants to do for these. Because it just makes it more difficult and it can become more debilitative with doing surgery for the jaw joint. So we try to do much more conservative treatments. Like I said, splint therapy with bite guards adjusting the bite, things like that. Muscle relaxant sometimes and that type of thing.

 TMJ is Explained by Shelby Township Dentist

I have quite a bit of experience with this type of dentistry. So if you do have some jaw problems or headaches, clicking in the jaw, please feel free to call our office in Shelby Township, Michigan at 586-247-3500. Thank you.

TMJ is Explained by Shelby Township Dentist