Symptoms of Jaw Disorder (pain, clicks)

Jaw disorders are most common in 20 to 40 years of age and is more common in women than in men and is associated with

• Jaw pain, facial pain, unexplained headaches and neck pain
• Tinnitus (ringing in ear), ear pain and heaviness.
• Sound of clicking while opening or closing mouth or during chewing
• Difficulty in chewing food
• Changes the way upper and lower teeth fit together.
• Swelling on the side of face.
• Tooth pain.
• Untreated cases may lead to Jaws that "lock" in the open- or closed-mouth position

Neglected cases may lead to long-term problems such as sleep apnoea, sleeplessness, depression and anxiety in patients which can cause and trigger TMJ pain again as a vicious cycle.

Diagnosis of Jaw disorder (Pain, Clicks)

You can examine yourself and see whether you have TMJ Disorder (pain, clicks)

1. Listen to and feel your jaw when you open and close your mouth. Do u hear any sound of click.
2. Observe the range of motion in your jaw by sliding the joint in all directions.
3. Press on areas around your jaw to identify sites of pain
or discomfort.
4. Look for facial asymmetry while opening the mouth.
5. Misalignment of the teeth.
6. Does your jaw lock while yawning or opening the mouth widely

If you have one of these symptoms, then you might be having TMJ dysfunction. Once you visit us, we will examine you completely and would require the following investigations for diagnosis-

1. Dental X-rays to See the status of your teeth and jaw
2. CT scan to provide detailed images of the bones involved in the joint and to rule out arthritis
3. MRI for detailed analysis of the joint space, joint disk or surrounding soft tissue. This is not done in TMJ dislocations
4. TMJ arthroscopy is sometimes used in the diagnosis of a TMJ disorder. During TMJ arthroscopy, a small thin tube (cannula) Is insertedinto the joint space with a small camera (arthroscope) to view the area and to help determine a diagnosis.

Surgical treatment of Jaw disorders (Pain, clicks)

When non-surgical methods have failed to give relief in TMJ disorders, then surgical treatmentcan be opted for. The various modalities of treatment available are-

• Injection of steroid into the joint space-reduces the inflammation and pain associated with problems within the bone across the joint
• Arthrocentesis. This procedure is performed under local anaesthesia. It is done when steroid injection does not give any relief in pain or reduce the inflammation and the condition has progressed to even having difficulty while opening the mouth. Arthrocentesis is also done when the jaw suddenly locks in the closed position. It is done with the help of needle inserted into the TM joint and then irrigation is done with saline fluid to wash off the debris and the products of inflammation out of the joint
• Arthroscopy. This procedure is performed under general anaesthesia. A small incision is made in front of the year and Arthroscopy with the light is inserted in TMJ andwhole joint is inspected and washed under vision.Any piece of inflamed tissue or debris is removed. Because arthroscopic surgery is performed through tiny incisions, there is less scarring, a shorter recovery time, less discomfort, and fewer complications compared with open-joint surgery.
• Open-joint surgery. it is done under general anaesthesia and a longer incision is placed within the curvature of your ear which is very well hidden. Open joint surgery is indicated in
  • If you hear clicking sound- MRI suggests internal derangement of the articular disc. In this, we need to repair or reposition the articular disc
  • Any tumours in and around TM joint
  • TM joint dislocations
  • Severe arthritis of the bony structures involving the joint which leads to TM Joint replacement.

Open joint surgery has a longer healing time and a chance of injury to frontal branch of the facial nerve but still is the surgery of choice in patients with recurrent painful clicks and joint dislocations

Within 48 hrs of surgery, patient begins physical therapy to regain the proper jaw movements.

Self-care in preventing Recurrent JAW disorder (Pain, Clicks)

• Eat soft foodsto chew less
• Avoid chewing gum, don’t clench your jaw tightly
• Do not open your mouth too wide.
• Wear a mouthguard at night to prevent from grinding teeth, and
• Relaxation exercises to minimise stress.
• Exercises to strengthen jaw can also help.

Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.

MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
MNAMS, FACS, FICS, FRCS (Edinburgh, UK)

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