TMJ

Question 1

What is TMJ dysfunction

Answer 1

Chronic disorder of TMJ function

Question 2

3 types

Answer 2

Myofascial pain - Increased tension/spasm - may be stress related
Disc displacement
Osteoarthritis - TMJ degeneration

Question 3

Myofascial pain presentation:

What type of pain and where?

Where may it radiate to?

What may exacerbate the pain?

What is this type also associated with?

Answer 3

Unilateral dull ache of masticators

May radiate to ear, temple, cheek, and/or cause headache

Worse on eating, talking and in the evening

Bruxism - night grinding

Question 4

Disc displacement - what do you get …..

With reduction
Without reduction

Answer 4

Jaw clicking as condyle moves onto disc on jaw opening and off disc on jaw closing

Limited jaw movement including locking on opening

Question 5

Osteoarthritis

Presentation

Answer 5

Pain on jaw movement and tender TMJ

Limited movement and possibly deviation to affected side

Crepitus

Question 6

Investigations:

How is a diagnosis typically made?

What should be considered?

What would you do to rule out:
OA
Inflammatory arthritis
RA

Answer 6

Diagnosis clinical

Psychological problem should be considered as they can exacerbate pain

XR

WBC,ESR,CRP

Rheumatoid factor

Question 7

Management:

What happens in most cases?

Patient advice?

Medication options? - 2

What if very severe?

Answer 7

Usually self-resolve

Chew soft foods that require less chewing
Gentle heat and massage masticators

Simple analgesia if mild
Benzodiazepine if severe

Splint
Intra-articular steroids
Arthoscopy