Japanese joint diseases are an important problem because they cause nutritional problems. The main complaints are pain in muscles and joints, tenderness, joint noises, limitation and irregularity in jaw movements. Problems usually begin in the teenage years and become obvious due to pain due to deformities that develop in the joint over time. Sometimes, the sounds coming from the joint and jaw locking are the reasons that bring the patient to the doctor.
The jaw joint is a joint located between the lower jaw bone and the temporal bone and functions during speaking and chewing. Between the two bones, there is a structure called a disc that allows the two bone surfaces to work harmoniously during movement. The capsule and ligaments around the joint ensure the harmonious functioning of the joint. Chewing muscles regulate the functioning of the jaw joint. Painful symptoms in the chewing muscles, clenching, teeth grinding, joint and harmony disorders in the teeth, and some treatments for these problems cause strain on the muscles, joints and ligaments, causing the disease to occur.
Causes of jaw joint diseases.
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Continuous chewing on one side,
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Teeth clenching,
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Teeth grinding
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Accidents affecting the jaw and face (fractures, ruptures in joint ligaments),
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Sports injuries
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Tumors affecting the joint and its surroundings, systemic diseases (Inflammatory rheumatism, etc.)
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Dental treatments that take a long time and strain the mouth opening, anesthesia excessive strain on the jaw
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Habits such as biting pencils and similar hard objects, chewing gum, thumb sucking, nail biting
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Shoulders and excessive forward bending of the neck (posture disorders)
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Holding the phone between shoulder and chin
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Some psychological disorders
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Congenital joint disorders (such as the joint not being fully developed)
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Fillings and crowns made at a height that will change the relationship between the teeth
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Playing the violin (pressure on the jaw due to the way it is held) can be listed as follows.
All of the above mentioned The causes are mechanical, and since the jaw joint is a joint that can be affected in rheumatoid arthritis, psoriatic arthritis (psoriasis arthritis) and gout, which are common inflammatory rheumatic diseases, careful evaluation should be made in this respect.
Another important reason. They are jaw joint calcifications that are generally seen in elderly patients. Degenerative changes detected on X-ray radiographs, pain in the jaw and limitation of movement make the diagnosis. It may negatively affect the general condition of elderly patients as it may disrupt nutrition.
Symptoms in jaw joint diseases
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Earache,
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Pain in the cheeks,
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Tinnitus
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Dizziness
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Headache concentrated in the temples,
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Pain radiating to the neck
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Difficulty in opening the jaw,
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Hearing noise when opening and closing the jaw,
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Jaw locking
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Jaw opening and opening opening by sliding to one side
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Impairment in biting, plucking and chewing functions
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Disorder in the closure of the lower and upper teeth
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Sensitivity, wear, shaking and breakage of teeth
Diagnosis of jaw joint diseases
In the majority of patients, the diagnosis is made by examination. In addition to the jaw joint, the neck, shoulder muscles and most importantly, the chewing muscles should be examined for the presence of trigger points and it should be determined whether there is tension. Evaluation by a dentist, orthodontist or maxillofacial surgeon is appropriate in terms of joint dentition disorders and other dental diseases. When necessary, normal radiographs and MRI can be performed. Blood tests may also be requested for the differential diagnosis of infection and inflammatory joint diseases.
Treatment in jaw joint diseases
The aim of the treatment is to eliminate the patient's pain and restore normal jaw functions. . Painkillers/antirheumatic drugs, supportive treatments (adjuvant), muscle relaxants and even weak opioids can be used to relieve pain.&nb sp;
Physical therapy applications are very effective in reducing spasms, increasing blood circulation and thus reducing pain in these patients. Among physical therapy agents, especially hot applications (infrared, hot packs, deep heaters) can be used.
Complementary medicine methods: Complementary medicine methods such as acupuncture, neural therapy, ozone therapy, mesotherapy, and prolotherapy can be used to control jaw pain. Acupuncture, electroacupuncture, neural therapy and ozone therapy are used in our clinic. These 3 methods are the methods we prefer because they have a low side effect profile, the ability to control pain quickly, and a holistic perspective that also allows the treatment of other systems that may cause jaw pain.
Trigger point injections provide very effective support to complementary medicine methods in the presence of tension and trigger points in the chewing muscles and neck-shoulder girdle muscles. In addition to trigger point injections, dry needling can also be performed.
Botulinum Toxin (Botox) applications to relax the jaw chewing muscle in patients with frequent teeth clenching problems can provide satisfactory results. After botulinum toxin application, it provides relief from jaw pain as it eliminates the squeezing problem for approximately 4-6 months, during which the effectiveness of the drug continues. Even after the effect of Botox wears off, the habit of teeth grinding can end and a full cure can be achieved. For this reason, consecutive applications can be made at 4-6 month intervals.
Manual treatments (such as manipulation, mobilization, post-isometric relaxation) are also among the treatments that can be applied.
Another important treatment method is exercises. Patients are taught stretching and relaxation exercises for the muscles that create load on the jaw. Heat application before these exercises increases the effectiveness of the exercise. In addition to exercises for the chin joint, stretching and strengthening exercises for the neck shoulder girdle muscles should also be added. In addition, the patient should be taught to effectively relax all his/her muscles through whole body relaxation exercises or biofeedback therapy. Aerobic exercises (running, swimming, walking) recommended for all musculoskeletal system diseases such as dancing, dancing) are also recommended for these patients.
Considering the close relationship between the jaw joint and teeth clenching and the close relationship between teeth clenching and a person's stress states, it is recommended to seek psychiatric support and treat anxiety and depression if necessary. In addition, behavioral treatments can also be effective in teeth grinding problems. The patient should also be given sleep hygiene training to ensure a quality sleep pattern that ensures complete muscle relaxation.
If necessary, surgical treatment can be planned by maxillofacial surgeons or plastic surgeons.
In addition, all patients are unilateral. It is recommended not to chew and to involve both parties in chewing. Night apparatus can also be used for clenching problems and teeth grinding. Patients are advised to avoid hard foods, break hard-shelled foods with their teeth, and stop biting hard fruits such as apples. The patient should eat soft foods and pay attention to oral hygiene until the pain and dysfunction disappear.
Japanese joint diseases, especially jaw joint dysfunction, are a group of diseases that fall under the umbrella of "central sensitivity syndromes" such as fibromyalgia, chronic fatigue syndrome, migraine, irritable colon syndrome.
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