Ear, Nose and Throat (Otolaryngology) – Head and Neck Surgery

TMJ Disorders

Many dentists are trained in conservative therapies for TMJ, such as a night guards and bite plates. However, patients and/or their dentists should be referred to an oral and maxillofacial surgeon if their condition requires further attention. Specifically, if patients are experiencing a lack of improvement with physical therapy, bite plates, and/or medication. At Mount Sinai, our oral and maxillofacial surgeons have vast experience with treating all stages and facets of TMJ. We collaborate closely with your dentist and physical therapist, as well as each patient, allowing all to become integral partners in their treatment planning.

About TMJ

The temporomandibular joint, also known as the TMJ, is the joint that allows the lower jaw to open and close. The TMJ functions differently than any other joint in the body, as it is a hanging joint. The joint rotates like most joints in the body, but it also translates. Translation is the process where the joint actually slides forward to allow for increased opening during eating. This essentially is a controlled dislocation. All joints in the body rotate and spin however none of the joints can translate like the lower jaw (or mandible).

The fact that the mandible can translate is the source of some of the problems that are associated with temporomandibular joint. This condition is commonly referred to as TMJ. The formal medical term is actually TMD, “temporomandibular dysfunction.” In order for the joint to accomplish this complex movement, it requires multiple muscles and a cartilaginous disc in the joint to act together. This synergistic activity allows the mandible to open and close without limitation, clicking, or pain.

Any malfunction of the disc or muscles will result in TMD. The signs and symptoms include:

  • Disc displacement
    • Clicking
    • Deviation on opening
    • Crepitus
    • Limited opening
    • Painful opening
  • Muscle dysfunction
    • Painful mandibular movement
    • Muscle spasm
    • Decrease strength

The reason for these aforementioned signs and symptoms can be trauma to the jaw, a bad bite, arthritis, systemic disease, congenital anomalies, clenching, and grinding.

Due to the complex nature of the temporomandibular joint, the correct diagnosis can be challenging, thus leading to difficulty in treatment of TMD. 

Temporomandibular Dysfunction (TMD) Treatment Options

Treatment options therefore vary related to the diagnosis. The various treatments include:

  • Non-surgical therapy
    • Medications
    • Orthotic  appliances
    • Physical therapy
    • Behavioral modification
  • Surgical treatment
    • Arthrocentesis
    • Arthroscopy
    • Arthroplasty
    • Total joint replacement

The treatment plan is directly related to the signs, symptoms and the diagnosis. The oral and maxillofacial surgeons at Mount Sinai will perform a complete work up to arrive at the correct diagnosis and develop an appropriate treatment plan for you.