Experiencing Jaw Pain: Could it be TMJ?

When patients are experincing jaw or facial pain, a jaw specialist like Dr. Wolford is best at evaluating you for temporomandibular joint (TMJ) disorder. The jaw must be capable of movement necessary for chewing, speaking and even breathing. Understandably, the jaw has complex structures that facilitate all of this movement. Indeed, the jaw is composed of many components, including bones and muscles, and if even one of those parts is out of whack, a temporomandibular joint (TMJ) disorder can develop. Indeed, the jaw is composed of many components, including bones and muscles, and if even one of those parts is out of whack, a temporomandibular joint (TMJ) disorder can develop.

Many patients will show some signs of a TMJ disorder, most often jaw or facial pain, as well as popping and clicking sounds coming from the jaw or problems with the jaw locking. TMJ can even result in headaches and earaches. If you have any of these symptoms, and they continue to persist, you may need to consult with a TMJ specialist for a diagnosis and treatment plan.

The TMJ specialist will thoroughly examine your jaw and take x-rays to determine what is causing your jaw pain.
Based on the results of that examination, the TMJ specialist will develop a treatment plan to help relieve your symptoms.

Sometimes the recommended course of action involves non-invasive treatments, such as self-massage and pain management with over-the-counter medications. Stress can exacerbate TMJ-related pain; so stress management techniques like meditation may also be effective in reducing TMJ symptoms.

For some patients, especially those with congenital or developmental jaw abnormalities, a surgical intervention may be warranted to address the TMJ disorder. This may involve correcting a malocclusion that occurred due to the growth patterns in the jaw. Patients may also need a treatment that focuses on stabilizing the disk in the jaw, if that is determined to be the source of pain.

Patients with significantly advanced TMJ disorders may need to pursue a total joint replacement if other treatments are ineffective.

Consulting with an experienced specialist will be your first step in determining whether your jaw pain is caused by a TMJ disorder, and after you have a diagnosis, the specialist can develop a plan to effectively treat the issue. If you have questions or would like to schedule an appointment, please contact Dr. Larry Wolford’s office using our online contact form or call 214-828-9115.

Condylar hyperplasia (CH) is a generic term describing enlargement of the condyle.  There are a number of different condylar pathologies that enlarge the mandibular condyle, with subsequent adverse effects on the morphology and function of the TMJ and mandible.  This may result in the development or worsening of a dentofacial deformity such as; mandibular prognathism (symmetric or asymmetric), and unilateral enlargement of the condyle, ramus, and body, facial asymmetry and malocclusion. 

Wolford has developed a simple, but encompassing classification that will allow the clinician to better understand the nature of the various CH pathologies, progression, and treatment options that have proven to eliminate the pathological process and provide optimal functional and esthetic outcomes.  The classification (Table 2 and Figure 29) also begins with the most common occurring form of CH and progresses to the least common occurring form.

CH Type 1:  This condition develops during puberty, is an accelerated and prolonged growth aberration of the normal condylar growth mechanism, is self-limiting but can grow into the 20’s, and can occur bilaterally (CH Type 1A) or unilaterally (CH Type 1B).

CH Type 2:  These condylar pathologies can develop at any age (although 2/3s develop in the 2nd decade), are unilateral condylar vertical and/or horizontal over-growth deformities, and are the most common occurring mandibular condylar tumors; osteochondroma (CH Type 2A) and less common osteoma (CH Type 2B).

CH Type 3:  These are other rare benign causing condylar enlargement. 

CH Type 4:  These are malignant conditions that can cause condylar enlargement.

The more common forms of CH (Types 1 and 2) will be presented relative to the clinical and radiographic findings, growth characteristics, effects on the jaws and facial structures, histology, and treatment considerations that are highly predictable in the elimination of the pathology and provide optimal treatment outcomes. 

FIGURE 29 Description

A-C) normal TMJ with balanced joint spaces.
D-F) CH Type 1 with relatively normal condylar shape, elongated condylar head and neck, and narrow joint space related to thin articular disc or displaced disc.  In the coronal view the condylar head is more rounded.
G-I) CH Type 2Av; an osteochondroma with a vertical growth vector without significant horizontal condylar enlargement or exophytic horizontal growth. This is a “young” osteochondroma with only about 3 years of growth.
J-L) CH Type 2Ah; an osteochondroma with horizontal (as well as vertical) enlargement of the condyle and exophytic outgrowth of the tumor. This tumor has been present for 6 years. Notice the significant increased vertical height of the mandibular body and ramus.

FIGURE 29