TMJ Disorder: What are the symptoms?

Symptoms of temporomandibular joint (TMJ) disorder may include seemingly unexplained facial or jaw pain and/or pain that radiates into the neck and shoulders, headaches and earaches, and a locking of the jaw. 

The jaw is a highly complex joint, composed of several different components that must work in concert for the joint to function properly and be capable of both lateral and vertical movements. Unfortunately, problems may develop in the temporomandibular joint (TMJ) that may cause painful symptoms.

You or your oral surgeon may suspect that you have a TMJ disorder if you present with certain symptoms. A clicking or popping sound while opening or closing the jaw is often a telltale sign. Other symptoms may include seemingly unexplained facial or jaw pain and/or pain that radiates into the neck and shoulders, headaches and earaches, and a locking of the jaw. 
 

Stress may also exacerbate a TMJ disorder that is already present.

Other, more subtle, indicators include changes in facial appearance, lightheadedness and a need to change the diet to favor softer foods.

Certain characteristics may make people more susceptible to TMJ disorders. For example, a malocclusion (“bad bite”) or other congenital jaw abnormality can contribute to pain in the joint. Stress may also exacerbate a TMJ disorder that is already present.

If you complain of symptoms that are potentially caused by TMJ, your oral surgeon will complete a thorough evaluation of your case. You likely will need to have x-rays taken so that your surgeon will have a birds-eye view of the jaw joint. This perspective will help the oral surgeon diagnose the specific nature of the problem and plan for treatment.

TMJ disorders often may result from problems with the disc or improper growth patterns of the jaw during puberty. As a result, early intervention during the teen years may be able to minimize a patient’s chances of having TMJ disorders later in life.

Older patients with TMJ issues may benefit from surgical interventions to reposition the jaw or correct the problematic structure causing the discomfort. Patients who develop TMJ due to autoimmune conditions, like rheumatoid arthritis or lupus, may need to be fitted with a prosthetic joint in order to get relief from their symptoms.

Don’t feel that you have to suffer from symptoms associated with TMJ disorders. You can discuss your treatment options with our experienced oral and maxillofacial surgery team.

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