Temporomandibular Joint Treatments

Not only interventions directly affecting the temporomandibular joint belong to the category of ‘temporomandibular joint treatments.’ We also include the treatment of complaints spreading to other organs due to the impairment or improper functioning of the ‘chewing system.’

Often referred to collectively as temporomandibular dysfunction or craniosacral dysfunctions, these terms encompass conditions and issues related to it.

In practice, besides direct joint issues such as pain, joint clicking, and limited mouth opening, the following “unexplained” complaints – those not showing deviations in other medical specialties – may also indicate temporomandibular joint/chewing system problems:

• Headaches
• Earaches
• Ear ringing
• Feeling of a lump in the throat
• Neck and shoulder stiffness, pain
• Tooth grinding or wear on tooth necks
• Tooth mobility

With a correct diagnosis – when the root cause is indeed the improper positioning or unfavorable shape of the teeth, or the poorly coordinated function of muscles involved in chewing/swallowing – addressing the triggering factor can lead to the lasting elimination of the listed complaints without the need for drug therapy, and chronic pain can be significantly reduced. Both pain relief and drug-free treatment represent a significant relief for the body.

In cases directly affecting the joint, persistent pain can be eliminated, joint clicking can often be reduced or eliminated, and further overloading and premature wear of the joint can be prevented.

For conditions directly affecting the joint, we employ the same examination procedures as in orthopedics: manually conducting a muscle-joint condition assessment. Within this assessment, we examine the joint’s range of motion, load-bearing capacity, and any existing or stress-induced pain that can be deduced to assess the joint’s condition and potential inflammatory processes within the joint.

This examination is conducted by a physiotherapist at our clinic because the body’s muscle and joint systems have an impact on each other. An injury in one area can cause disturbances/complaints in neighboring or more distant systems.

It requires a qualified professional to determine whether the strain/injury in other areas primarily causes or significantly influences complaints affecting the chewing system. Most commonly, we find disorders in the cervical spine, cervical muscles affected by a sedentary and stressful lifestyle/occupation as the primary triggering cause or parallelly affected areas.

To get an accurate picture of the joint’s condition – as is also done in orthopedics when examining other joints in the body – we rely on MRI scans. When assessing this healing/regeneration process, it is also of great significance. The interpretation of MRI images also requires a separate specialist. For the creation of MRI images, we direct our patients to an external location where a radiologist specialist provides a detailed report for us.

In every medical case, it is crucial to examine how the dental condition influences the development of the specific complaint. Completely healthy, aligned, regularly contacting teeth can also cause overload and issues in the temporomandibular joint and muscle system. If the closure of the teeth is not within the “comfortable” range of the joint/muscle, each closure of the dental arch receives a significant overload.

Therefore, in determining dental involvement, we examine it in reverse – we assess whether the joint and muscle have the correct range of motion and whether the teeth close accordingly. In practice, we record/”simulate” the position and movement of the jaw, and based on these movements, we examine how the existing upper and lower dental arches would ideally contact. We assess the deviation between the reality and the ideal situation.

To replicate the ideal and actual movement of the jaw and joints, we are the first in Hungary to use a completely digital procedure, which allows for much greater accuracy and traceability than traditional methods.” This is the MODJAW technology.

The film industry has been using motion capture technology for decades, which essentially allows transferring an actor’s movements into a computer environment. By applying this method in dentistry, we can precisely record the patient’s jaw movements. Moreover, it makes the examination more comfortable for the patient because, once the recorded data is available, we can share it with our dental technicians or, if necessary, with specialist colleagues without the patient having to come in for another examination.

After evaluating all examination results, efforts can be made to eliminate the underlying causes.

Treatment can involve stress relief/relaxation, simple medication for reducing inflammation – sometimes combined with home relaxation exercises – or possibly the use of a special, periodic/nighttime muscle-relaxing splint. In complex cases, a 24-hour mandatory bite-raising splint may be necessary – and after such treatments, a complete transformation of the contact between the teeth may be required. This can be achieved through orthodontics, simple grinding, or even the transformation of the entire chewing surface of each tooth, with crowns or ceramic veneers attached to the chewing surface (so-called tabletop).