Temporomandibular Joint (TMJ) Syndrome (cont.)
TMJ Syndrome Causes
TMJ syndrome can be caused by trauma, disease, wear and tear due to aging, or oral habits.
- Trauma: Trauma is divided into microtrauma and macrotrauma. Microtrauma is internal, such as grinding the teeth (bruxism) and clenching (jaw tightening). This continual hammering on the temporomandibular joint can change the alignment of the teeth. Muscle involvement causes inflammation of the membranes surrounding the joint. Teeth grinding and clenching are habits that may be diagnosed in people who complain of pain in the temporomandibular joint or have facial pain that includes the muscles involved in chewing (myofascial pain). Macrotrauma, such as a punch to the jaw or impact in an accident, can break the jawbone, cause dislocation of the TMJ, or damage the cartilage disc of the joint. Pain in the TMJ can be brought on by dental work whereby the joint is stretched open for extended periods of time. Massage and heat application after the dental procedure can be helpful.
- Bruxism: Bruxism, or teeth grinding, is a habit that can result in muscle spasm and an inflammatory reaction that can cause the initial pain. Changes in the normal stimuli or height of the teeth, misalignment of teeth, and repetitive use of chewing muscles may cause temporomandibular joint changes. Generally, someone who has a habit of grinding his or her teeth will do so mostly during sleep. In some cases, the grinding may be so loud that it disturbs others.
- Clenching: Someone who clenches continually bites on things while awake. This might be chewing gum, a pen or pencil, or fingernails. The constant pounding on the joint causes the pain. Stress is often blamed for tension in the jaw, leading to a clenched jaw.
- Osteoarthritis: Like other joints in the body, the jaw joint is prone to arthritic changes. These changes are sometimes caused by breakdown of the joint (degeneration) or the usual wear and tear of normal aging. Degenerative joint disease causes a slow progressive loss of cartilage and formation of new bone at the surface of the joint. Cartilage destruction is a result of several mechanical and biological factors rather than a single entity. Its prevalence increases with repetitive microtrauma or macrotrauma, as well as with normal aging. Immunologic and inflammatory diseases contribute to the progress of the disease.
- Rheumatoid arthritis: Rheumatoid arthritis causes inflammation in joints and can affect the TMJ, especially in children. As it progresses, the disease can cause destruction of cartilage, erode bone, and eventually cause joint deformity. Rheumatoid arthritis is an autoimmune disease. It causes disease in a variety of organs with features of persistent joint inflammation. It occasionally affects the TMJ, especially in young children.
- Other causes of TMJ syndrome include infection of the joint, cancer, and bone deformity that occurs at birth.
Medically Reviewed by a Doctor on 11/9/2015
Steven S. Bhimji, MD, MSc, PhD
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