Temporomandibular Injury

The temporomandibular joints are located on each side of the head, in front of the ears at the upper edges of the jaw. These make up the jaw joint, used in the successful opening and closing of the mouth, and can be particularly fragile due to the fact that the joint's movement involves perpetual dislocation as part of its regular procedure. Direct trauma to the face can therefore be damaging to the joint.

Symptoms

Most temporomandibular joint injuries are characterised by pain in the jaw. Due to the structure of the joint the pain is often accompanied by limitation of jaw movement. In some cases, especially when severe inflammation is involved, the injury may provoke persistent pain whether the mouth is in motion or not.

In the event of a dislocation the jaw will feel noticeably irritated and 'out of place'; injury of this nature occurs when the 'ball' section of the ball and socket joint moves or is shoved too far out of position to fall back into place. This means that the dislocation can result in the mouth becoming stuck in its open position until the injury is corrected.

Other symptoms, which can regularly point to deterioration over time, include jaw popping and clicking. Any movements of the mandible which seem irregular should also be taken seriously.

Causes

A heavy blow to the face can cause injury to the joint if it causes unnatural movement or tears the surrounding ligaments; in sport this can involve strikes from other players in contact sports, falling onto the face (particularly from a height, such as in cycling), or impact from high speed projectiles such as balls. Damaging impacts unrelated to sport include car accidents and whiplash sustained at speed. A tooth condition can also increase the risk of temporomandibular injury. Teeth falling out (which can arise due to a similar facial blow) or tooth abnormalities can result in the configuration of the mouth changing, which in turn causes the temporomandibular joint to move in a different manner.

Treatment

See a medical professional as soon as you suspect a temporomandibular injury. Dislocations will need to be corrected medically. For other injuries, an exam and a series of tests are likely to be run in order to diagnose the condition, especially as such injuries are sometimes mistaken for ear conditions. Treatment attempts to stabilise and restore suitable movement to the area, and can incorporate the use of a bite splint to position the jaw back in place, appropriate injections, heat treatments, and myofunctional therapy (to retrain the oral muscles to act regularly and effectively). A doctor might also prescribe anti-inflammatory pain medication. These treatments can take up to 9 months, after which time surgery will be considered for an unhealed injury. When pain has diminished and the original injury recovered, a potentially long term rehabilitation program will begin to assist in restoring functionality and regular movement to the jaw.