TMJ 6

Organic joint dysfunction

Popping and clicking---Whenever there is a discrepancy between the position of the jaws when the upper and lower teeth are fully together, and the position of the joints, as described on page 3, constant bruxing on the teeth produces constant pressure on the joints which brings about traumatic changes in them. In many cases, the cartilage that separates the ball from the socket may tear and displace so that it bunches up in front of the ball.

When opening the jaw wide, the condyle (the ball on the lower jaw) ball moves forward pushing the bunched up cartilage in front of it. At some point in this forward movement, the condyl jumps over the mass of cartilage snapping back hard onto the bone on the other side causing a loud pop, or clicking sound. This can happen in reverse upon closing as well. Most of the time, these noises are NOT accompanied by pain, and it has become the common practice in dentistry NOT to treat these patients if the popping noises are the only symptom of the disease. For a more detailed discussion of this subject, click the icon on the right to proceed to my page on occlusion.

Crepitus--In other patients these organic changes can produce joint inflammation (arthritis) which can be quite painful and lead to other degenerative changes in the joint. Sometimes, the bones are forced into such close approximation that you might hear a grinding noise (crepitus) when opening or closing. Crepitus can be an indication of more advanced deterioration, and it may be time to seek the advice of an oral surgeon. (Note: Cartilage lines both the condyle (the ball) and the articular fossa (the socket) within the joint. The meniscus (disk) is a third layer of cartilage that is sandwiched between the other two layers. If you can hear actual crepitus, it generally means that all three layers of cartilage have been damaged, or are actually missing, allowing the unprotected bone of the ball to grind into the unprotected bone of the socket.) Whenever there is a suspected organic joint dysfunction linked to severe localized pain in the joint, special medical tests are needed to assess the extent of the damage, and the situation has progressed into the hands of specialists. Fortunately, this situation is very rare.

The TMJ section used to occupy a single page on this website, but due to its extreme length, it has been broken up into seven separate pages. A good understanding of the Temperomandibular joint, occlusion and their associated disorders may be gained by reading them in order.

Next page==>The treatment of TMD

TMJ Pages 1, 2, 3, 4, 5, 6, 7