How Does a Dentist Treat TMJ Pain? Advanced Cosmetic & Prosthetic Dentistry Ko Explains!

Hi everybody. Dr. Co here. I would like to take the next few moments to talk about TMJ. TMJ is actually quite complex if you really dive into it. It is a joint. It is a joint that’s freely moving. It’s a joint that consists of ball in the socket in between the cushion’s cartilage disc that’s attached to muscles. A typical joint would look like this. You will have a ball that’s nicely rounded, but with equal space that’s all the way around it could distance behind it, above it. And in front of it, I’m going to show you a CT scan of a patient who does not have that. Okay? And then I’m going to show you a CT scan of a 6-year-old boy that has a nice anatomy.

So this is one of my adult patients who is in hers emis, that is suffering from T injury issue. So can you see that what we talked about is we want the spaces to be equal distance behind it, above it, and also in front of it. So we do have a little space in the front. As you can see here. We do have a little space, much, much less space on top and also some space behind it. So this doesn’t look quite like what we see here, even though this doesn’t really give you a great presentation of it. But in essence, the CT scans does not show where the cartilage is, but that cartilage basically is presented as space. So when there is distance that’s equal all the way around it, it is a healthy joint. So going back to this CT scan where we start to see that there’s compression of space of that disc space, we know that there’s definitely some destruction of the cartilage. There’s probably a malposition of the cartilage. And then there’s a good chance that that compression is pressing against the nerve tissue at the back. So in this particular patient, she is suffering from pain whenever she opens one full prolonged period of time, or when she opens really wide try to eat. I’m going to show you another patient, a 6-year-old boy that has basically a healthy joint.

This is, so this is a CT scan of a 6-year-old boy that has a healthy joint. The teeth are nicely aligned together. You can see as a contrast. So you can see as a contrast, the space, the space that’s all the way around the joint. There’s distance in the front, right above it and behind it. This is a sign of healthy joint. This is what we want, this is what we want to see. So typically when patients who have a breakdown of the joint, there’s a few reasons behind it and the reason behind it is actually quite complex. So for 6-year-old, there’s obviously less wear and tear, but also developmentally they’re not at the stage where everything is fixed together. So oftentimes, believe it or not, the joint issue came from the position of the front teeth. So if the front teeth is underdeveloped, if the front jaw, if the front of the jaw is underdeveloped, the lower jaw does not have the ability to develop forward. And a lot of times that causes distalization. Basically the joint gets pushed back and over the years it causes inflammation, which is what’s degrading the joint space and also causing inflammation and pain.

Alright? So really the key is the spacing. Okay? So notice the nice space around the TMJ and then as a contrast of the 70-year-old who is suffering from pain, the joint space is completely different. Okay? So that’s really the key of TMJ and we can talk about what’s causing this to happen a lot of times and developmentally, what’s inducing this and how do we prevent it from happening to other dots.