Archive for August, 2014

What is temporomandibular joint (TMJ)?

Temporomandibular joint (TMJ) disorders facts

  • The temporomandibular joint (TMJ) is the site where the upper jaw (maxilla) and lower jaw (mandible) temporomandibular joint meet.
  • TMJ disorders are a group of complex problems with many possible causes.
  • Symptoms of TMJ disorders include headache, ear pain, dizziness, and fullness or ringing in the ear.
  • There are many treatment options for TMJ disorders.

What is the temporomandibular joint?

The temporomandibular joint (TMJ) is the area directly in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. Within the TMJ, there are moving parts that allow the upper jaw to close on the lower jaw. This joint is a typical sliding “ball and socket” that has a disc sandwiched between it. The TMJ is used throughout the day to move the jaw, especially in biting and chewing, talking, and yawning. It is one of the most frequently used joints of the body.

The temporomandibular joints are complex and are composed of muscles, tendons, and bones. Each component contributes to the smooth operation of the TMJ. When the muscles are relaxed and balanced and both jaw joints open and close comfortably, we are able to talk, chew, or yawn without pain.

We can locate the TMJ by putting a finger on the triangular structure in front of the ear. The finger is moved just slightly forward and pressed firmly while opening the jaw. The motion felt is from the TMJ. We can also feel the joint motion if we put a little finger against the inside front part of the ear canal. These maneuvers can cause considerable discomfort to a person who is experiencing TMJ difficulty, and doctors use them for making the diagnosis.

What are TMJ disorders, and what are causes of TMJ disorders?

 

TMJ disorders are a group of complex problems of the jaw joint. TMJ disorders are also sometimes referred to as myofascial pain dysfunction and Costen’s syndrome. Because muscles and joints work together, a problem with either one can lead to stiffness, headaches, ear pain, bite problems (malocclusion), clicking sounds, or locked jaws. The following are behaviors or conditions that can lead to TMJ disorders.

  1. Teeth grinding and teeth clenching (bruxism) increase the wear on the cartilage lining of the TMJ. Those who grind or clench their teeth may be unaware of this behavior unless they are told by someone observing this pattern while sleeping or by a dental professional noticing telltale signs of wear and tear on the teeth. Many patients awaken in the morning with jaw or ear pain.
  2. Habitual gum chewing or fingernail biting
  3. Dental problems and misalignment of the teeth (malocclusion). Patients may complain that it is difficult to find a comfortable bite or that the way their teeth fit together has changed. Chewing on only one side of the jaw can lead to or be a result of TMJ problems.
  4. Trauma to the jaws: Previous fractures in the jaw or facial bones can lead to TMJ disorders.
  5. Stress frequently leads to unreleased nervous energy. It is very common for people under stress to release this nervous energy by either consciously or unconsciously grinding and clenching their teeth.
  6. Occupational tasks or habits such as holding the telephone between the head and shoulder may contribute to TMJ disorders.

What are common TMJ symptoms?

 

TMJ pain disorders usually occur because of unbalanced activity, spasm, or overuse of the jaw muscles. Symptoms tend to be chronic, and treatment is aimed at eliminating the precipitating factors. Many symptoms may not appear related to the TMJ itself. The following are common symptoms.

Headache: Approximately 80% of patients with a TMJ disorder complain of headache, and 40% report facial pain. Pain is often made worse while opening and closing the jaw. Exposure to cold weather or air-conditioned air may increase muscle contraction and facial pain.

Ear pain: About 50% of patients with a TMJ disorder notice ear pain and do not have signs of ear infection. The ear pain is usually described as being in front of or below the ear. Often, patients are treated multiple times for a presumed ear infection, which can often be distinguished from TMJ disorder by an associated hearing loss or ear drainage (which would be expected if there really was an ear infection). Because ear pain occurs so commonly, ear specialists are frequently called on to make the diagnosis of a TMJ disorder.

Sounds: Grinding, crunching, clicking, or popping sounds, medically termed crepitus, are common for patients with a TMJ disorder. These sounds may or may not be accompanied by increased pain.

Dizziness: Of patients with a TMJ disorder, 40% report a vague sense of dizziness or imbalance (usually not a spinning type vertigo). The cause of this type of dizziness is not well understood.

Fullness of the ear: About 33% of patients with a TMJ disorder describe muffled, clogged, or full ears. They may notice ear fullness and pain during airplane takeoffs and landings. These symptoms are usually caused by eustachian-tube dysfunction, the structure responsible for the regulation of pressure in the middle ear. It is thought that patients with TMJ disorders have hyperactivity (spasms) of the muscles responsible for regulating the opening and closing of the eustachian tube.

Ringing in the ear (tinnitus): For unknown reasons, 33% of patients with a TMJ disorder experience noise or ringing in the ears (tinnitus). Of those patients, half will have resolution of their tinnitus after successful treatment of their TMJ disorder.

What is the treatment for TMJ disorders?

 

The mainstay of treatment for acute TMJ pain is heat and ice, soft diet, and anti-inflammatory medications.

1. Jaw rest: It can be beneficial to keep the teeth apart as much as possible. It is also important to recognize when tooth grinding is occurring and devise methods to cease this activity. Patients are advised to avoid chewing gum or eating hard, chewy, or crunchy foods such as raw vegetables, candy, or nuts. Foods that require opening the mouth widely, such as a big hamburger, are also not recommended.

2. Heat and ice therapy: These assist in reducing muscle tension and spasm. However, immediately after an injury to the TMJ, treatment with cold applications is best. Cold packs can be helpful for relieving pain.

3. Medications: Anti-inflammatory medications such as aspirin, ibuprofen (Advil and others), naproxen (Aleve and others), or steroids can help control inflammation. Muscle relaxants, such as diazepam (Valium), aid in decreasing muscle spasms. In certain situations, local injection of cortisone preparations (methylprednisolone [Depo-Medrol], triamcinolone [Kenalog], Celestone) into the TMJ may be helpful.

4. Physical therapy: Passively opening and closing the jaw, massage, and electrical stimulation help to decrease pain and increase the range of motion and strength of the joint.

5. Stress management: Stress support groups, psychological counseling, and medications can also assist in reducing muscle tension. Biofeedback helps people recognize times of increased muscle activity and spasm and provides methods to help control them.

6. Occlusal therapy: A custom-made acrylic appliance (mouth guard) that fits over the teeth is commonly prescribed for night but may be required throughout the day. It acts to balance the bite and reduce or eliminate teeth grinding or clenching (bruxism).

7. Correction of bite abnormalities: Corrective dental therapy, such as orthodontics, may be required to correct an abnormal bite. Dental restorations assist in creating a more stable bite. Adjustments of bridges or crowns act to ensure proper alignment of the teeth.

8. Surgery: Surgery is indicated in those situations in which medical therapy has failed. It is done as a last resort. TMJ arthroscopy, ligament tightening, joint restructuring, and joint replacement are considered in the most severe cases of joint damage or deterioration.

 

What is the prognosis (outlook) of TMJ disorder?

The outlook of TMJ disorder depends on its particular cause. Sometimes simple stress management and jaw rest lead to recovery within days. More serious TMJ problems can require corrective orthodontics and surgery.

Can TMJ problems be prevented?

Yes. TMJ problems can often be prevented by using simple nighttime mouth guards. The dentist is the first line of defense in this setting.

REFERENCES:

Klippel, John H., et al., eds. Primer on the Rheumatic Diseases. New York: Springer and Arthritis Foundation, 2008.

http://www.onhealth.com/temporomandibular_joint__disorder/page4.htm

Ruddy, Shaun, et al., eds. Kelley’s Textbook of Rheumatology, 6th ed. Philadelphia: Saunders, 2001.

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Did you know the benefits of Ginger?

Did you know the benefits of Ginger?

Ginger is one of the world’s seven most potent disease-fighting spices.

 

Ginger has been used for its health benefits for over 5000 years and is a favorite medicinal as well as culinary herb. rhizome by Crystl.

 

 

Unlike most spices, the part that has the most medicinal value grows under ground. Often mistakenly called “ginger root” this is actually the rhizome of the plant which is more of a subterranean stem than a root. Although you can use dried ginger and powdered ginger for health benefits, fresh ginger is preferred.

Roots by 
Amontillada.

 

 

The intake of ginger helps stimulate the secretion of mucus, quieting your cough and soothing any scratchiness in your throat.

 

Ginger has been proven (in multiple studies) to treat feelings of nausea, particularly in the form of seasickness, morning sickness, motion sickness and as a side effect of chemotherapy.

Ginger by 
FotoosVanRobin.

 

 

In pregnancy is to be extra careful!! Never use any herb, including ginger, without first discussing it with your doctor!! As for those suffering from ulcer, or other very serious gastric problems, they should also consult their doctor.
Doctor Hand by Truthout.org.

 

 

Ginger contains anti viral, anti toxic, and anti fungal properties, and is used for the prevention of and treatment against the common cold.

Honey Lime 
Ginger Drink by Nags The Cook.

 

 

Ginger acts as an antihistamine and

aids in the treatment of allergies.

Giant Ginger 
Root by Damian Cugley.

 

 

Ginger displays anti inflammatory properties and can be used to treat rheumatoid arthritis, osteoarthritis, and various other muscular disorders.

Ginger Study (1)
 by Ida Christine Kvisgaard.

 

 

The chemical components of the root are instrumental in inhibiting the biosynthesis of prostaglandins which are responsible for causing inflammation.

cid:D2F496746D804D33B03EFFAEE30615D0@DavidWong

 

 

Thus the root has proven to be a highly effective form of treatment, in some cases, even more so than the NSAID’s that are traditionally prescribed.

cid:871516E6BF1643349BF15FB43BD62203@DavidWong

Chewing on fresh ginger,,
can help freshen the breath.
cid:065F5841FEDF45EAB266D2328EFB7CDB@DavidWong

Being a warming herb, ginger can help knock out a fever. This property also makes it effective in stimulating circulation of the blood.

Ginger Root by 
J. Pollack Photography.

 

It can also help relax muscles around the blood vessels and is said to help prevent blood clots from forming. The warming effects make it a natural decongestant as well as an antihistamine, making it the perfect remedy for colds.

Lemon and Ginger
 Drink by Red Snapper9.

 

Some studies show that it can even help inhibit

the replication of the herpes simplex virus.

a ginger root by
 left-handed.

 

Recent studies show that ginger might also have a role in lowering LDL cholesterol because the spice can help reduce the amount of cholesterol that is absorbed.

Curry with 
Zucchini by Jernej K.

 

It has also been shown in animal trials to help slow

or even prevent cancerous tumor growth.

Is it safe to fly during pregnancy?

Is it safe to fly during pregnancy?

Answers from Roger W. Harms, M.D.

 

Generally, commercial air travel during pregnancy is considered safe for women who have healthy pregnancies. Still, if you’re pregnant, it’s best to check with your health care provider before you fly.

Your health care provider might caution against air travel if your pregnancy is considered high risk or you’re at risk of preterm labor. Similarly, your health care provider might restrict travel of any type after 36 weeks of pregnancy.

If your health care provider approves air travel and you have flexibility in your travel plans, the best time to fly might be in the middle of your pregnancy — about weeks 14 to 28. This is when you’re likely to feel your best, and the risks of miscarriage and premature labor are the lowest.

When you fly:

  • Check the airline’s policy about air travel during pregnancy. Guidelines for pregnant women might vary by carrier and destination.
  • Choose your seat carefully. For the most space and comfort, consider requesting an aisle seat.
  • Buckle up. During the trip, fasten the lap belt under your abdomen.
  • Promote circulation. If possible, take occasional walks up and down the aisle. If you must remain seated, flex and extend your ankles often.
  • Drink plenty of fluids. Low humidity in the cabin can lead to dehydration.

Decreased air pressure during flight can slightly reduce the amount of oxygen in your blood, but this doesn’t pose risks if you’re otherwise healthy.

Likewise, the radiation exposure associated with air travel at high altitudes isn’t thought to be problematic for most business or leisure travelers who fly during pregnancy.

There’s a caveat for frequent fliers, though.

Pilots, flight attendants and others who fly steadily might be exposed to a level of cosmic radiation that raises questions during pregnancy. If you must fly frequently during your pregnancy, discuss it with your health care provider. He or she might limit your total flight time during pregnancy.

http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/expert-answers/air-travel-during-pregnancy/faq-20058087