The connection of orthodontics and mandibular joint problems
Mandibular joint diseases include the complaints of the joint in front of the ear connecting the jaws to the rest of the skull, the insufficient operation of the masticatory apparatus and the connected areas. Although symptoms are in most cases not so serious that people would turn to specialists, however in more than one third of the population certain kinds of symptoms of this group of diseases can be experienced.
- pain at the mandibular joint area, the masticatory muscle, but this pain may spread out to the ear, the temple, even it may case pain in the teeth or the nape, possibly in the neck muscle.
- sound effects, clack or crackle while moving the jaws.
- the abnormal (limited or excessive, sometimes irregular) movement of jaw.
Formerly simple explanations were born about the complaints and disorders were handled as an intergrated problem.
- One of the explanations was the abnormal jaw positions due to irregular tooth contact which overload the joint, or the masticatory muscles try to compensate this situation, however after some time, exhausted, these will cause themselves complaints.
- Nowadays we are aware that the role of irregular tooth contacts are not so important as it was supposed and other factors (stress, looseness of ligaments, so called para-functions) may be at least as important in the formation of disorders, however there are some irregularities that have clear impact on the operation of mandibular joints.
Therefore it is of greatest importance to recognize these irregularities in time and the treatment prior to mandibular joints complaints. At the same time certain situations and states may also emerge during orthodontics treatment that favour the emergence of problems. It’s important to recognize this, because if sypmtoms appear, treatments can be directed to other direction avoiding more serious symptoms.
Therefore it is very important to examine the patient applying for orthodontics treatment in respect of the operation of mandibular joints and masticatory muscles as well as the repeat of these examinations also in course of the later stages of orthodotics treatment, enabling to filter out persons who are increasingly endangered by problems of this nature. In course of such examination the patient is asked in details if he has already had previous complaints of mandibular joints, masticatory muscles, if he used to gnash his teeth, then we observe the regularity of the jaws movement (mouth opening, side movements, pushing the jaw forward), we also examine sound phenomenon incidently occuring during movements, we measure the maximum values of movements. Finally we examine the joint, the masticatory muscles and the surrounding areas by touching. This is then followed by a detailed examination inside the mouth (if this has not yet been peformed during the orthodontics treatment), in respect of the situation of teeth, the contacts resulting from this as well as the status of the mucosal. Supplementary examinations may be necessary, like X-ray photographs, MRI-tests, diagnostic narcotization.
The diagnosis shall be set up based on the information gained from the above examinations and orthodontics treatment has to be scheduled with consideration of the above. The evaluation of the results of treatment shall at the same time provide supplementary information about the data characterizing the operation of the mandibular joints and the masticatory muscles, on the basis of which (in case of need) the orthodontics treatment can be modified to cause you the least possible unconveniences.