Osteoarthritis is not only the most common type of arthritis affecting the temporomandibular joint. According to statistics, 16% of the total population have symptoms of arthrosis of the maxillofacial joint.
Arthrosis of the maxillofacial joint is characterized by:
If conservative treatment does not produce the desired results, surgery may be required.
• stage 0 (no radiological changes). To relieve inflammation and swelling, non-steroidal anti-inflammatory drugs (Dolaren, Ketorolac, Diclofenac, Amidopyrine) are prescribed.
More than 50% of people with rheumatoid arthritis also have problems with the maxillofacial joint. The disease occurs more often in women than in men in a ratio of 3 to 1.
Rheumatoid arthritis of the temporomandibular joint is characterized by bilateral pain (that is, on both sides), swelling is present, and movement is limited.
Symptoms tend to come and go periodically. The pain is worse in the morning.
Treatment of rheumatoid arthritis of the maxillofacial joint is the same as for the treatment of rheumatoid arthritis of other joints. Anti-inflammatory and antirheumatic rheumatic drugs are used depending on the severity.
Sometimes surgery is required to correct an anterior open bite.
Treatment of maxillofacial psoriatic arthritis is the same as for rheumatoid arthritis and its main goal is to control inflammation.
If ankylosis develops, surgery may be required.
Reactive arthritis of the temporomandibular joint is more common in men than in women. Again, symptoms of pain, swelling, and limited range of motion of the temporomandibular joint are typical.
Treatment is the same as other spondyloarthropathy with the addition of an antibiotic to kill the infection.
When we hear the word arthritis, we see an image of an elderly man with swollen knees and hand joints. Imagine a person who experiences excruciating pain whenever he moves his jaw. This is how arthritis of the temporomandibular joint (TMJ) manifests itself. Movements of the lower jaw are carried out thanks to the work of the TMJ. It gets its name because it connects the temporal bone and the lower jaw. The joint is a pair (the same structures are on the right and left sides), it works as one.
Just like other joints, it contains bones, cartilage, tendons, ligaments, muscles, and intra-articular fluid. All these structural elements can become inflamed as a result of certain influences. This is TMJ arthritis. According to some authors, arthritis of the jaw joint occurs in 5-25% of all those who visit the dentist. In the group of patients with maxillofacial anomalies it reaches 84%.
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The causes and factors contributing to the occurrence of arthritis of the maxillofacial joint are very diverse and consist of both causes common to any joint and those that determine the specificity of jaw arthritis. We can highlight:
Based on their origin, arthritis of the jaw joint is divided into infectious and non-infectious. Infectious arthritis of the TMJ can be specific or nonspecific. Nonspecific include those that occur if streptococcal, staphylococcal and other pathogenic microflora enter the body and develop. Specific – occur after a person has had tuberculosis or sexually transmitted diseases (gonorrhea, syphilis, chlamydia). Specific arthritis of the TMJ is a very rare form of the disease.
Non-infectious arthritis is divided into:
Arthritis of the maxillofacial joint can be acute or chronic. Acute arthritis can have serous and purulent periods of disease development.
Infectious nonspecific acute arthritis is most common in practice. The jaw joint can become infected as a result of an ENT disease, for example, otitis media, tonsillitis, pharyngitis or pathologies of other nearby structures: inflammation of the salivary glands, dental problems (caries, periodontitis, purulent diseases of the teeth and gums).
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Each type and period, each stage and form of arthritis of the jaw has its own distinctive characteristics.
Acute nonspecific arthritis of the TMJ is characterized by:
During the purulent period, the following may be added: fever, chills, fever, nausea, dizziness. As a result of severe swelling, the patient may begin to hear worse; ulcers sometimes break into the ear canal, in which case pus may flow from the ear.
In the chronic form of the course, all symptoms are blurred. The main complaint is limited mobility; crunching and cracking sounds are heard when the jaw moves. The pain is aching and usually has low intensity.
Rheumatoid is characterized not only by symptoms of damage to the jaw joint, but also to the body as a whole:
Since traumatic arthritis is caused by maxillofacial injuries, severe pain occurs. Symptoms are determined by the nature of the injury.
A distinctive feature of maxillary arthritis is a rather long asymptomatic period. An increase in body temperature may occur. Symptoms appear already at a late stage of the disease.
The complexity of the jaw structure and numerous factors influencing its condition lead to difficulties in making an accurate diagnosis. The problem arises even when choosing a specialist. Who should I contact: a surgeon, a traumatologist, a rheumatologist, a dentist? This choice is determined by the type of maxillofacial arthritis. The main diagnostic method is radiography, and, if necessary, computed tomography. If rheumatoid arthritis of the jaw is suspected, general, biochemical and immunological blood tests are required.
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Treatment tactics are determined by the type, form, and period of the disease.
When treating acute arthritis of the TMJ, the joint must be fixed for a certain time so that it is motionless. For nonspecific and traumatic arthritis, the following drugs are used:
The doctor selects specific therapeutic agents individually for each patient, depending on the characteristics of the disease and the patient’s condition.
Treatment is complemented by the use of physiotherapeutic procedures, they accelerate metabolic processes, improve blood supply to the joint, relieve swelling, and reduce pain:
During the recovery period, treatment may include special exercises and massage.
If acute arthritis of the TMJ becomes purulent, most often it is necessary to resort to surgical intervention. The abscess is opened and drainage is placed, analgesics and antibiotics are prescribed, and later physiotherapy is added.
Chronic arthritis of the TMJ usually occurs if acute arthritis has not been treated. In this case, you need to be patient; chronic arthritis takes a long time to be treated. Electrophoresis and phonophoresis with bee products are used, and massage is prescribed.
Arthrosis is a joint disease in which cartilage is destroyed and dystrophic changes in the joint occur. At a certain stage of development of articular pathology, changes inherent in both arthritis and arthrosis can be observed. This is arthrosis-arthritis of the jaw joint.
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Use tinctures, ointments, decoctions, compresses. Folk remedies, as well as drug treatment, are aimed at eliminating symptoms and also act on the cause of the disease. You just need to strictly follow the instructions - consult with your doctor and discuss the use of folk remedies.
A few simple recipes:
There are many recipes, everyone can choose the one that suits them and helps them. Do not under any circumstances engage in self-diagnosis or self-medication, do not replace a visit to a doctor with advice from neighbors, relatives, friends, or members of online forums. Do not use medications or folk remedies that have helped someone. The basic rule is that any remedy should be prescribed only by a doctor, this also applies to traditional methods of treatment.
Preventive measures require timely treatment:
Try to avoid facial injuries, jaw bruises, hypothermia, which can provoke inflammatory processes. Eat rationally and lead a healthy lifestyle.
The consequences of ignoring or insufficiently serious approach to treatment can lead to severe consequences, depending on its type. The serous period of acute arthritis can turn into a purulent one. The inflammatory process can spread to other organs and systems, which can lead to sepsis, meningitis, and phlegmon. Untreated acute and traumatic arthritis of the jaw turns into a chronic form of the disease.
Chronic arthritis causes the appearance of adhesions in the joint, which eventually leads to ankylosis, in which the joint is completely immobile or contracture, while mobility is only partially preserved. Untimely treatment of rheumatoid arthritis of the TMJ leads to damage to other joints and internal organs: kidneys, lungs, heart. The prognosis for this is the most unfavorable.
Arthritis of the maxillofacial joint is a serious, rapidly progressive disease. Remember, the earlier treatment is started, the more effective it is.
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Arthritis of the maxillofacial joint is a fairly rare phenomenon. Therefore, there are very few specialists who can recognize the disease without a full examination. However, due to the fact that modern diagnostic methods are being introduced everywhere, this is not a problem. In any clinic, doctors will quickly make an accurate diagnosis and prescribe the necessary therapy.
Any inflammatory process in the jaw can cause arthritis of the maxillofacial joint. Symptoms and treatment depend on the form of the disease and its severity.
Most often, this disease develops for the following reasons:
Depending on the cause of inflammation, the following types of this disease are distinguished:
As we already know, the symptoms of arthritis of the maxillofacial joint depend on the nature of the disease. Doctors distinguish two forms of inflammation:
Regardless of the type of arthritis and the form of inflammation, the disease is characterized by the following general symptoms:
It is worth noting that a number of symptoms of jaw arthritis are similar to the symptoms of other diseases: neuritis and inflammation of the trigeminal nerve , dental diseases, etc. This confirms the need for differential diagnosis.
The inflammatory process in the facial joint, if treatment is not prescribed in a timely manner, can negatively affect internal organs. The same thing can happen with home treatment without medical supervision. Untreated arthritis can lead to a sharp deterioration in the patient's well-being.
With rheumatoid arthritis of the jaw joint, after the disease becomes chronic, damage to adjacent tissues often occurs . This can eventually cause ankylosis. Simply put, the jaw will stop moving completely.
Untreated infectious arthritis can cause sepsis. And since the source of infection is located near the brain, there is a high risk of death.
Therapy for this disease always begins with fixing the jaw. This is necessary to reduce the load on it. If arthritis of the jaw joint is caused by dislocation or subluxation, then a cape-like bandage is used . Subsequent treatment depends on the cause of the disease and may consist of the following:
The use of traditional medicine recipes is not prohibited in the treatment of jaw arthritis. However, when selecting them, you must definitely consult with specialists.
The most effective for inflammation of the jaw joint are compresses, rubbing, and decoctions .
The best decoction is considered to be cinquefoil decoction. It's easy to prepare. You need to take a tablespoon of crushed cinquefoil roots, and a teaspoon each of elecampane and galangal roots. Mix all this and pour 500 ml of boiling water. Next, simmer for 30 minutes over low heat. The finished broth is filtered and cooled. You need to drink 100 ml each time after meals. The taste of the decoction can be improved by adding honey or jam.
Sabelnik, elecampane and galangal are also used in preparing the infusion. All components are taken in the same proportions and poured into a thermos. The roots are poured with 500 ml of boiling water and infused for 3 hours. The decoction should be taken one tablespoon before each meal.
Another effective decoction is prepared using buckthorn bark . Take two large spoons of this component and mix them with fennel and dandelion roots. Add a little mint to the mixture. Mix everything thoroughly and add half a liter of water. Boil the broth over medium heat for 15 minutes. You need to take two large spoons with your first meal.
A rubbing of egg yolk, a teaspoon of turpentine and a large spoon of apple cider vinegar is good for relieving inflammation of the facial joint. The resulting mixture should be rubbed into the area of the affected joint.
You need to understand that traditional medicine for diseases of the jaw joint cannot be used as the main therapy . Traditional methods should act as auxiliary treatment and prevention.
To increase the effectiveness of treatment, patients must switch to a special diet. It focuses on a large number of fresh vegetables and fruits. Various boiled dishes are also prepared from them.
If the patient regularly consumes May honey , his condition will improve very quickly. Ordinary cherries have a very good effect on a sore joint. The substances it contains strengthen blood vessels and reduce the risk of vascular thrombosis.
For arthritis of the maxillofacial joint, it is recommended to drink apple and grapefruit juices.
As for the drinking regime, there is only one recommendation - drink at least 2 liters of water per day.
Arthritis of the maxillofacial joint
Along with other types of arthritis, arthritis of the maxillofacial joint occurs, the symptoms and treatment of which have some similarities with them.
In medical terminology, this disease is abbreviated as TMJ arthritis, or arthritis of the temporomandibular joint. This joint ensures the mobility of the lower jaw; movement in it should be carried out in several directions - the ability to open and close the mouth, moving the jaw forward, shifting the jaw to the side.
Both older people and children are susceptible to the disease. If in children the occurrence of such a pathology is caused by the growth of teeth and bones and injuries, then in older people it can occur as a result of infectious or inflammatory diseases. If we talk about adults, the disease occurs equally often in both men and women. Temporomandibular arthritis is characterized by increased pain when opening the mouth.
Inflammation of the jaw joint occurs for a number of reasons, which are grouped into 3 groups - infection, trauma and inflammatory diseases. Injury can occur from a blow or fall, resulting in the formation of a focus of inflammation. This process causes swelling, impairing the mobility of the joint.
As for the infectious causes of arthritis, the root cause is pathogenic microorganisms that, when they enter the joint, cause an inflammatory process. Penetration of infectious microorganisms occurs through direct, contact and hematogenous routes. The direct route is when the infection occurs when a joint is injured. This may be a fracture of the lower jaw as a result of a blow, knife or gunshot wound. The result of direct infection is specific and nonspecific inflammation. Specific causes tuberculous and syphilitic arthritis of the TMJ, nonspecific causes staphylococcal and streptococcal arthritis.
Hematogenous infection occurs with infectious diseases of the ear, nose, throat, and lower jaw. In this case, the infection is spread by the bloodstream. The contact route involves the spread of pathogenic bacteria from nearby tissues that have already been infected. Infection by contact is a consequence of:
The third group of causes of maxillofacial arthritis - inflammatory diseases - includes mainly rheumatic diseases, which are characterized by systemic inflammation of the organs and tissues of the body. Such systemic diseases that provoke inflammation include:
Arthritis of the maxillofacial joint is classified according to the form of the disease and the reasons that caused it. Thus, according to the form of arthritis of the temporomandibular joint, it can be acute or chronic. By the nature of occurrence - infectious and traumatic. Infectious arthritis is divided into specific and nonspecific. A separate type of disease is rheumatoid and purulent arthritis of the temporomandibular joint.
The acute form of arthritis is usually inflammatory-infectious or traumatic in nature, and the chronic form is rheumatoid in nature. Common symptoms of facial arthritis:
Each type of arthritis of the mandibular joint has its own distinctive features. Thus, with infectious arthritis, severe increasing pain is observed in the joint affected by the deformity. The pain usually increases with jaw movements. The soft tissue and skin around the joints also become inflamed. This form of the disease is characterized by the inability to open the mouth.
Signs of arthritis of the maxillofacial joint
A distinctive feature of purulent arthritis is the formation of infiltrate. When palpating the joints, the pain increases significantly, general intoxication of the body occurs, and body temperature rises. A characteristic symptom of this form is hearing loss, which is the result of narrowing of the ear canal under the influence of infiltrate.
Traumatic arthritis is accompanied by sharp pain when opening the mouth and swelling of nearby tissues. Palpation is also accompanied by sharp pain. There is a displacement of the chin to the side.
Symptoms of arthritis of the maxillofacial joint, which occurs in an acute form, are characterized by the presence of a pronounced inflammatory process. The sensitivity of the nerve endings increases, which causes a feeling of pain, swelling of the soft tissues occurs.
Acute inflammation manifests itself in the form of sharp pain, which increases as the jaw moves. This situation significantly reduces the patient’s quality of life, because he cannot open his mouth due to the resulting pain, which spreads throughout the head and face.
Acute inflammatory arthritis of the TMJ is accompanied by redness and swelling of the soft tissues of the joint. This symptom is usually a sign of purulent arthritis. Actively reproducing pathogenic microorganisms cause dilation of blood vessels in the inflamed cavity and increased blood flow to the site of inflammation. This leads to swelling and redness of the soft tissues.
Another symptom is a feeling of fullness in the area of the affected joint. This sensation is caused by tissue swelling and accumulation of exudate. The patient may experience hearing loss. This occurs due to the fact that the inflammatory process spreads to the ear canal and causes it to narrow. The patient experiences a feeling of ear congestion.
Acute inflammation is often accompanied by an increase in temperature in the joint area. The dilation of blood vessels and the influx of warm blood to the inflamed area leads to an increase in temperature by several degrees. If the temperature rises above 38 degrees, a fever occurs. The headache intensifies, general weakness appears and fatigue increases. These kinds of symptoms, as a rule, indicate purulent inflammation in the jaw joint.
Arthritis of the jaw joint
Symptoms of maxillofacial arthritis in the chronic form of the disease are as follows:
Osteoarthritis of the maxillofacial joint, unlike arthritis, occurs as a result of joint deformation, and it mainly affects older people. The affected joint becomes thinner, which causes limited mobility of the lower jaw and pain that occurs when moving the lower jaw. This form of arthrosis can be asymptomatic for a long time and then becomes chronic.
The risk group for the likelihood of developing maxillofacial arthrosis includes people over 50 years of age, as well as women during menopause, when the body undergoes significant hormonal changes. In addition, individuals who have undergone temporomandibular joint and facial surgery and suffer from osteoarthritis are also at risk of having a history of arthrosis of the maxillofacial joint in the future. This deformation is a consequence of improper distribution of the load on the jaws and occurs for the following reasons:
Arthrosis of the temporomandibular joint often occurs without symptoms. Some time after the onset of the disease, as the articular cartilage undergoes degenerative changes, the patient may experience pain when putting stress on the jaw, and then discomfort even when talking or chewing non-solid food. Here are the most common symptoms:
Diagnosis of the disease has some difficulties due to its asymptomatic course. Therefore, visiting a doctor often occurs in advanced forms. Arthrosis of the mandibular joint can be diagnosed using instrumental methods - conventional and contrast radiography, as well as computed tomography. X-rays can only reveal gross changes in cartilage tissue in the joint, while computed tomography can detect pathology in the early stages of its development.
Examination by a doctor
Diagnosis of the noted pathology is carried out by various methods - CT, MRI and radiography, as well as palpation. Laboratory methods for diagnosing such arthritis include a general blood test, a blood test with determination of ESR and C-reactive protein, and uric acid.
If instrumental methods revealed a narrowing of the joint space, the formation of marginal patterns on the head of the joint or tubercle, then this indicates chronic arthritis of the TMJ. If the joint space is widened, this is a sign of acute arthritis. Depending on the causes of the disease, its treatment is carried out by doctors of various specialties - dentists, orthopedists, traumatologists, phthisiatricians, rheumatologists, neurologists, infectious disease specialists. Treatment of maxillofacial arthritis is carried out according to the symptoms of manifestation.
Regardless of the type of maxillofacial arthritis, treatment includes mandatory rest and exclusion of any stress. For several days, a special bandage is applied and an interdental plate is inserted, so during this period the patient can only take food in liquid form.
Treatment of acute jaw joint arthritis includes the following therapeutic measures:
Treatment of arthritis of the mandibular joint caused by injury is carried out with the use of painkillers, and ice is applied to the site of inflammation for several days. In addition, physiotherapy measures are used. In case of purulent arthritis, emergency surgery is performed. The source of inflammation with infiltrate is opened and drained. In the postoperative period, physiotherapy procedures are indicated.
Treatment of arthritis of the maxillofacial joint in chronic form is carried out with the help of massage, physiotherapy, and physical therapy. Sanitation of the oral cavity and nasopharynx, as well as restoration of the integrity of teeth, are also provided.
Treatment of arthrosis of the mandibular joint is complex and includes (depending on the indications) medicinal, surgical, physical, and orthopedic measures. The main ones for this diagnosis are orthopedic measures, this is due to the reasons that caused the disease. So, its main goal is to eliminate the factors that caused joint overload and deformation. This is achieved through the following measures:
If you are treating arthrosis of the jaw joint, you should remember that an important part is following a special diet. Its main purpose is to reduce the load on the deformed joint. Food should be easy to chew without causing unpleasant painful sensations. During treatment, it is better to switch to a diet that includes cereals and fermented milk products. In addition, it is not recommended to talk a lot, chew gum, or bite your nails.
X-ray of arthritis
To relieve pain, the doctor will prescribe medications. These are usually painkillers that fall under the category of non-steroidal anti-inflammatory drugs. They are presented in the form of external medications intended for local use - ointments and gels. In addition, these are oral medications in tablet form. Chondroprotectors are also prescribed; they will stimulate the nutrition of the cartilage tissue of the joint.
Physiotherapeutic therapeutic measures include:
Jaw arthrosis can also be treated surgically; it is used only in significantly advanced cases of the disease. During the operation, the articular head of the lower jaw or the articular disc is removed. In some cases, the removed articular head is replaced with a graft.
Many people are unaware of the possibility of developing arthritis of the maxillofacial joint, the symptoms and treatment of which have much in common with those of other joint diseases. Pain in the jaw area is most often associated with dental diseases. Especially if the pain syndrome was preceded by a visit to the dentist. The temporomandibular joint bears a tremendous load. It is almost constantly in motion when a person is awake. With the help of articulations they chew food, speak and even express emotions. If normal movements cause difficulty or pain, this may be a sign of arthritis.
The temporomandibular joint (TMJ) is a paired organ. It connects the lower jaw with the skull.
Arthritis of the temporomandibular joint is diagnosed when an inflammatory process appears in the joint. At an early stage of pathology, the source of inflammation is located in the joint capsule. As the disease progresses, the inflammatory process affects other parts of the joint. If the disease is not treated, the joint may lose its mobility.
The disease often develops after infectious diseases. The infection can spread to the joint from neighboring tissues. Contact arthritis of the TMJ type occurs when:
Pathogenic microorganisms penetrate the joint cavity, creating a focus of inflammation.
Hematogenous infection of the joint develops against the background of:
Reactive arthritis of the TMJ is detected when:
It develops against the background of meningococcal infection. In such cases, pathogenic organisms do not penetrate the joint cavity, but are the cause of the disease.
People who have been diagnosed with rheumatism or rheumatoid arthritis are at risk.
Trauma can trigger the pathological process. Arthritis sometimes begins to bother a person after a blow or fall.
The disease can be provoked by:
People who are often under stress over-tighten their facial muscles, putting increased stress on the temporomandibular joint.
In the acute form of arthritis of the maxillofacial joint, symptoms can be recognized by a stabbing pain in the joint area, which intensifies when trying to open the mouth. Sometimes the pain is felt not in the joint itself, but in the ear. It can appear in the temple, in the back of the head and even in the tongue. The nature of the pain syndrome is similar to the signs of trigeminal neuralgia. A special feature is the pulsation of pain.
The main symptom of arthritis is a decrease in the range of motion of the joint. The patient has difficulty opening his mouth. The motor function of the jaw is limited.
During an exacerbation of the disease, a swelling is visible in front of the ear tragus. The skin at the epicenter of inflammation turns red and becomes very sensitive. When feeling the problem joint, a person feels intense pain.
If maxillofacial arthritis enters the purulent stage, the person’s condition worsens. His body temperature rises to 38°C. On the side of the affected joint, the external auditory canal narrows. The patient partially or completely loses hearing. Ear congestion is observed on both the problematic and healthy sides. The person becomes very weak and dizzy. He loses his appetite and cannot sleep. The patient feels pain when pressing on the chin in an upward and forward direction.
With arthritis of a rheumatic nature, both joints become inflamed. During the examination, the patient is often diagnosed with heart problems.
In patients with rheumatoid arthritis, only one TMJ is affected. However, pain is also felt in the hip, knee or shoulder joint.
If the disease is not cured during the acute stage, it gradually becomes chronic. The patient suffers from moderate pain in the joint and in the ear area. They may get worse in the morning. When chewing and yawning, the joint clicks, crunches or creaks. It is not possible to open the mouth completely. Movements of the joint become limited, they are carried out with effort. It is especially difficult to move the jaw in the morning, after a long rest.
When the jaw drops, it moves slightly towards the problematic joint. If such symptoms appear, arthritis of the maxillofacial joint has become chronic.
When the disease passes from an acute to a chronic form, damage to the auditory canals may disappear on its own. But more often, individual hearing problems persist.
Chronic jaw arthritis often causes muscle pain in the back of the head and neck. Painful lumps appear in the muscles. Unpleasant sensations occur in the joint area and on the side surfaces of the face. The patient has difficulty speaking or chewing for a long time. He suffers from headaches.
Over time, asymmetry develops on the patient's face. It becomes skewed towards the affected joint.
Sometimes arthritis of the maxillary joint develops gradually, without an acute stage. In this case, it is difficult to detect it in time. Changes occur slowly and unnoticed by the patient. Patients often ignore a slight crunch in the joint and aching pain.
When more serious complications develop, the disease is much more difficult to cure. In the later stages of arthritis, irreversible changes appear. Therefore, it becomes impossible to completely restore the motor function of the joint.
If arthritis is diagnosed, symptoms and treatment depend on the severity. Therapy begins with the appointment of complete immobilization of the problematic joint. If inflammation occurs due to injury, a fracture may occur. While motor function is maintained, bone fragments can damage nearby tissue. Immobilization will help alleviate the patient's condition until the causes of inflammation are fully clarified.
To fix the jaw, a special sling-like bandage is used. It is a strip of fabric, cut on both sides in the longitudinal direction. The lower ends of the bandage are placed in front of the ears and tied at the crown of the head. The upper ends are tied at the back at the base of the head. A sling bandage holds the jaw in a closed position. An interdental plate is placed on the side of the affected joint, separating the jaws. During the acute period (2-3 days), the patient can only eat liquid food. He is not allowed to speak.
If arthritis of the jaw joint is confirmed, treatment should be prescribed by a doctor. Non-steroidal anti-inflammatory drugs quickly relieve pain in TMJ arthritis. The patient is prescribed:
Diclofenac is administered intramuscularly, then switched to tablets for oral administration. If the pain is not very severe, Paracetamol is prescribed.
When arthritis is provoked by rheumatic processes, the attending physician prescribes steroidal anti-inflammatory drugs:
If arthritis in the temporomandibular joint is caused by pyogenic pathogens, the surgeon decides on the advisability of opening the purulent capsule and draining it. Immediately after surgery, broad-spectrum antibiotics (Ceftriaxone) are prescribed intramuscularly. Narcotic painkillers (Morphine) are administered intramuscularly. Then they switch to non-steroidal anti-inflammatory drugs (Ketorolac, Indomethacin).
Your doctor will determine how to treat jaw arthritis after injury. Surgery may be necessary if a fracture of the articular surfaces, rupture of the joint capsule or ligaments is detected.
After the inflammatory process has subsided, the patient is prescribed physiotherapy:
With the rheumatic nature of the disease, there is a high risk of fusion of the articular ends (ankylosis). This complication leads to complete immobility of the joint. To prevent its development, the patient must perform a therapeutic set of exercises.
In rare cases, a person encounters a pathology that affects the maxillofacial joints, which greatly complicates the diagnosis and choice of therapy. Not every doctor is able to correctly identify the disease and choose the appropriate treatment method.
Diagnosis is further complicated by the fact that arthritis of the maxillofacial joint, the symptoms and treatment of which differ depending on the cause that provoked the development, gives a different clinical picture in people.
Arthritis of the maxillofacial joint or temporomandibular arthritis is an inflammatory disease that affects the tissue of the temporomandibular joint, which connects the lower part of the main skull with the lower jaw.
The factors that provoke the development of the disease lead to disruption of the normal functioning of the joint, creating interference in the full functioning of the lower jaw.
Doctors identify three reasons leading to the development of arthritis:
The disease is usually divided into groups not only by the causes of occurrence, but also by the forms of its course. There are two forms:
The border between acute and chronic forms of arthritis of the maxillofacial joint often has unclear outlines, since the first type of pathology, without timely diagnosis and treatment, flows into the second.
Treatment of arthritis of the maxillofacial joint depends on the symptoms of the pathology. Symptoms help the doctor determine the type of disease and select an appropriate treatment regimen.
There are five types of the disease, characterized by differences in the clinical picture.
The cause of the development of pathology is mechanical trauma. Main symptoms:
The patient's history includes a work injury, an episode of a fight, and an unsuccessful movement.
The disease occurs due to the transport of infection through blood vessels. The inflammatory process in a joint can be triggered by:
The patient complains of acute pain in the area of the projection of the joint, which intensifies when trying to make a movement. It is not possible to open the mouth fully, since attempts increase the severity of the pain symptom. The doctor pays attention to inflammatory changes in the skin around the affected joint.
In the anamnesis, it is necessary to pay attention to an episode of infection.
The purulent form of the pathology develops if pathogenic pyogenic microflora enters the area of the already affected TMJ. The patient's complaints are as follows:
Purulent arthritis of the maxillofacial joint may be accompanied by signs of general intoxication: weakness, headaches, increased fatigue, and lack of appetite. Upon visual examination, attention is drawn to redness of the skin over the lesion site and swelling. In some cases, it is possible to visually determine the infiltrate if it has reached a sufficiently large size.
The history is noteworthy of open injuries in the articulation area and past illnesses.
The rheumatoid type of disease is a consequence of rheumatism. The TMJ is affected secondarily, after damage to other joints of the body, but in some cases primary damage to the TMJ can be found.
The rheumatoid form is characterized by severe joint pain and complaints of the inability to open the mouth wide. If the doctor detects an exacerbation of rheumatism, then it is possible to record an elevated temperature in the patient.
Rheumatoid arthritis can have a long course, and then the symptoms are accompanied by complaints of increased fatigue and weight loss. Attention must be paid to the symmetry of the lesion, which speaks in favor of rheumatic tissue damage.
The differences between the chronic version of the disease and other forms are the constancy of the pain symptom and the severity of pain in the morning, after being in a long state of rest.
When examining the patient, the doctor notes the opening of the mouth by 2-2.5 cm, a crunch in the affected joint and a displacement of the lower jaw towards the affected side. Noteworthy is the absence of skin inflammatory reaction, temperature and other complaints from the patient.
Any type of maxillofacial arthritis begins with sharp pain in the area of the affected joint. The pain radiates in some cases to the temporal region, the back of the head, the ear, and the tongue. Due to irradiation, patients cannot indicate the location of pain during examination, making diagnosis difficult. If the pain symptom radiates to the temporal or occipital region, doctors may mistakenly suspect headaches and begin searching for causes without thinking about TMJ arthritis.
The irradiation of pain is facilitated by a wide network of nerves in the temple and lower jaw, making it difficult to differentiate between the inflammatory pathology of the joint and trigeminal neuralgia.
When making differentiation, doctors pay attention to the locality of pain and the presence or absence of pulsations, which are the fundamental criterion.
Regardless of the symptoms, treatment of maxillofacial arthritis begins with the application of a fixing bandage, providing rest to the affected joint. Doctors use a cape-shaped bandage to install an interdental plate that fixes the bite. While wearing the bandage, the patient is fed only liquid food.
In addition to applying a bandage, therapy is selected that is suitable for treating the established form of the disease. Principles of therapy:
To relieve pain, analgesics or novocaine blockade are used. The drugs are selected by the doctor based on the characteristics of the disease, the severity of symptoms and an assessment of the patient’s allergy history. Preference is given to non-steroidal anti-inflammatory drugs; novocoin blockade is a last resort when other methods of combating pain have proven ineffective.
Antibiotics are not the main medication for the treatment of pathology, but are used if an infectious or purulent process is diagnosed. When choosing therapy, the doctor must conduct a study on the sensitivity of microorganisms to antibiotics, after which preference is given to drugs with a narrow spectrum of action. The choice of narrowly targeted drugs prevents the development of side effects.
During an exacerbation of a painful symptom, doctors recommend making compresses that have warming properties. Preference is given to ointments and creams that contain snake or bee venom. Ointments with a warming effect relieve severe pain and improve joint mobility.
Important! If arthritis is caused by an infectious or purulent process, warming up is prohibited. Under the influence of heat, the reproduction of pathogenic microflora is more active, which leads to a worsening of the disease.
Purulent arthritis can only be treated with surgery and is considered one of the most dangerous. After eliminating the purulent focus, the patient is in the hospital, undergoing a rehabilitation period. After draining the lesion, it is allowed to use warming dry compresses to relieve pain.
If the rheumatoid variety of the disease is diagnosed, anti-inflammatory drugs are widely used. The use of medications with hormonal activity is recommended. Depending on the severity of the process, different treatment regimens are used. The attending physician may recommend visiting a dentist to sanitize the oral cavity, or visiting a specialist who eliminates bite defects.
Attention should be paid to physical exercises that help restore mobility of the maxillofacial joint. The main exercise is carried out according to the following scheme: a fist is placed below the chin, blocking the activity of the lower jaw. The patient should open and close the mouth only by moving the upper jaw. The exercise is repeated for 2-2.5 minutes several times a day. If severe pain is present, you can combine physical activity on the joint with the use of analgesics or the application of a warming ointment.
Treatment of arthritis of the maxillofacial joint can be carried out using traditional medicine, which effectively relieves the symptoms of the disease.
There are several effective recipes:
When choosing treatment with folk remedies, the patient should consult a doctor to avoid unforeseen complications. Traditional medicine recipes are less likely to cause complications, but often provoke allergic reactions to components, the prevention of which requires separate consultation with a physician.
Traditional medicine is used in the treatment of maxillofacial arthritis to eliminate the symptoms of the pathology, as maintenance therapy during remission, and as an adjuvant during the main treatment.