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FAQ:  TMJ / TMD - Jaw Joint Pain



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Question:
I am 21 years old and am not able to open my mouth more than a few inches. Several years ago, I had arthrocentesis done on the right side of my jaw, which helped.

I am now at an age where I need to remove my wisdom teeth especially because they are impacted. I was wondering if the procedure will be possible given my inability to open my mouth very wide. ....Visitor from DC

Answer:
You are presenting with a difficult concern. The inability to open your mouth more than a few millimeters may have several causes.

The joint is called the Temporal-Mandibular joint(TMJ). The location is just in front of the ear. The TMJ consists of two bones which are held together and moved by ligaments and muscle. There is a cushioning disc (articular disc) which keeps the bones from rubbing against each other and the inside is bathed with a fluid (Synovial Fluid) to nurture and lubricate the joint.

The Nerves tell the joint how to move and the brain what the joint feels. The jaw starts it's movement by rotating within the socket and then translates (moves) forward and down the front slope to move past the articular eminence (the bump at the end of the socket) to continue the wide open movement.

Sound can be heard both when the disc slides back on the head of the condlye (part of the lower jaw which attaches the joint) and when the condlye moves past the eminence. Difficulties can arise from any or a combination of these things, such as:

1) The disc can pop out of place, often forwards and block the joint from opening
2) The muscles can get tight and limit the movement of the joint
3) There may be a large socket of the joint and when you move the jaw forward the bones have trouble moving past the bump (eminence)
4) There may be inflammation in the joint (Synovitis) which is too painful for the joint to move
5) Due to the surgery there may be fibrous adhesions inside the joint, limiting the movement

This should be investigated for someone so young. The wisdom teeth may need to be removed under general anesthesia. and you will be sore for the few days following with even more limited movement as you heal. Following that the movement should return to normal and you may need to do exercises to keep the mobility proper.

Editorial Staff

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