Temporomandibular joint (TMJ) disorder is one of the few health problems where laughter is definitely not the best medicine...
Smiling hurts. Laughing is even worse - it can be excruciating.
But however painful, the joy of a good laugh is what gets me through the day.
The temporomandibular joints (TMJs) are commonly referred as the jaw joints and are located in front of the ears, where the lower jaw is attached to the skull. They are the most frequently used joints of our body, and their function is responsible for the most elementary needs - eating, chewing, talking, yawning, and general mouth/mandible movement.
Lateral aspect of the left TMJ
(source wikipedia.org)
The term temporomandibular disorder (TMD) groups several disarrangements affecting the TMJs, masticatory muscles and associated structures (tendons, ligaments, blood vessels, and other tissues). The symptoms of any of these disorders include pain in the jaw and surrounding muscles (commonly extending to the neck, shoulders and back), limited mouth opening and joint noises.
The causes of these disorders are many, including factors affecting the joint itself (degenerative arthritic conditions, trauma, intra-articular disc derangements) or the muscles and joint function (myofascial pain dysfunction, dental malocclusion or "bad bite", bruxism, muscle overactivity).
Cross-section of a normal TMJ - articular disc at centre
(source wikipedia.org)
My left TMJ is in good shape, looking just like the one showed above. So far, I have no signs of any kind of disorder. Lets hope it stays as it is!
As for the right side... things are not so good.
My right TMJ has an intra-articular disc derangement and bone structure alterations. My disorder was caused by a conjunction of several factors - trauma, bruxism (teeth grinding and jaw clenching), a TMJ surgery gone wrong (arthrocentesis), and too much time waiting. Waiting for answers, waiting for a proper diagnose, waiting for solutions, waiting lists.
My current condition goes by the name of anterior disc displacement without reduction. In other words, the articular disc is dislocated away from its normal position, staying in front of the condyle. The disc becomes a barrier and prevents full motion of the condyle, limiting mouth opening and normal jaw function. As the disc is moved out from between the condyle and the fossa (its normal position in the image above), the contact between the lower jaw and the temporal bone is made on the adjacent tissues and nerves. Basically, the largest and most important facial nerve - the trigeminal nerve - is being affected or "crushed" between two articulating bones. It causes inflammation and pain. A lot of pain!
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