Issue 43.16
I often have many TMJ patients come to me with a history of hearing a loud pop followed by pain in their jaw joint and an inability to open very wide. Usually they have a lot of pain when they try to open very wide for the first few days or weeks. The clinical description for the diagnosis for such a problem is, “Disc displacement without reduction.” This means that you “can’t get the door stop out and so can’t open the door all the way.” The door in this case is your jaw that can’t open very wide. Perhaps 25 to 35 millimeters (two fingers wide) is as wide as you can open. A normal opening measurement for a person is 48 o 52 millimeters (three fingers wide). The ability to open your mouth normally allows you to eat a Big Mac sandwich. The door stop is your TMJ disc that has become stuck in front of the ball (condyle) of your jaw joint. It usually lies between your skull and your condyle traveling forward as you open your mouth. With compression of you TMJ you can push the disc forward, in from of the condyle, which inhibits your ability to open wide.
Chronic clenching for many years is a common cause of this condition. If you try to force your mouth open when the disc is locked forward, the disc becomes pinched and inflamed, making it even harder to resume its normal position. Once this disc remains in the wrong place for very long it becomes possible permanently stuck there and it take a person some five years to gradually be able to open wide again. If you hear the loud pop and your joint becomes locked like this try opening by moving your jaw from side to side from one extreme to the other as you gently try to open wide again. If you cannot achieve wide opening again come and see me quickly. If you come soon enough I can usually get you unlocked and through treatment, keep you there and out of pain.
Phillip Hall is a practicing general dentist in St. George. He is also head of the St. George Craniofacial Treatment Center, and operates St. George Dental Careers, a successful dental assisting school . Appointments for general dentistry or dentures call 656-1111. For sleep apnea appliances or TMJ problems call 435-634-8338.