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Arthritis (Temporomandibular Joint)

Several different kinds of arthritis can affect the temporomandibular joint (TMJ). The most common kind of arthritis, called osteoarthritis, causes degeneration of cartilage and bone at the joints and can occur at the TMJ. It can be brought on by severe trauma to the joint or can simply occur due age-related deterioration. Rheumatoid arthritis, a chronic inflammation of the joint can affect the TMJ in the same manner it affects other joints. Arthritic changes can also be caused by an infection in the joint. Arthritic joint damage tends to increase as the disease progresses. Ankylosis (fusion of the jaw joint) can occur in cases of severe rheumatoid arthritis.

Symptoms

Symptoms can vary depending on the type of arthritis, but can include painful swelling in the joint, limited range of movement of the jaw, and various joint sounds such as popping, clicking, scraping or grinding during opening and closing.

Diagnosis

Diagnosis involves examining the motion of the jaw and visualizing the structural integrity of the jaw joint using imaging techniques such as X-ray, CT or MRI scans, or arthroscopy. Arthrocentesis, the removal and analysis of fluid in the joint using a syringe, can also be helpful, and can determine if an infection is present.

Treatment

Often, pain and discomfort caused by arthritis can be relieved with treatments and self-care techniques similar to those used for other TMD's and arthritic conditions. For example, treatment may involve eating a soft diet and applying moist heat packs to the painful area. Splints worn in the mouth can be effective in managing the symptoms. Non-steroidal anti-inflammatory drugs, physical therapy involving mild jaw exercises, and stress management may also be helpful in managing the condition.

Injection of steroids directly into the painful joint, an arthritis treatment used at other joints, may provide pain relief. However, steroid injections can only be done a limited number of times, as repeated use can harm the joint. Arthrocentesis, washing out of the inflamed joint fluid, may also help in some patients.

Surgery may be appropriate if the symptoms of the arthritic degeneration of bone and cartilage are not responsive to conservative and non-surgical care. Surgery cannot cure the disease, but may be able to ease the symptoms. Arthroscopic surgery, using tiny instruments and fiber optics to visualize the joint, is less invasive than open surgery, and is associated with less scarring and shorter recovery time. However, in some cases, open surgery may be more appropriate.

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