Key points to remember here are:
1. The first step here is to make sure there is no dental issues causing the TMJ such as the mandible not lining up with maxilla. It is not unusual for this to develop after dental work.
2. MRI often provide the details needed to make proper diagnosis as to what is causing the pain in TMJ.
3. The causes here vary from trauma with damage to the joint structures to various forms of arthritis including:
– Disc displacement
– Meniscal tear
– Juvenile Idiopathic Arthritis (Juvenile rheumatoid arthritis)
– Rheumatoid arthritis
– Psoriatic arthritis
– Traumatic arthropathy
4. Treatment obviously depends on the cause. Early treatment of the underlying disease is the key to avoid damage to TMJ.
5. Aggressive and early treatment of Rheumatoid, Psoriatic, and JIA with new biologics treatments such as Enbrel and Humira has resulted in significant decline of TMJ problems in these patients.
6. Oral Surgeons often deal with TMJ when medical therapy is exhausted.