TMJ Locked Jaw Treatment (Case Study #8)

TMJ Locked Jaw Treatment (A Frightening Experience of a ‘Closed Lock’) (Case Study #8)

Patient Profile & Diagnosis of TMJ Locked Jaw

KJ, a 17 year old male patient, came to Nourish Dental Sleep & TMJ Care in distress. He had experienced a locked jaw for the past few days, and could barely open his mouth. Previous visits to medical and dental practitioners for TMJ locked jaw treatment were unsuccessful.

KJ’s quality of life was badly impacted, as he could not even do basic everyday tasks. Eating, drinking and brushing his teeth were painful and difficult. Attempts at opening his locked jaw only resulted in intense headaches, facial, jaw and ear pain.

Whilst he had a history of TMJ locked jaw, each episode had only lasted for short periods of time. This time, however, his jaw remained locked.

At our clinic, we discovered that KJ had a ‘closed lock’ of the lower jaw due to a jammed jaw joint disc – technically known as Disc Displacement without Reduction (Young, 2015). We subsequently performed a jaw-unlocking procedure and freed the restricted jaw joint.

*Disclaimer: As of March 30, 2020, the ADA (American Dental Association) has officially recognised Orofacial Pain as its 12th dental speciality. Any reference to ‘specialisation’ is made in the context of the United States of America and not Singapore. Please visit our Disclaimers and FAQ pages for more information.

What is TMJ Locked Jaw?

Temporomandibular Joint Disorders (TMD) is a broad term used to describe many disorders that involve the Temporomandibular Joint (TMJ). This includes internal derangements such as Disc Displacement without Reduction, which was what KJ was suffering from.

The TMJ functions like a hinge so that you can move your lower jaw (mandible), and consists of a few different parts that work together to make that happen. Without the TMJ, you cannot chew, talk, make facial expressions or open your mouth. You can read more about TMD and TMJ here.

The jaw is usually able to open about 45 – 50mm. With a TMJ Locked Jaw, the patient can only open ≤ 30 mm of their jaw, and it will deflect to the affected side.

Causes & Symptoms of TMJ Locked Jaw

TMD and TMJ Locked Jaw happen for a variety of reasons, from bruxism (teeth grinding), to medication side effects, physical trauma, stress, arthritis and more.

Many patients can remember the exact moment when the ‘closed lock’ happened, and usually have a history of ‘clicking’ or ‘popping’ sounds when their TMJ moves.

They may or may not experience pain, but if they do it is usually a sharp pain, especially when they move their jaw. They may also report a dull, throbbing pain, but this is often because inflammation has set in. Attempts at trying to ‘fix’ the locked jaw by pushing against resistance can trigger pain.

Acute vs Chronic Disc Displacement Without Reduction

TMJ Locked Jaw can be acute or chronic in nature (Young, 2015). Acute conditions do not produce any sounds, and usually can be managed through non-invasive, manual therapies. In the chronic stage, the disc has degenerated into a greater state of deformity. At this stage, surgical intervention may be necessary.

It is also important to note that TMJ disorders happen for a wide variety of reasons. Even within a diagnosis of TMJ Locked Jaw itself, there are varying stages of progression. The medical history and lifestyle of the patient play a role as well.

Investigation & TMJ Locked Jaw Treatment

One of the most important things about TMJ Locked Jaw Treatment (Al-Baghdadi et al., 2014) is to see an Orofacial Pain Specialist as soon as possible. The longer you wait, the more the disc becomes displaced, which decreases the chances of a successful repositioning.

Early intervention yields better results, and may only require conservative treatments such as early mandibular manipulation, oral appliance therapy, analgesics, jaw exercises or muscle relaxation. Chronic cases of TMJ Locked Jaw on the other hand, may require surgical intervention with varying results.

Dr. Eric Chionh did a thorough step-by-step investigation of KJ’s case before concluding that it was TMJ Locked Jaw. He had to perform a jaw-unlocking procedure on him in order to free the restricted jaw joint.

Dr. Eric and his team also took measures to prevent future recurrent jaw locking incidents from happening. KJ was relieved that his jaw could move normally again – Anyone who has experienced this will understand how frightening a locked jaw can be.

The Importance of Seeing an Experienced Orofacial Pain Specialist for TMJ Locked Jaw Treatment

As this excerpt from the book, “Maxillofacial Surgery and Craniofacial Deformity – Practices and Updates”, states (Ivkovic and Racic, 2018):

“Diseases and functional disorders of the TMJ can be globally divided into several categories:

  • deviations in the form of articular surfaces,
  • disorders in the functions of the condyle-disc complex,
  • inflammatory diseases of the TMJ,
  • degenerative TMJ disorders,
  • ankylosis of TMJ.”

TMD symptoms often overlap, as the TMJ is a fairly small yet highly intricate anatomical structure. A misdiagnosis not only prolongs the patient’s pain, but can cause further damage if the wrong treatments are rendered.

Sometimes, the orofacial pain experienced in the area may not even stem from the joint itself, but may be muscular or inflammatory in nature. For more examples, you can read our case study on a patient with Myofascial Pain, or another case of TMD that was further complicated by comorbidities.

It is critical to get a proper assessment and diagnosis, in order to render the best treatments possible, minimise damage, and manage pain effectively.

How Nourish Dental Sleep & TMJ Care Can Help with TMJ Locked Jaw Treatment

Our clinic focuses on orofacial pain treatment, and dental pain management. We see many different types of TMD and facial pain disorder patients. You can read more about our dental practice in this post.

Dr. Eric Chionh has a lot of hands-on experience for both common and rare orofacial pain disorders. He is also formally trained in Oral Medicine and Orofacial Pain, and holds a Singapore Dental Council approved qualification in these areas.

He is passionate about pain management, and strives to improve his patients’ quality of life to the best of his abilities. You can learn more about Dr. Eric Chionh’s qualifications on our About Page. Visit Our Services Page to view all dental and pain management services provided at Nourish Dental Sleep & TMJ Care, Singapore.

References:

  • Al-Baghdadi, M., Durham, J., Araujo-Soares, V., Robalino, S., Errington, L., & Steele, J. (2014). TMJ disc displacement without reduction management: a systematic review. Journal of Dental Research, 93(7_suppl), 37S-51S. https://doi.org/10.1177/0022034514528333
  • Ivkovic, N., & Racic, M. (2018). Structural and functional disorders of the temporomandibular joint (Internal disorders). Maxillofacial surgery and craniofacial deformity-practices and updates. https://doi.org/10.5772/intechopen.81937
  • Young, A. L. (2015). Internal derangements of the temporomandibular joint: A review of the anatomy, diagnosis, and management. The Journal of Indian Prosthodontic Society, 15(1), 2-7. https://doi.org/10.4103/0972-4052.156998