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Dr. Andrew Rynne

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Persistent pain around TMJ with popping sound in it. Have chronic sinusitis. Is it arthritis?

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Dr. Bindiya Bhaskar

Dentist

Practicing since :2008

Answered : 2059 Questions

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Posted on Mon, 11 Feb 2013 in TMJ
Question: I have dull but persistent pain around my right TMJ, inside my ear down into my throat, sometimes down into the salivary gland under the jaw, under the tongue and into my back teeth. There is often a feeling of somethins swollen and oozing mucus copiously just at the inner opening to the right ear.

I also have cracking, popping and grating sounds in that jaw hinge, sometimes minor, sometimes more severe so that i am afraid to open my mouth wide. There is sometimes a raw sore inside the ear in the front side of the tube and apparently it has bled because i found blood on the Qtip whenever i dried out that right ear after a showerFinally, there is often a slight swelling feeling right in front of the ear, down and right under the right ear, that crackles with a spongy sound and feeling if i press it with a finger.

I must mention two other things that might be important. My TMJs have not worked symmetrically for years or possibly all of my life. When I open my mouth, the left bump of the lower jaw seems to swing out and back while the right has no such bump or motion, it just opens. And, I had an incident about 4 years ago in which I was biting an XXXXXXX and my jaw stuck open. In a panic, I forced me mouth shut, which resulted in a cracking sound in the right TMJ. After that i had the symptoms mentioned. These symptoms come and go in various combinations. Sometimes the insidious pain increases and I find myself clenching my teeth so then I consciously relax the jaw.

I don't think this problem is simply bruxism,as my doctor seems to think, because I often sleep with my mouth open to breathe and it dries out. And I don' t think there is a stone in the salivary gland duct because the saliva flows freely on left and right. I do have a chronic sinusitis for which i have used Fluicasone on and off.

I find it curious that these symptoms come and go in different combinations, and that sometimes, especially in the morning, i can open my mouth wide without the cracking that i hear later in the day. Could this be some sort of arthritis?
doctor
Answered by Dr. Bindiya Bhaskar 2 hours later
Hello
Thanks for writing

It is a traumatic disturbance of the temporomandibular joint.
It is probably a case of luxation/subluxation or complete/incomplete dislocation

causes:-

1, anterior displacement of condyles
2, anterior open bite
3, spasm of muscles of mastication
4. Sudden traumatic injury resulting in fracture of the condyle or more frequently only in stretching of the capsule usually at the point of attachment for the external pterygoid muscle into the capsule

Clinical features-

1. Sudden locking or immobilization of jaws when the mouth is open, accompanied by prolonged spasmodic contraction of temporal, XXXXXXX pterygoid and masseter muscles with protrusion of jaw.

2. the mouth cannot be closed

Treatment-

1.     TMJ dislocation can be reduced by applying pressure on the mandible in downward and backward direction.

2. Inducing relaxation of muscles and then guiding the head of condyle under the articular eminence into its normal position by an inferior and posterior pressure of the thumbs in the mandibular molar area.

3. Necessary relaxation can be brought about only by means of general anaesthesia or by tiring the masticatory muscles by cupping the chin in the palm of hand and applying a posterior and superior pressure for 5-10 minutes.

PLEASE DO VISIT AN ORAL-MAXILLOFACIAL SURGEON SOON FOR FURTHER TREATMENT.

Hope this suffices.

Please feel free to ask, if any doubts.

Thanks

DR XXXXXXX


Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Bindiya Bhaskar 17 minutes later
Thanks for the detailed response. I do wonder, though, if the sore ear, spongy-ness around ear, and pain in the ear and throat are probably related to the TMJ dislocation? Would these be ongoing complications, or something else, like an infection?
doctor
Answered by Dr. Bindiya Bhaskar 9 minutes later
HI,

Thanks for writing again.

The symptoms are related to TMJ dislocation.

For detailed examination and diagnosis, direct clinical examination and TMJ view of x-ray is required.

So please do visit an oral and maxillofacial surgeon regarding this.

Hope this clarifies.


dr XXXXXXX

Above answer was peer-reviewed by : Dr. Shanthi.E
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