September 20th this year is the 37th National Teeth Day, with the theme of "Oral Health and Whole Body Health". Recently, a 28 year old programmer described his condition to a dentist in distress, unable to open his mouth while eating and making a "clicking" sound. Lu Hongyan, Deputy Chief Physician of the Bafang Outpatient Department of Changsha Stomatological Hospital, said that the patient's condition reminds us that oral health is not only about the teeth themselves, but also includes the coordination of the entire oral and maxillofacial system such as joints and muscles. Although the temporomandibular joint is small, it is related to basic functions such as chewing and speech, and requires early attention and comprehensive protection. The young man couldn't open his mouth while eating, it turned out to be temporomandibular joint disorder. "Doctor, my mouth is like a rusty door. Before, eating made a clicking sound, but now I can't even open my mouth and eat! ”Recently, at the Department of Maxillofacial Surgery at Changsha Stomatological Hospital, 28 year old programmer Wang Lei (pseudonym) described his condition to the attending physician Ouyang Yipeng. According to Mr. Wang's recollection, six months ago when he was gnawing on corn, a "click" sound similar to pressing a ballpoint pen suddenly came from in front of his left ear, but he didn't pay much attention at that time. As time goes by, the sound of bouncing becomes increasingly dull, and the mouth becomes smaller and smaller. Until last week when he worked overtime continuously, he suddenly realized that his mouth could only barely open about the width of a finger, and when he woke up in the morning, his cheeks were sore and swollen, making it difficult for him to chew. That's why he hurriedly went to Changsha Stomatological Hospital for treatment. After detailed examination and imaging diagnosis, Mr. Ouyang Yipeng was diagnosed with "temporomandibular joint disorder". Many patients, in the early stages of illness, do not take it seriously and delay seeking medical treatment until it seriously affects their daily life. In fact, the earlier the intervention and treatment, the better the effect. ”Lu Hongyan explained that the temporomandibular joint is the "precise hub" of the body. As the only joint in the body that requires bilateral linkage, it is located in front of both ears and is a key structure connecting the mandible and skull. Whether it's opening and closing the mouth, chewing food, or speaking and singing, they all rely on the coordinated operation of this' living hinge '. Once functional abnormalities or structural damage occur in the temporomandibular joint, it may lead to temporomandibular joint disorder. It is not a specific disease, but a general term for a series of problems, mainly including three categories: one is chewing muscle dysfunction, peripheral muscle pain, spasms, and excessive chewing muscle function; The second type is joint structural disorder, such as disc displacement (such as meniscus displacement in the knee), joint capsule laxity, etc; The three types are organic joint lesions, such as osteoarthritis, joint bone hyperplasia, joint stiffness, etc. Temporomandibular joint disorder is mainly found in young and middle-aged people aged 20-40, with a incidence rate of 40%. If not intervened in a timely manner, it may also lead to other complications in severe cases, such as headaches, tinnitus, hearing loss, etc. There are multiple psychological and physiological factors that may harm the temporomandibular joint. Temporomandibular joint disorder is the result of the combined effects of multiple factors, including psychological, physiological, anatomical structure, trauma, and genetic factors. Psychological factors play an important role. Long term mental stress, anxiety, and pressure can lead to unconscious biting or grinding of teeth at night (night grinding). This unconscious action can cause the chewing muscles to be in an overly tense state for a long time, repeatedly pulling the temporomandibular joint, which can eventually cause joint damage. Occlusion factors, long-term unrepaired tooth loss, malocclusion such as "crooked teeth" or "overbite", or wearing inappropriate dental restorations can all lead to abnormal occlusion, forcing joints to adjust their positions to adapt and causing joint damage. Bad habits, such as chewing on one side frequently and liking to eat hard objects (such as gnawing on bones, opening bottle caps, chewing betel nuts, etc.), can put excessive pressure on the temporomandibular joint; Long term looking down at mobile phones and improper sleeping posture (such as sleeping with one side pressed against the face) may also indirectly interfere with the normal function of the temporomandibular joint by affecting the position of the cervical spine. Traumatic factors, such as facial trauma from a car accident, sudden biting of hard objects, or prolonged opening of the mouth, can directly damage joints. Other factors, such as autoimmune diseases, infections, and cold stimulation, may also trigger the occurrence of temporomandibular joint disorders. Most patients can significantly improve their symptoms through conservative treatment. Lu Hongyan said that the overall treatment principle for temporomandibular joint disorder patients is: simple first, then complex, conservative first, then invasive. Most patients can significantly improve their symptoms through conservative treatment alone. Firstly, prioritize prevention. Reduce stress on emotions, learn stress management, and relax through exercise, meditation, and cultivating hobbies and interests. Climbing mountains and taking walks in my spare time are good choices for relaxing both body and mind. Adjust your eating habits, eat less hard, tough, and bulky food, and learn to chew both sides in a balanced manner. Quit bad habits, avoid biting pencils and nails, and refuse to use teeth as tools to open bottle caps. Maintain the correct posture, avoid long-term bowing, and do more neck and jaw relaxation exercises during work breaks. Slightly separate the upper and lower teeth, close the lips, and lightly press the tongue against the upper jaw. Secondly, there is a tiered treatment approach, selecting the appropriate plan based on the condition. Basic treatment. Learn relevant popular science knowledge, understand the basic situation of the disease, and avoid exacerbating symptoms due to excessive fear and anxiety. Most temporomandibular joint disorders can be relieved through standardized treatment without excessive worry. Physical therapy involves relaxing the chewing muscles and relieving joint tension through local hot compress, professional massage, ultrasound therapy, and other methods; With the guidance of a doctor's oral training, normal mouth opening can be gradually restored. Jaw pad treatment, by wearing a jaw pad designed and made by a professional doctor, relieves nighttime grinding and muscle tension symptoms. medication. When the pain symptoms are obvious, non steroidal anti-inflammatory drugs (such as ibuprofen, topical Voltaren ointment, etc.) can be taken under the guidance of a doctor to relieve pain and inflammation. For those with severe spasms in the chewing muscles, muscle relaxants can be used under the guidance of a doctor to relieve muscle spasms. For patients with severe local pain and poor drug efficacy, local blockade treatment can be performed by a doctor. Minimally invasive and surgical treatment. Joint cavity irrigation is suitable for patients with fluid accumulation and inflammation in the joint, and removes inflammatory substances in the joint through irrigation. Surgical treatment, including arthroscopic minimally invasive surgery and open surgery, is only used for patients with ineffective conservative treatment and severe joint structure damage (such as joint stiffness and severe disc displacement), and should be evaluated by professional doctors before making a decision. Life tips: how to protect the temporomandibular joint in acute stage: when joint pain and difficulty in opening mouth are obvious, soft food such as Congee, noodles, yogurt, etc. should be the main diet to reduce the number of chewing; Apply warm towels to the joint area multiple times a day for 15-20 minutes each time to promote local blood circulation; Avoid actions such as opening your mouth wide, and gently support your chin with your hand when yawning to prevent excessive joint pulling. Daily maintenance points: It is recommended to regularly practice relaxing the lower jaw, maintain a 2-3mm gap between the upper and lower teeth, and avoid prolonged biting of the teeth; Slowly perform opening and closing exercises within the painless range, gradually restoring the function of opening the mouth, but the movements should be gentle and avoid forcing; Pay attention to keeping your neck and face warm in cold weather, and avoid direct cold air blowing on joints and other areas. Once the following situations occur, it is necessary to seek medical attention promptly at a dental hospital or temporomandibular joint specialist clinic: joint clicking accompanied by severe pain, significant reduction in opening angle (less than the width of two fingers), joint jamming and inability to move when the mouth is long closed, or facial asymmetry. The prognosis of temporomandibular joint disorder is good, and patients do not need to be afraid or overly anxious. At the same time, it can reduce the "subconscious self inspection" of the temporomandibular joint. (New Society)