Temporomandibular joint (TMТ) disorders are disorders of the structures within the joint. The latter can be bones, cartilage, ligaments and intra-articular structures that are highly innervated.

TMJ disorders can occur as a result of hormonal problems, problems with the bite, teeth, muscles, or the posture of the entire body.

They can be treated successfully and in not so many different ways, dentist Dr Manol Ivchev, one of the top specialists in our country and in the world in TMJ disorders, says.

Different philosophies around the world: surgery, medications, symptomatic treatment

“There are different approaches according to the different philosophies in the world – surgical and non-surgical. I personally absolutely prefer non-surgical protocols, Dr Ivchev adds.

Surgical protocols are the so-called open surgery in which the joint is opened, the damaged structure is moved, sutured in the appropriate place and some kind of joint recovery is expected.

Very often, symptomatic treatment is also resorted to. My issue with this is that if the problem that caused the joint condition is not treated, the disorder recurs.”

There are philosophies of following drug therapy and they are very popular in the USA. Medications are taken to nourish the joint itself. This is also something that I personally do not prefer in my practice. I dare say that my patients successfully treat their temporomandibular conditions without medication.”

Conservative approaches: splints

A so-called conservative approach – with splints – also exists. A splint is designed to help the patient hold their lower jaw in a new position, and not in the usual bite position. This should result in muscle relaxation and regeneration of the joint itself. When a splint is used, it is possible that the symptoms will disappear, but there is also a high possibility that after the symptoms disappear, the joint itself will not begin to regenerate.

In other words, some of the existing philosophies are limited to the treatment of muscle pain, others – to the treatment of the intra-articular problem. “In my practice at, we cover all aspects of disorders of the jaw muscles and the temporomandibular joint. What I strive for is to treat not the symptoms, but the cause,” Dr Ivchev says.

Muscle pain can be treated conservatively through the so-called splints, through medications (painkillers), which I do not prefer, but it can also be treated with electrical stimulation – something I prefer to use in my practice, as well as with photobiomodulation and laser therapy, the dental specialist says.

Holistic Approach

It is very important that the treatment of muscle pain occurs in parallel with the treatment of the cause of the problem. Muscle pain is in most cases a consequence of another problem, localised elsewhere. That is why we need to target the pain and bring relief to the patient, but at the same time it is necessary to find the cause of the pain and treat it. In most cases, it is in the bite and in poor contacts between the teeth.

What are the symptoms

       Here are some of the symptoms characteristic of TMJ disorders. It should be made clear that these disorders can manifest themselves in a variety of ways and with symptoms that are sometimes in other parts of the body and at first glance would not be related to the oral cavity and the jaw joint. The presence of one or more symptoms does not mean that you suffer from a TMJ condition. This diagnosis can only be made by a specialist after a comprehensive examination and tests.

●  Jaw pain and/or tenderness. One of the most common symptoms. The pain often radiates to the face, neck, and shoulders. It usually worsens when chewing, speaking, or yawning.

●  Popping, grinding or clicking in the jaw. Another common symptom. Sometimes accompanied by pain, but it may be just a sound. It should not be ignored, as it is a sign of misalignment of the disc that moves the jaw.

●  Limited jaw movement. Locked jaw. Blocking of the mouth in an open or closed position – complete or partial.

●  Headache, facial pain. Long-lasting, chronic pain caused by improper function of the jaw muscles.

●  Ear problems – tinnitus (ringing, buzzing), feeling of fluid in the ear, impaired hearing, pain.

●  Changes in the bite.

Do not hesitate to seek advice from a specialist if you suspect a problem in the temporomandibular joint. Timely diagnosis facilitates and shortens treatment, and contributes more rapidly to the patient’s quality of life.