Dr. my right ear has been hurting for a few days and this is the first time I have had this discomfort. could it be otitis?
This is a frequent question that patients ask a doctor. The doctor explores the patient and determines that it is not otitis, although the discomfort or pain is located in front of the ear canal and increases when palpating or pressing the area, even extending to the face. There is also discomfort when opening and closing the mouth, sometimes with clicking in the painful area. The doctor informs the patient that it is not otitis, but Temporomandibular Joint, so you have to visit the specialist in Oral and Maxillofacial Surgery.
The Temporomandibular Joint is a joint that allows opening and closing the mouth like a hinge but more complex. “Temporo” because the fixed part is in the temporal bone of the skull and “Mandibular” because the mobile part is in the jaw.
Why does the Temporamandibular Joint hurt?
The Temporamandibular Joint hurts because it is forced to work more than it should and to do it in bad conditions, although the patient is not aware of this situation. This excessive work is unconscious and is known as bruxism; it consists of clenching or grinding the teeth.
Bruxism
Bruxism forces the joint, which theoretically acts as a guide for jaw movements, to work as a load-bearing joint; like the knee, for example. The Temporomandibular Joint is not designed for this and as a result there is a progressive deterioration of its structures, the bony parts, the articular disc, the articular sleeve or capsule and the masticatory musculature.
Bruxism cannot be cured, but its intensity and frequency can be reduced. To improve this situation, it is necessary to act on the stimuli that trigger it, which are mainly negative emotional situations, which unfortunately are many.
Also, these stimuli can be triggered by defects in the structure of the oral area, mainly:
- Missing teeth
- teeth that are too many
- Badly positioned teeth
- Jaw jaws are not the right size.
The defects of the structure of the buccal area can be solved with prosthesis, surgeries, orthodontics or with a frequently used and very effective resource, which is the unloading or rest splint.
Treatment of bruxism
To find the appropriate treatment for bruxism in each patient, it is important to study the patient’s complete medical history and perform a thorough examination. The latter must be accompanied by relevant radiological and laboratory studies, CT scans, MRI, X-rays, molds or models of the teeth, among others.