Univ.-Prof. Dr. Dr. Gerhard Undt
Specialist for TMJ (temporomandibular joint) disorders, TMD, facial pain and salivary gland diseases

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Which temporomandibular joint is under strain if you generally chew on one side?

If you avoid chewing on one side, because of toothache, for instance - the temporomandibular joint on that side is placed under increasing and unphysiological strain. So if you only ever chew on the right, the left temporomandibular joint responds by dysfunctioning.

What happens if the molars are lost on one side of the maxilla or mandible (upper or lower jaws)?

This is then referred to as a lack of molar support. This means that the temporomandibular joint on this side is under great strain when the teeth are clenched or if the patient is chewing.

Is chewing gum harmful for the temporomandibular joint?

Yes it is. Excessive chewing not only places strain on the joint but also on the masticatory muscles. If one of the temporomandibular joints is already damaged, you should avoid chewing gum altogether.

I have had over 6 months of physiotherapy without success, and have also been treated with muscle relaxants without lasting success. My chewing muscles are still tense and painful.

The next step would be to relax the most severely affected masticatory muscles by injecting Botulinum Toxin A (Botox).

Can problems with the temporomandibular joint not only be improved but worsened by orthodontic  treatment?

It is possible that new dental contacts from orthodontic movements of the teeth can cause bruxism (teeth grinding). This places the temporomandibular joints and the masticatory muscles under strain and these may in turn respond with pain.

What is the success rate of arthroscopic temporomandibular surgery?

Large-scale international studies show the success rate to be in the region of 90%.


Why do only a small number of centers offer minimally invasive temporomandibular joint surgery?

In contrary to open TMJ surgery, it takes many years of intensive training to learn minimally invasive techniques in TMJ surgery. The surgeon then has to maintain his skills by continuous training. For these reasons, there is only a small number of specialists who are able to perform these techniques safely.

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