Jaw Joint Cartilage Wear and Its Impact on Dental Health - Dentistry

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Cartilage wear in the temporomandibular joint (TMJ) of the left and right mandible?


I don't know when it started, but for at least a few years now, I've been experiencing a clicking sensation in my cheeks when I open and close my mouth.
Recently, I've noticed that my upper and lower teeth seem to be gradually misaligned, with the upper row shifting to the left and the lower row to the right.
A doctor I consulted mentioned that my bite is misaligned and that my upper teeth are slightly protruding and leaning to the left.
Because of this, only my back teeth are making contact when I bite down.
My facial shape seems fine, but for the past few years, I've been experiencing mild pain in various areas, which usually resolves on its own after a few days.

Since the beginning of this year, I've had persistent mild itching and pain in my lower left back tooth, which sometimes becomes a bit more pronounced, resembling an inflamed sore, but it doesn't hurt directly.
I'm not sure which tooth it is.
In the last two months, my upper left back tooth has also started to hurt slightly, but it feels normal when not acting up.
Today, I visited a medical center for a dental check-up and underwent several examinations.
The dentist said my teeth and gums are normal but suspects it might be a muscle issue.

I also mentioned to the doctor that a previous scan of my face and X-rays indicated that the cartilage between my upper and lower jaws is almost completely worn down, which is unusual for someone my age of 34.
Additionally, I have four upper front teeth that underwent root canal treatment but did not receive crowns, which complicates the cartilage issue.
I have now decided to get fixed crowns for my four upper front teeth.
Both the hospital and clinic dentists agreed that all four teeth need to undergo root canal treatment again.
My upper front teeth typically don't hurt, but occasionally I feel a slight pain when I breathe in or rinse my mouth, likely because a previous dentist didn't clean them out completely 20 years ago.

Now, there isn't much tooth structure left, and all of them will need posts.
I would like to ask what treatments would be best to pursue after getting crowns for my front teeth.
I forgot to mention that I've been under continuous stress throughout my life, which has led to significant teeth grinding.
Thank you.

Li Qiuqiu, 30~39 year old female. Ask Date: 2020/09/04

Dr. Lin Jiayong reply Dentistry


Hello: Based on what you have described, the fundamental issue lies with the cartilage of the temporomandibular joint (TMJ).
It is recommended that you first visit a larger medical center to consult with an oral surgeon regarding the joint issue, after which you can proceed with further treatments such as dentures or orthodontic adjustments.
Thank you and wishing you good health.
Sincerely, Dr.
Lin Chia-Yung, Department of Dentistry, Taichung Hospital.

Reply Date: 2020/09/04

More Info


Understanding jaw joint cartilage wear and its impact on dental health is crucial, especially for individuals experiencing discomfort or misalignment in their teeth and jaw. The symptoms you describe, such as clicking sounds when opening and closing your mouth, discomfort in various areas of your jaw, and the gradual misalignment of your teeth, suggest that you may be dealing with temporomandibular joint (TMJ) dysfunction or other related issues.

The TMJ connects your jawbone to your skull and is responsible for the movement of your jaw. Over time, factors such as grinding your teeth (bruxism), stress, and misalignment can lead to wear and tear on the cartilage within the joint. This wear can result in inflammation, pain, and a limited range of motion. The fact that you have been experiencing these symptoms for several years indicates that the issue may be chronic, and it is essential to address it to prevent further complications.

The wear of the cartilage can lead to a condition known as osteoarthritis, which can exacerbate the pain and discomfort you are experiencing. When the cartilage wears down, the bones may rub against each other, leading to inflammation and pain. This can also affect your bite, causing your teeth to shift and misalign over time, as you've noted with your upper and lower teeth not aligning correctly.

Regarding your dental health, the decision to undergo root canal treatment and place crowns on your anterior teeth is a significant step. Given that you have a history of root canal treatments that may not have been entirely successful, it is crucial to ensure that the new treatment is thorough. The crowns will help protect the remaining tooth structure and restore function, but it is also essential to address the underlying issues contributing to your TMJ dysfunction.

After completing the treatment for your anterior teeth, consider the following steps to maintain your dental health and manage your TMJ issues:
1. Follow-Up Care: Regular follow-ups with your dentist are essential to monitor the condition of your teeth and jaw. This will help ensure that any issues are addressed promptly.

2. Stress Management: Since you mentioned experiencing significant stress, finding effective stress management techniques can help reduce teeth grinding and jaw clenching. Techniques such as mindfulness, meditation, or even physical exercise can be beneficial.

3. Physical Therapy: Consult with a physical therapist who specializes in TMJ disorders. They can provide exercises to strengthen the jaw muscles and improve flexibility, which may alleviate some of the discomfort you are experiencing.

4. Orthodontic Evaluation: After your crowns are placed, consider consulting an orthodontist to evaluate your bite and alignment. They may recommend treatments to correct any misalignment, which can help alleviate pressure on the TMJ.

5. Mouthguards: If bruxism is a concern, a custom-fitted mouthguard can protect your teeth from grinding during sleep and reduce strain on the jaw.

6. Dietary Adjustments: Eating softer foods can help reduce the strain on your jaw while it heals. Avoiding hard or chewy foods may also prevent exacerbating any discomfort.

7. Pain Management: Over-the-counter pain relief medications may help manage discomfort, but consult your healthcare provider for recommendations tailored to your situation.

In conclusion, addressing the wear of the jaw joint cartilage and its impact on your dental health requires a comprehensive approach that includes dental treatment, stress management, and possibly physical therapy. By taking proactive steps, you can improve your overall dental health and alleviate the discomfort associated with TMJ dysfunction. Always consult with your healthcare providers to develop a personalized treatment plan that suits your specific needs.

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