Lockjaw
In contrast to lockjaw, where the opening of the mouth is obstructed, it is not possible to close the jaw completely with a lockjaw. The teeth cannot bite each other completely again. The causes can be arthrosis or acute arthritis, i.e. problems with the jaw joint.
The most common reason is a jaw dislocation. This means a dislocation of the lower jaw. Since at least one joint head has slipped forward in the dislocation, it is purely physiologically impossible to close the mouth completely.
In some patients, this occurs more frequently, almost “usually”. This is known as a habitual jaw dislocation. With the help of the Hippocrates handle, the dentist can set the jaw back in place.
It looks like this: the dentist stands behind the patient, grasps the lower jaw with both hands, right and left. The thumbs are placed at the bottom of the teeth or bone. The lower jaw is pulled forward and down.
This allows the joint heads to slide back into their joint pit through the ligaments and muscles. As therapy, a joint centric splint can be made. It holds the lower jaw in this position, in which the joint is located exactly in the middle. This allows the joint capsule to recover and any inflammation to heal.
Innervation
The above-mentioned muscles and the temporomandibular joint are all supplied by the mandibular nerve, which is the third branch of the trigeminal nerve.
Vessels
The maxillary artery runs behind the ramus mandibularis and supplies the lower jaw (mandible), the upper jaw (maxilla), and the chewing muscles with arterial blood.Most of the venous blood flows into the maxillary vein via the pterygoid plexus, which lies below the mandibular ramus. The maxillary vein merges into the retromandibular vein, which then flows into the internal jugular vein.
Jaw Pain
Pain in the jaw can have various causes. Usually the temporomandibular joint is the trigger, but often also the muscles or radiating pain from the tooth area or the maxillary sinus. The causes of jaw pain caused by the jaw muscles include tension, but also overstretching or injuries.
If pain in the jaw is caused by the temporomandibular joint, the cause is usually trauma, injury, overstretching or incorrect loading (e.g. due to ill-fitting dentures, orthodontic malposition of the teeth or gap dentition with unphysiological loading). In some cases, an inflammation in the temporomandibular joint or arthrosis may also be the cause. In addition, jaw pain often occurs when the wisdom teeth break through and may not find their place, but infections in the ear, nose and throat area can also project onto the jaw.
Back pain (especially in the neck area), hip malpositions and the resulting tilting of the head or incorrect weight bearing are also associated with jaw pain. These described symptoms should be clarified by the appropriate specialist. The most common cause of pain in the jaw (joint and musculature), however, is clenching or grinding of teeth (bruxism).
If the symptomatology is due to bruxism, most patients describe the increased occurrence of the complaints when waking up in the morning. The reason for this is the reduction of stress at night through clenching and grinding of teeth. Often this leads to an enormous noise level and lack of sleep of the life partner, who usually notices the problem before the patient himself.
Doctors use the term “CMD” (Craniomandibular Dysfunction) for this. Various questionnaires, analyses and x-rays are used to make a diagnosis. Often several symptoms occur together: Bruxism is associated with tinnitus and severe headaches.
Therapeutically, crunch splints/bite splints are usually used. An alternative is “Myofunctional Therapy”, a special functional therapy by a physiotherapist, which also relieves muscular tension. Drug therapies (such as muscle relaxants) should only be used in short-term therapy.
Autogenic training and self-massage, orthodontic or prosthetic therapy for malpositioned teeth and loss of tooth substance may also be indicated. In case of a prosthetic realignment of the bite situation, the adaptation of the surrounding structures to the new situation must always be considered and tested. Various measurements, up to the joint path measurement with special electrical sensors, can be necessary. Jaw pain rarely occurs even after long-term dental treatment. In this case, the masticatory apparatus is overstretched due to the prolonged stay, but after some waiting time, it regulates itself again.
