Friday 17 May 2013

TEMPOROMANDIBULAR JOINT DISORDERS

The temporomandibular joint (TMJ) is where the jaw bone is hinged on the skull. It is a sliding hinge type of joint and can easily be dislocated in some patients. A temporomandibular joint disorder refers to the situation when the patient feels pain around the jaw, difficulty chewing or locking of the jaw either in opened or closed position. Some patients may even experience clicking or grating sound of the jaw; when opening or closing the mouth. However if there is no pain then no further treatment is required.
The cause of TMJ disorder can be difficult to elicit. It can be due to various underlying factors such as  osteoarthritis of the joint, traumatic injury, habit of teeth grinding, jaw clenching, habit of munching on hard food such as peanuts, stress and chewing gum. An abnormal dental bite can also contribute to TMJ disorders.

Treatment options

  • Pain killers such as non-steroidal anti-inflammatory drugs such as mefenamic acid, diclofenac etc. However these painkillers should be taken with advice given by your doctor. Sometimes stronger painkillers are needed.
  • Muscle relaxants to help relax the jaw muscles which are often tensed up due to pain.
  • Sedatives may be needed for a short period of time
  • Oral splints especially those with nightime teeth grinding
  • Physiotherapy with heat or ice and even ultrasound can help ease the inflammation and pain
  • Surgical procedures are rarely needed but may be considered in some patients eg joint injection


Home care advice

Patients are advised to take soft diet or to cut up their foods into small pieces to reduce chewing; which can aggravate the acute TMJ problem.
Applying heat or ice to the side of the face may help with the pain
Jaw exercises aimed at relaxing the jaw muscles and yet strengthen them at the same time


HILANG DERIA BAU (HYPOSMIA)

Deria bau adalah salah satu fungsi hidung. Di kawasan langit hidung terdapat saraf-saraf halus (olfactory nerves) yang dapat menghasilkan deria bau. Molekul-molekul bau dari pelbagai punca dapat merangsang saraf-saraf halus tersebut.
Pesakit boleh mengalami masalah kurang deria bau sekiranya hidung sumbat atau kerosakan pada saraf deria bau tersebut. Masalah deria bau terbahagi kepada separa atau kurang deria bau (hyposmia) atau kehilangan seluruh deria bau (anosmia).
Kebanyakan pesakit yang mempunyai masalah deria bau juga mengalami masalah deria rasa. Ia seringkali berkaitan tetapi ada juga pesakit yang mempunyai masalah deria rasa tetapi deria bau adalah normal.

Sistem deria bau (olfaktori) manusia terletak di bahagian atap hidung. 


Punca-punca kurang deria bau

  • Alahan hidung (allergic rhintis)
  • Polip hidung
  • Radang pada sinus (rhinosinusitis)
  • Ketumbuhan atau tumor di dalam rongga hidung
  • Toksin seperti kokain, asap rokok
  • Radang pada saraf deria bau (olfactory nerve) yang disebabkan oleh jangkitan virus, sarcoidosis, Wegener's granulomatosis
  • Masalah endokrin seperti penyakit diabetes/kencing manis, tiroid etc
  • Trauma kepada kepala
  • Proses penuaan
  • Masalah degeneratif seperti Parkinson's disease, Alzheimers
  • Sindrom Kallman