Let us fix your ‘door hinges’

Let us fix your ‘door hinges’

By: Dr. Goh Yet Ching, Assoc. Prof. Dr. Kathreena Kadir

The temporomandibular joint (TMJ), often likened to a door hinge, serves as the link between the jaw and the skull. Structurally, it consists of the temporal bone of the skull and the mandible, or lower jaw, with a disc of cartilage that cushions the interaction between these two components. When one considers the TMJ in its entirety, the striking resemblance to a door hinge becomes evident.

The hinge-like mechanism of the TMJ facilitates fundamental oral functions, akin to how a hinge enables the smooth operation of a door. Just as a hinge allows for the controlled movement of a door, the TMJ permits the lower jaw to perform essential actions such as chewing and speaking. Moreover, the joint’s design and smooth articulation enable the mandible to move in a manner that is both precise and adaptable, much like a well-constructed door exhibiting seamless motion when opened and closed.

The movement of the door will require a manpower to swing the door hinge. The door hinge and manpower are considered as a whole system that function together. In essence, the door hinge resembles the TMJ whereas the manpower are the muscles surrounding the joint. Any malfunction related to the door hinge and manpower will result in improper movement of the door itself. The door creaks or becomes stuck. Likewise, any problem related to the TMJ and the associated muscles will lead to dysfunction of the TMJ, causing pain and clicking sounds at the jaws. That is the concept of Temporomandibular Disorders (TMD).

This parallel between the TMJ and the muscles with a door hinge and the manpower serves as a powerful visual aid, allowing us to appreciate the significance of this joint in their day-to-day lives.

What makes the TMJ and the surrounding muscles particularly fascinating is its dual nature – it not only facilitates essential functions but can also be a source of discomfort. Pain arising from the TMD can be quite debilitating, and what exacerbates the issue is the potential overlap with other causes of facial pain. The multifaceted nature of facial pain necessitates a comprehensive approach to diagnosis. Often, the journey to find the root cause of facial pain involves visiting multiple specialists, each contributing their expertise. However, this approach can be cumbersome, time-consuming, and ultimately exacerbate the patient’s suffering.

Recognizing this challenge, our institution took a proactive step in 2019 by establishing a dedicated multidisciplinary clinic at the Faculty of Dentistry to address facial pain related to TMD. The clinic brings together experts in restorative dentistry, orthodontics, oral medicine, and oral maxillofacial surgery, forming a unified team with the singular goal of diagnosing and alleviating TMD-related facial pain. This collaborative effort serves as a beacon of hope for those grappling with the distressing symptoms caused by TMD issues.

By assembling a team of specialists under one roof, the clinic aims to streamline the diagnostic process, sparing patients the ordeal of navigating between various experts. This not only expedites the identification of the underlying cause but also ensures a holistic approach to treatment. With a multidisciplinary team on hand, patients need not endure prolonged pain or feel despondent due to the protracted diagnostic journey. This collective expertise is akin to being the “fixers of your hinges,” working diligently to restore the TMJ’s function and alleviate associated discomfort.

The significance of this multidisciplinary approach cannot be overstated. It represents a paradigm shift in the management of TMD-related issues, offering a ray of hope for individuals grappling with inexplicable facial pain. The clinic’s establishment signifies a commitment to providing comprehensive care, acknowledging the complex nature of TMD and the need for a cohesive, collaborative approach to address it.

Moreover, this initiative underscores the importance of integrating various disciplines to tackle healthcare challenges effectively. Bridging the gap between different specialties, this approach emphasises the collective wisdom of diverse expertise and fosters an environment where the whole is indeed greater than the sum of its parts. Understanding the intricacies of the TMD and its potential to cause distress requires a comprehensive approach that goes beyond traditional silos of medical practice.

In conclusion, the temporomandibular joint and the associated muscles, much like a humble door hinge and its manpower, quietly fulfils its duty until it becomes a source of discomfort. Acknowledging its important role and the potential pain it can cause, our institution’s proactive step to establish a dedicated multidisciplinary clinic serves as a testament to our commitment to comprehensive, patient-centric care. This unified approach not only expedites the diagnostic process but also brings together a wealth of expertise to provide holistic solutions.

It is a manifestation of our ethos – to be the fixers of your hinges, diligently working to restore function and alleviate distress.

The authors are from the Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya.


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