DISEASE NAME: TEMPOROMANDIBULAR JOINT DISORDER

DESCRIPTION:
The temporomandibular joint (TMJ) is the joint that connects your mandible (lower jaw) to your
skull. The joint can be found on both sides of your head in front of your ears. It allows your jaw
to open and close, enabling you to speak and eat.

Temporomandibular joint (TMJ) syndrome is a disorder of the jaw muscles and nerves caused
by injury or inflammation to the temporomandibular joint.

CAUSE:

In many cases, it’s not known what causes a TMJ disorder. Trauma to the jaw or joint may play
a role. There are also other health conditions that may contribute to the development of TMJD.
These include:

 arthritis

 erosion of the joint

 habitual grinding or clenching of the teeth

 structural jaw problems present at birth

SYMPTOMS

The symptoms of TMJ disorders depend on the severity and cause of your condition. The most
common symptom of TMJD is pain in the jaw and surrounding muscles. Other symptoms
typically associated with these disorders include:

 pain that can be felt in the face or neck

 stiffness in the muscles of the jaw

 limited movement of the jaw

 locking of the jaw

 clicking or popping sound from the TMJ site

  shift in the jaw, changing the way that the upper and lower teeth align
(called malocclusion)

TREATMENT:
In some cases, the symptoms of TMJ disorders may go away without treatment. If your
symptoms persist, your doctor may recommend a variety of treatment options, often more
than one to be done at the same time.
Medications

Along with other nonsurgical treatments, these medication options may help relieve the pain
associated with TMJ disorders:

 Pain relievers and anti-inflammatories. If over-the-counter pain medications aren't

enough to relieve TMJ pain, your doctor or dentist may prescribe stronger pain relievers
for a limited time, such as prescription strength ibuprofen.

 Tricyclic antidepressants. These medications, such as amitriptyline, are used mostly for

depression, but in low doses, they're sometimes used for pain relief, bruxism control and
sleeplessness.

 Muscle relaxants. These types of drugs are sometimes used for a few days or weeks to
help relieve pain caused by TMJ disorders created by muscle spasms.

Therapies

Nondrug therapies for TMJ disorders include:

 Oral splints or mouth guards (occlusal appliances). Often, people with jaw pain will
benefit from wearing a soft or firm device inserted over their teeth, but the reasons why
these devices are beneficial are not well-understood.

 Physical therapy. Along with exercises to stretch and strengthen jaw muscles,

treatments might include ultrasound, moist heat and ice.

 Counseling. Education and counseling can help you understand the factors and
behaviors that may aggravate your pain, so you can avoid them. Examples include teeth
clenching or grinding, leaning on your chin, or biting fingernails.
Surgical or other procedures

Arthrocentesis Open pop-up dialog box

When other methods don't help, your doctor might suggest procedures such as:

 Arthrocentesis. Arthrocentesis (ahr-throe-sen-TEE-sis) is a minimally invasive procedure

that involves the insertion of small needles into the joint so that fluid can be irrigated
through the joint to remove debris and inflammatory byproducts.

 Injections. In some people, corticosteroid injections into the joint may be helpful.
Infrequently, injecting botulinum toxin type A (Botox, others) into the jaw muscles used
for chewing may relieve pain associated with TMJ disorders.
  TMJ arthroscopy. In some cases, arthroscopic surgery can be as effective for treating
various types of TMJ disorders as open-joint surgery. A small thin tube (cannula) is placed
into the joint space, an arthroscope is then inserted and small surgical instruments are
used for surgery. TMJ arthroscopy has fewer risks and complications than open-joint
surgery does, but it has some limitations as well.

 Modified condylotomy. Modified condylotomy (kon-dih-LOT-uh-mee) addresses the TMJ

indirectly, with surgery on the mandible, but not in the joint itself. It may be helpful for
treatment of pain and if locking is experienced.

 Open-joint surgery. If your jaw pain does not resolve with more-conservative treatments
and it appears to be caused by a structural problem in the joint, your doctor or dentist
may suggest open-joint surgery (arthrotomy) to repair or replace the joint. However,
open-joint surgery involves more risks than other procedures do and should be
considered very carefully, after discussing the pros and cons.

DISEASE NAME: ORAL CANCER or MOUTH CANCER

DESCRIPTION: Cancer is defined as the uncontrollable growth of cells that invade and cause
damage to surrounding tissue. Oral cancer is cancer that develops in the tissues of the mouth or
throat. It belongs to a larger group of cancers called head and neck cancers. Most develop in
the squamous cells found in your mouth, tongue, and lips. Oral cancer, which includes cancers of
the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx (throat),
can be life threatening if not diagnosed and treated early.

CAUSE:

 Smoking. Cigarette, cigar, or pipe smokers are six times more likely than nonsmokers to
develop oral cancers.
 Smokeless tobacco users. Users of dip, snuff, or chewing tobacco products are 50 times
more likely to develop cancers of the cheek, gums, and lining of the lips.
 Excessive consumption of alcohol. Oral cancers are about six times more common in
drinkers than in nondrinkers.
 Family history of cancer.
 Excessive sun exposure, especially at a young age.
 Human papillomavirus (HPV). Certain HPV strains are etiologic risk factors for
Oropharyngeal Squamous Cell Carcinoma (OSCC).
DIAGNOSIS:
Tests and procedures used to diagnose mouth cancer include:

 Physical exam. Your doctor or dentist will examine your lips and mouth to look for
abnormalities — areas of irritation, such as sores and white patches (leukoplakia).

 Removal of tissue for testing (biopsy). If a suspicious area is found, your doctor or
dentist may remove a sample of cells for laboratory testing in a procedure called a biopsy.
The doctor might use a cutting tool to cut away a sample of tissue or use a needle to
remove a sample. In the laboratory, the cells are analyzed for cancer or precancerous
changes that indicate a risk of future cancer.

Determining the extent of the cancer

Leukoplakia Open pop-up dialog box

Once mouth cancer is diagnosed, your doctor works to determine the extent (stage) of
your cancer. Mouth cancer staging tests may include:

 Using a small camera to inspect your throat. During a procedure called endoscopy,

your doctor may pass a small, flexible camera equipped with a light down your throat to
look for signs that cancer has spread beyond your mouth.

 Imaging tests. A variety of imaging tests may help determine whether cancer has
spread beyond your mouth. Imaging tests may include X-ray, CT, MRI and positron
 emission tomography (PET) scans, among others. Not everyone needs each test. Your
doctor will determine which tests are appropriate based on your condition.

SYMPTOMS:

TREATMENT:

Treatment options include surgery, radiation and chemotherapy.

Oral Surgery

Surgery for mouth cancer may include:

 Surgery to remove the tumor. Your surgeon may cut away the tumor and a margin of
healthy tissue that surrounds it to ensure all of the cancer cells have been removed.
Smaller cancers may be removed through minor surgery. Larger tumors may require
more-extensive procedures. For instance, removing a larger tumor may involve removing
a section of your jawbone or a portion of your tongue.

 Surgery to remove cancer that has spread to the neck. If cancer cells have spread to
the lymph nodes in your neck or if there's a high risk that this has happened based on the
size or depth of your cancer, your surgeon may recommend a procedure to remove lymph
nodes and related tissue in your neck (neck dissection). Neck dissection removes any
cancer cells that may have spread to your lymph nodes. It's also useful for determining
whether you will need additional treatment after surgery.

 Surgery to reconstruct the mouth. After an operation to remove your cancer, your

surgeon may recommend reconstructive surgery to rebuild your mouth to help you regain
the ability to talk and eat. Your surgeon may transplant grafts of skin, muscle or bone from
other parts of your body to reconstruct your mouth. Dental implants also may be used to
replace your natural teeth.
ORAL CANCER