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Temporomandibular Joint Disease

Temporomandibular Joint Disease or TMJ is a group of conditions that involve the temporaomandibuluar joints. These joints are located in front of each ear and connect the lower jaw bone to the skull. The temporomandibular joints allow sideward and up-and-down movements such as speaking, chewing food, biting and speaking. A person suffering from Temporomandibular joint disease has pain in the jaw and surrounding tissues that make movement painful. TMJ is also referred to as myofacial pain dysfunction and Costen's syndrome. Mandibular muscle tension caused due to stress can be a cause for TPD. Certain triggering factors for TMJ may be teeth grinding, teeth clenching, dental problems and high stress.


It is noticed that more women, especially in their childbearing years tend to be affected by TMJ than men. Some form of arthritis, hormones, autoimmune conditions and low-grade infections are thought to be the causes for Temporomandibular Joint Disease. There is a dull ache in the jaw joint and ears. Persons suffering from temporomandibular joint disease suffer headaches and pain in the neck, shoulder and back. They may find it difficult to open the mouth comfortably or notice locking of the jaw. Swelling is sometimes noticed on the sides of the face. There might be ear pain or ringing in the ears. These symptoms may last a few weeks.


A diagnosis of TMJ can be made after an examination of the cheek muscles for any neurological symptoms. The physician will check for any joint clicking sounds and assess the range of motion of the mandibular joints. Analgesics or NSAIDs are prescribed to reduce pain and discomfort. Muscle relaxants such as diazepam are used to reduce muscle spasms. Therapy such as massage, exercise and electrical stimulation can aid in improving the strength and motion of the mandibular joints. Dental therapy such as orthodontics can help in rectifying an abnormal bite and teeth misalignment. Cortisone injections are given to those who do not respond to any other treatment. Patients suffering temporomandibular joint disease can alleviate the pain and other symptoms by eating soft food, applying ice or moist heat and avoiding extreme jaw movements that can be painful. The jaw must be rested.

Actinomycosis

An acute bacterial infection that is caused by the bacteria acitnomyces, actinomycosis is a rare occurrence in humans. It is more prevalent in cattle. This disease is also called lumpy jaw as it most commonly affects the head and the neck of the affected. Commonly seen on the face, mouth, nose, lungs, neck and abdomen, in women it may show up in the pelvic area too. Though not contagious, it does spread gradually to infiltrate the body's tissues thus causing inflammation or swelling.


Actinomycosis causes sores in the soft tissues in the body. Inflammation of the affected area, formation of multiple abscesses and sinus tracts that discharge sulfur-like granules may also be noticed. This condition is more common in the tropical areas of the world. The condition may not be easily diagnosed but gets painful as it advances. Actinomycosis sets in the soft tissues of the body and if left untreated can affect the surrounding bones. The infected bone needs to be surgically removed.


The type of the disease is classified based on the location of the infection:

Oral cervicofacial actinomycosis: Infection in the tissues of the jaw, mouth or neck.

Pelvic actinomycosis: Infection develops in the pelvis, bacteria spreads from the female genitals to the pelvis.

Thoracic actinomycosis: Develops inside the lungs or the connected airways.

Abdominal actinomycosis: Develops in the abdomen when some food particle tears the tissues and allows the bacterium to penetrate into the deep tissues.

Symptoms vary depending on the type of actinomycosis. Commonly reported symptoms include locked jaw, lump in the face or neck, weight loss, chest pain, draining sores on the skin, fatigue, stomach pain and abnormal vaginal discharge.


Cause of actinomycosis

Actinomycosis is caused by a bacterium that lives in the nose and the throat, this bacterium does not cause an infection on its own. It combines with other bacteria that enter the body to cause the infection. In the initial stages this condition is often mistaken as a fungal infection. In general the bacteria may get active along with other bacteria to cause this condition if a person has:


  • A weak immune system caused by other illness or diseases.

  • Neglected dental care after a dental surgery procedure; oral abscess is a major cause for this condition.

  • Is malnourished.

  • Women with an intrauterine device are also considered to be at high risk as the IUD can be a possible cause for the infection to spread.

Diagnosis of the condition is done by


  • Studying the fluid or the tissue sample of the area for the bacteria/infection.

  • Studying the abscess for red or purple color.

  • Reviewing the patients history for the spread/migration of bacteria.

Treatment for actinomycosis includes high doses of penicillin, antibiotics, medical draining of the infected area and removal of the IUD, if that has been the cause for the infection.


Sinusitis

When your sinuses (air chambers in the bone behind your cheeks, eyebrows and jaw) are inflamed or infected, it leads to sinusitis. The different sinus areas are:


Frontal sinus – on the brow area
Maxillary sinuses – inside each cheekbone
Ethmoid sinuses – behind the nose bridge and between the eyes
Sphenoid sinuses – behind the ethmoids in the upper region of the nose


When the sinuses are blocked, the mucus is not sufficiently drained thereby leading to sinusitis. Sinusitis occurs when trapped air lays pressure and causes pain in the sinus regions. Typically, sinusitis follows a cold or respiratory ailment. The increased mucus and fungal production leads to inflammation in the nasal passage. Often a structural defect in the nasal cavity or weakened immune system can be the cause for a sinus attack. Allergic rhinitis can bring on an attack of sinusitis. The symptoms and pain associated with sinusitis depend on the affected sinus. Damp weather, environmental pollutants and asthma often lead to sinus attacks. This inflammation is usually the result of a viral infection, an allergy (pollen, dust, pet dander, molds, and food), or an environmental irritant such as air pollution, perfume or cigarette smoke. Persons suffering from chronic inflammation of the nasal passages have an increased risk of suffering sinusitis. Swimming, diving, nasal polyps, smoking or alcohol consumption can lead to blocked sinuses. Air travel is yet another possible trigger.


Acute sinus infection lasts for about a fortnight whereas chronic sinus infection festers longer, for months or years. Most affected persons tend to suffer from acute sinus infection. Typical symptoms of sinus infection:


  • Pain over frontal sinuses
  • Headache
  • Swelling of eyelids or tissues around the eyes
  • Earache
  • Neck pain
  • Stuffy nose
  • Facial tenderness
  • Bad breath
  • Ache in the upper teeth
  • Nasal congestion

Blood tests and cultures aid in diagnosing and detecting bacterial or fungal infections. Acute sinusitis is treated with antibiotics to control the bacterial infection. Decongestants and painkillers can provide relief to those suffering from sinus infection. On the other hand, chronic sinusitis may need to be treated with steroid nasal sprays. But prolonged use of such products are not without side-effects. Allergies and infections that contribute to the sinus infection must be appropriately treated. Children suffering from chronic sinus infection are treated with removal of adenoids. Functional endoscopic sinus surgery is performed on severe cases of chronic sinusitis where the natural openings of the sinuses are dilated to allow drainage of accumulated mucus.


Home remedies for treating sinus infections
1. Steam inhalation
2. Gentle warm compress on painful area
3. Use of electrostatic filters attached to heating and air conditioning equipment
4. Saline nasal spray
5. Rest with your head elevated to help drain your sinuses
6. Drink plenty of fluids and warm liquids in order to thin mucus

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Collection of Pages - Last revised Date: September 23, 2019