Temporomandibular joint disorders (TMJ)

Temporomandibular joint and muscle disorders (TMJ disorders) are problems that affect the chewing muscles and joints that connect your lower jaw to your skull.

There are two matching temporomandibular joints on each side of your head. They are located just in front of your ears. The abbreviation "TMJ" refers to the name of the joint but is often used to mean any disorders or symptoms of this region.

Many people end up having "trigger points." These are contracted muscles in your jaw, head, and neck. Trigger points can refer pain to other areas, causing a headache, earache, or toothache.

Many of the home-care steps to treat TMJ problems can also help prevent the condition.

These steps include:
  • Avoid eating hard foods and chewing gum.
  • Learn relaxation techniques to reduce overall stress and muscle tension.
  • Maintain good posture, especially if you work all day at a computer. Pause often to change position, rest your hands and arms, and relieve stressed muscles.
  • Use safety measures to reduce the risk of fractures and dislocations.

For many people with temporomandibular joint disorders, the cause is unknown. Some causes given for this condition are not well proven. These include:

  • A bad bite or orthodontic braces
  • Stress and tooth grinding. Many people with TMJ problems do not grind their teeth, and many who have been grinding their teeth for a long time do not have problems with their TMJ joint. For some people, the stress associated with this disorder may be caused by the pain, as opposed to being the cause of the problem.
  • Poor posture can also be an important factor in TMJ symptoms. For example, holding the head forward while looking at a computer all day strains the muscles of the face and neck.

Other factors that may make TMJ symptoms worse include stress, poor diet, and lack of sleep.

Symptoms associated with TMJ disorders may be:
  • Biting or chewing difficulty or discomfort
  • Clicking, popping, or grating sound when opening or closing the mouth
  • Dull, aching pain in the face
  • Earache
  • Headache
  • Jaw pain or tenderness of the jaw
  • Locking of the jaw
  • Difficulty opening or closing the mouth

Other possible causes of TMJ-related symptoms include arthritis, fractures, dislocations, and structural problems present since birth.

 

You may need to see more than one medical specialist for your TMJ pain and symptoms. This may include a primary care provider, a dentist, or an ear, nose, and throat (ENT) doctor, depending on your symptoms.

You will need a thorough exam that involves:
  • A dental exam to show if you have poor bite alignment
  • Feeling the joint and muscles for tenderness
  • Pressing around the head to locate areas that are sensitive or painful
  • Sliding the teeth from side to side
  • Watching, feeling, and listening to the jaw open and shut
  • X-rays or MRI of the jaw

Sometimes, the results of the physical exam may appear normal.

Your doctor will also need to consider other conditions, such as infections, ear infections, or nerve-related problems and headaches that may be causing your symptoms.

 

Simple, gentle therapies are recommended first.
  • Learn how to gently stretch, relax, or massage the muscles around your jaw. Your doctor, dentist, or physical therapist can help you with these.
  • Avoid actions that cause your symptoms, such as yawning, singing, and chewing gum.
  • Try moist heat or cold packs on your face.
  • Learn stress-reducing techniques.
  • Exercising several times each week may help you increase your ability to handle pain.

Read as much as you can, as opinion varies widely on how to treat TMJ disorders. Get the opinions of several doctors. The good news is that most people eventually find something that helps.

Mouth or bite guards, also called splints or appliances, have long been used to treat teeth grinding, clenching, and TMJ disorders.

If conservative treatments do not work, it does not automatically mean you need more aggressive treatment. Use caution when considering nonreversible treatment method, such as orthodontics or surgery that permanently changes your bite.

Reconstructive surgery of the jaw, or joint replacement, is rarely required. In fact, studies have shown that the results are often worse than before surgery.

 

For many people, symptoms occur only sometimes and do not last long. They tend to go away in time with little or no treatment. Most cases can be successfully treated.

Some cases of pain go away on their own without treatment. TMJ-related pain may return again in the future. If the cause is nighttime clenching, treatment can be very tricky because it is a sleeping behavior that is hard to control.

Mouth splints are a common treatment approach for teeth grinding. While some splints may silence the grinding by providing a flat, even surface, they may not be as effective at reducing pain or stopping clenching. Splints may work well in the short-term, but could become less effective over time. Some splints can also cause bite changes if they are not fitted properly. This may cause a new problem.