TMJ Disorders

Overview

Temporomandibular joint disorders (often called TMD) are painful conditions of the jaw joint and muscles of the head and neck. The temporomandibular joints (TMJ) connect the lower jaw (mandible) to the temporal bones, and their hinge-like function is temporomandibular jointessential in activities such as chewing, talking, and swallowing.

TMJ disorders are very common problems, which occur more frequently in women than men. Although some types of TMJ disorders result in severe symptoms, most cases are mild and resolve with self-care or minimal treatment.

Causes

Temporomandibular joint disorders may result from problems with the muscles and soft tissues around the joint or problems within the joint itself. Often, though, the specific cause of an individual’s TMJ disorder is unclear.

  • Muscle painSome cases of TMJ disorders are attributed to muscle tension and stress. Habits such as teeth clenching and grinding may result in muscle soreness, muscle spasms, and pain.
  • Jaw joint issuesTMJ disorders can result from displacement of the soft disc, termed an articular disc, inside the temporomandibular joint itself. This disc is a cushioning material within the joint that normally absorbs shock during chewing. Jaw trauma, injury, or dislocation can lead to a TMJ disorder.
  • illustration of articular discArthritisArthritis is a joint disease that causes joint inflammation throughout the body, including the temporomandibular joints.

Symptoms

The symptoms of TMJ disorders are often mild and typically come and go over a period of time. Most individuals experience short-term problems, although, some individuals develop persistent or severe pain.

The following are the most common symptoms associated with TMJ disorders:

  • Pain in the jaw and muscles of the face and neck
  • Headache
  • Earache
  • Clicking or popping noises in the jaw joint
  • Jaw stiffness
  • Difficulty opening the mouth (jaw locking)
  • Difficulty eating and swallowing
  • Difficulty talking.

Diagnosis and Treatment

Clinicians diagnose TMJ disorders based on a patient’s history, symptoms, and physical examination. Occasionally, x-rays are used to provide an image of the jaw and neck. Computerized tomography or magnetic resonance imaging are additional studies, which provide highly detailed images of the bones and soft tissues.

Most TMJ problems are temporary and resolve spontaneously with little or no treatment. For mild joint pain, self-care and conservative treatments are often very effective.

Treatment of minor TMJ disorders

  • Resting the jaw joint
  • Ice pack applied to jaw
  • Soft diet
  • Stress reduction
  • Physical therapy and jaw exercises
  • Pain medications.

Treatment of severe or chronic TMJ disorders

  • Bite guards (stabilization splints), plastic devices placed between the upper and lower jaw, help reduce clenching and grinding.
  • Corticosteroid medication, injected into the joint, decreases inflammation.
  • Botulinum toxin (Botox), injected into adjacent facial muscles, reduces jaw tension and pain.
  • Surgery is sometimes performed to repair a damaged joint and surrounding tissues. Such surgery is very rarely recommended to treat TMJ disorders, because it is often ineffective and may result in additional complications.

Prevention

Avoiding stress and teeth grinding helps prevent certain TMJ disorders. Maintenance of good posture prevents excessive straining of the facial and neck muscles and may decrease a person’s risk of developing TMJ problems. Additionally, healthy lifestyle habits such as relaxation techniques, proper diet, and adequate sleep are generally recommended as preventative health measures.

Sources

  • TMJ Disorders. National Institute of Dental and Craniofacial Research website. http://www.nidcr.nih.gov/oralhealth/Topics/TMJ/TMJDisorders.htm. Accessed January 21, 2015.
  • Temporomandibular Joint Disorders. University of California San Francisco website. http://www.ucsfhealth.org/conditions/temporomandibular_joint_disorders/. Accessed January 21, 2015.
  • TMJ Disorders. Medline Plus website. http://www.nlm.nih.gov/medlineplus/ency/article/001227.htm. Accessed January 21, 2015.
  • TMJ disorders. Mayo Clinic website. http://www.mayoclinic.org/diseases-conditions/tmj/basics/definition/con-20043566. Accessed January 21, 2015.