Temporomandibular Joint Disorder (TMJ)

TMJ (also called TMD) is the common medical term for a number of conditions that affect the function of the temporomandibular joint in the jaw. This is the joint on either side of the face where the mandible connects to the skull. You can feel it by placing your finger on the skin directly in front of your ear and opening/closing your mouth. Normally, the motion of this joint should be smooth and free of discomfort.

Warning Signs of TMJ

There are many different warning signs of temporomandibular joint disorder. You might notice one or more of the following symptoms on one or both sides of your jaw:

• A popping, clicking or grinding sound in your jaw when you eat, speak or yawn (this may be or may not be painful)
• Difficulty moving your jaw in its full range of motion
• Pain in your jaw joint or the muscles that connect to it
• Facial asymmetry (your jaw appears shifted to one side)
• A “locked” jaw that gets stuck in an open or closed position
• Headache or other aching sensations in the face, neck, or shoulders
• Tinnitus (ringing) in your ear
• Balance problems
• Pain or sensitivity in your teeth

Causes of TMJ

Any medical condition or injury that affects the muscles or temporomandibular joint in the jaw can lead to TMJ disorder. In a significant percentage of cases, the cause of jaw pain is not discovered. Some of the most common known causes are:

• Tooth grinding (bruxism) or jaw clenching from stress
• Injury to the jaw (sports or auto accident, etc.)
• Prolonged extension of the jaw during extensive dental work (usually only causes temporary TMJ)
• Deterioration or fusing of the bone due to osteoarthritis (arthritis of the bone)
• Inflammation and damage to the joint and ligaments from rheumatoid arthritis or connective tissue disorders

Treatment for TMJ

In cases of mild or intermittent TMJ, medical treatment may not be necessary. However, you should still visit a medical or dental provider to uncover the underlying cause of any ongoing jaw pain or discomfort. Some factors that cause TMJ are degenerative in nature. This means they can get worse over time and make TMJ symptoms more difficult to alleviate. Just because you see a doctor does not mean you will need invasive treatment.

In fact, many treatments for TMJ are fairly conservative. In the case of bruxism that is causing muscle spasms in your jaw, you may be prescribed an anti-inflammatory, a mild muscle relaxer and a splint to keep you from grinding your teeth.

When jaw pain is moderate to severe, persistent, or becoming worse, you may need a more advanced treatment. This might include flushing the joint with saline to remove scar tissue and other debris. This process (arthrocentesis) is done as an outpatient procedure with needles rather than with a scalpel and the recovery time is usually short.

More extensive surgical procedures include various surgeries to reshape, restore or reposition the jaw bone and socket or the disk of cartilage that lies between the two. These more invasive surgeries have a mixed track record for success and are typically only recommended as a last resort.

Managing TMJ at Home

Sometimes, simply stopping habits (such as chewing gum) that cause symptoms to flare up may be enough to make the problem stop. Jaw inflammation can be treated with hot or cold packs and OTC medications based on your dentist’s advice. You will need to eat a diet of soft foods until the swelling in your jaw subsides. Keeping your stress level to a minimum may help ease jaw tension as well. In some cases, physical therapy is helpful for retraining your jaw to move properly.