Temporomandibular Joint Disorders (TMJ)
TMJ disorders affect the joints in the jaw and the muscles around them. These joints are located on each side of the face in front of the ear and connect the lower jaw to the skull. The muscles that control the joints are attached to the mandible (jawbone) and allow the jaw to move up and down, side to side, and forward and back. When the mandible and joints are properly aligned, smooth muscle actions like chewing, talking, yawning, and swallowing easily take place. However, when the muscles, ligaments, disk, or jaw or temporal bone is not aligned, the complex, synchronized, three-dimensional movement of these joints cannot occur and may result in TMJ dysfunction.
Symptoms
Symptoms can range from sounds in the joint to severe pain and debilitating dysfunction. Common symptoms include:
- Pain/discomfort in the jaw, face, neck, shoulders, and/or behind the eyes
- Headaches or migraines
- Jaw stiffness, locking, clicking, popping, and/or grinding
- Trouble opening or closing the mouth
- Ear pain, pressure, fullness, and/or ringing in the ears
- Misalignment in the way the upper and lower teeth fit together
Risk Factors
TMJ disorders can occur for several reasons including injuries to the jaw, teeth grinding or clenching, jaw tension from stress, arthritis, infections, autoimmune diseases, overextension of the jaw during medical or dental procedures, and misaligned bite. Some habits can make TMJ worse such as using teeth as tools, daytime teeth clenching, stomach sleeping, taking large bites of food, chewing on pens or ice, and poor posture. Additionally, there are genetic, hormonal, and environmental factors that can increase the risk for TMJ disorders. There have been observations that jaw problems are commonly found in people with a uterus in their childbearing years leading researchers to determine the role of estrogen and other female sex hormones in TMJ.
Complications
TMJ disorders can lead to long-term discomfort, pain, chewing problems, chronic headaches, and damage from teeth grinding.
Treatment
Medical providers diagnose TMJ disorders by performing a physical exam, checking how the jaw moves, and looking for signs of stiffness and pain. Diagnostic imaging like dental x-rays, CT scans, or MRI testing may also be necessary. Blood tests are sometimes ordered to rule out possible medical conditions that may mimic TMJ symptoms.
Treatment depends on the cause and severity of symptoms but primarily focuses on non-invasive options. Medications such as acetaminophen, ibuprofen, and muscle relaxants can ease the pain, discomfort, swelling, and muscle tension associated with TMJ. Other therapies focus on relaxing the jaw and improving movement like using custom mouth guards or splints, jaw exercises through physical therapy, trigger point injections, ultrasound therapy, TENS treatment, improving posture, applying ice or moist heat, eating soft foods, and avoiding extreme jaw movements such as wide yawning and gum chewing. Since TMJ involves the jaw and teeth, it is commonly managed by a dentist and should be mentioned during your regular dental examination.
Resources