What You Need to Know About TMJ Disorder
If you’re looking for answers about TMJ (temporomandibular joint) pain, your dentist is a good place to start. For sufferers of this all-too-common disorder, a proper diagnosis is the first step toward relief—that’s where your oral health care team can help.
The Facts About TMJ Disorder
More than 10 million Americans of all ages suffer from TMJ Disorder. The words “TMJ Disorder” is a general term used to describe dysfunction of the jaw muscles and joints. Symptoms can be as minor as a slight clicking or popping sensation when the mouth is open and closed, or as serious as a persistent pain extending into the face, neck and shoulders, affecting posture and even mobility.
Two joints and several jaw muscles make it possible to open and close the mouth. They work together when you chew, speak and swallow. These structures include muscles and ligaments, as well as the jawbone, the lower jaw (mandible) with two joints, the TMJs.
The temporomandibular joints, or TMJs connect the jawbone to the skull and are located just in front of each ear. These joints are the most complex and frequently used joints in your body, cycling over 2,000 times per day.
Healthy TM joints work together to make many movements, including a gliding action, used when chewing and speaking.
What are the signs of TMJ disorder?
When the joints are not working properly, you may experience any of these symptoms:
- Pronounced noises associated with movement in the TM joints (clicking, popping or crunching)
- Pain when the jaw is opened fully
- Limited range of opening
- Clenching or grinding teeth
- Facial pain and a sense of facial muscle fatigue
- Ear pain not related to ear infections
- Occasional “locking” when the jaw seems to “stick open” temporarily
- Ringing in the ears (tinnitus)
- Frequent headaches or swelling
What causes TMJ disorder?
Several muscles help open and close the mouth. They control the lower jaw as it moves forward, backward and side-to-side. Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket (see diagram). The disc cushions the load while enabling the jaw to open widely and perform rotating and translocational movements. Any problem that prevents this complex system of muscles, ligaments, discs and bone from working together properly may result in a TMJ disorder.
When the protective disc thins or becomes compressed, the jaw may make popping noises when you open and close your mouth.
- Lost or crooked teeth
- Teeth that fit together poorly (malocclusion)
- Degenerative arthritis
- Various head or neck injuries including whiplash and dislocation
- Stress causing clenched teeth (bruxism) and muscle spasms
Any of these conditions can result in a misalignment or displacement of the jaw which places stress on the nerves, blood vessels, muscles and connecting tissues of the TM joints. When the condition is prolonged, your body may begin to compensate by adapting an unnatural position involving the muscles of the neck, back or even the arms and pelvis.
TM joints consist of a “ball” on the lower jaw and the “socket” on each side of the skull. Severe compression and damage to the protective disk between them causes pain and misalignment of the jaw.
How can my dentist help?
Your dentist can serve as the key member of a health care team which could, depending on the cause of your TMJ Disorder, include an orthodontist, oral surgeon, your primary care physician, a physical therapist, and even a psychologist. Because other types of pain have been shown to mimic TMJ Disorder, a careful and thorough dental and medical evaluation is essential. Several conditions may be related to TMJ disorders, but they can be quite varied and they are often difficult to pinpoint. TM disorders can result when the jaw muscles or jaw joints are affected.
If your symptoms point to a dental problem, your dentist will most likely take x-rays of your teeth and jaw. Dental casts may be required to check the fit (occlusion) of your upper and lower teeth and determine whether they come together correctly.
Because most common jaw and joint problems are temporary, lasting only weeks or months, simple care is all that is usually needed to relieve the discomfort. Self-care practices, for example, eating soft foods, applying ice or moist heat and avoiding extreme jaw movements are useful in easing symptoms.
According to the National Institutes of Health (NIH), TMJ treatments should be reversible; the treatment should not cause permanent changes to the jaw or teeth.
Example of reversible treatments:
- Over-the-counter pain medication
- Prescription medication to manage pain
- Gentle jaw stretching and relaxation exercises
- A professionally fitted oral splint such as a biteplate or nightguard
Your dental health care team may recommend realignment of your “bite” and TM joints that may include recontouring tooth surfaces. If self-care efforts aren’t effective, physical therapy and anxiety-reducing therapies can help.
Only in rare cases is surgery required to correct a TMJ Disorder. Arthroscopy and soft tissue repair can be helpful in certain cases. When arthritis causes severe degeneration of the joints, various procedures are performed to repair or replace severed or perforated discs and smooth bone surfaces.
Surgery, however, for TMJ Disorders is generally considered only after all other therapies have been fully explored. If you experience jaw pain, it’s important to get more than one opinion. For more information about TMJ treatments, visit The American American Association of Oral and Maxillofacial Surgeons at www.aaoms.org/tmj.php.
If you suffer pain or discomfort you believe may be related to your TM joints, please ask us for help. The successful treatment of many TMJ Disorder sufferers begins with gentle, experienced care—right here in the dental office.