Temporomandibular joint (TMJ) disorders are a group of conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement. The temporomandibular joint is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull, which is located in front of the ear on each side of your head. The joints are flexible, allowing the jaw to move smoothly up and down and side to side so you can talk, chew, and yawn. Muscles attached to and surrounding the jaw joint, control its position and movement.
TMJ disorders can occur if:
– The disk erodes or moves out of its proper alignment
– The joint cartilage is damaged by arthritis
– The joint is damaged or broken by a blow or other trauma
– There is habitual grinding or clenching of teeth, putting pressure on the joint
– Connective tissue diseases develop that affect the temporomandibular joint
In many cases, however, the cause of TMJ pain is unclear. Some people who have jaw pain may also clench or grind their teeth, but many people habitually clench or grind their teeth and never develop TMJ disorders.
Signs and Symptoms of TMJ Disorders
The most common symptom of TMJ disorders is pain, particularly in the chewing muscles and/or jaw joint.
Other common symptoms include:
– Radiating pain in the face, jaw, or neck
– Jaw muscle stiffness
– Limited movement or locking of the jaw
– Painful clicking, popping or grating in the jaw joint when opening or closing the mouth
– A change in the way the upper and lower teeth fit together
– Limited opening of the mouth
TMJ Causes and Risk Factors
We don’t know the exact causes of TMJ disorders. Dentists believe symptoms arise from issues with the jaw muscles or the joint itself.
Injury to the jaw, temporomandibular joint, or muscles of the head and neck can lead to TMJ disorders.
Other possible causes include:
– Grinding or clenching the teeth, which can put a lot of pressure on the joint
– Irregular movement of dislocation of the soft cushion or disc between the ball and socket of the joint
– Arthritis in the joint
– Stress, which can cause tightening of facial and jaw muscles
Information from the National Institute of Dental and Craniofacial Research (NIDCR) does show that:
– Women are twice as likely to be affected than men
– A bad bite or orthodontic braces don’t directly cause TMJ disorders
– TMJ disorders are most common among people between the ages of 20 and 40
Diagnosis of TMJ Disorders
There is no standard test to diagnose TMJ disorders. Your dentist will examine your jaw joints for pain or tenderness and listen for clicking, popping or grating sounds during jaw movement. They will also check that your jaw works properly and doesn’t lock when opening or closing your mouth. Your bite will be examined to ensure teeth fit together properly.
Your dentist may take full face X-rays to view your jaws, temporomandibular joints and teeth to rule out other problems. Sometimes other imaging tests, such as CT or MRI scans, are needed for a more detailed view of the joint to diagnose a problem.
If the cause of your TMJ pain is still unclear, you may be referred to a Prosthodontist (a dentist specialising in jaw disorder), an oral and maxillofacial specialist or an otolaryngologist (ENT doctor) for further evaluation.
Treatment Options for TMJ Disorders
In many cases, the pain and discomfort associated with TMJ disorders can be alleviated with self-managed care or nonsurgical treatments. Surgical treatments are typically a last resort.
Medications
– Over-the-counter pain relievers and anti-inflammatory drugs may help to relieve TMJ pain and swelling
– Prescription pain medications or other medications may be required in severe cases
Always talk to your doctor or dentist before taking medications for TMJ/jaw pain and swelling.
Non-Surgical Therapies
– Oral splints or mouth guards (occlusal appliances) can be used to reduce the impact of clenching or grinding
– orthodontics may be used to correct bite and tooth alignment, especially if it is causing the joint to shift or not si correctly
– Physical therapy with jaw exercises can help to strengthen muscles, improve flexibility and range of motion
Surgical or Other Procedures
– Arthrocentesis: A procedure during which the jaw joint is washed out with sterile fluid
– TMJ arthroscopy: Procedure using an arthroscope and small surgical instruments for surgery
– Modified condylotomy: Surgical procedure to reduce the head of the condyle (mandible) where it sits in the joint
– Open joint surgery: Surgery to repair or replace the joint; typically only considered if other treatments fail
Home Remedies and Self-Care
If you suffer from TMD some steps you can take to care for your TMJ and reduce symptoms at home include:
– Eat soft foods and avoid hard or chewy foods
– Apply ice or heat pack to the side of your face for 10 minutes
– Perform gentle jaw stretches and exercises to increase jaw movement
– Avoid extreme jaw movements like wide yawning and gum-chewing
– Practise good posture and keep your teeth slightly apart to relieve pressure on the jaw
– Learn relaxation techniques to help loosen up your jaw and relieve tension
Bruxism and TMJ Disorders
Teeth grinding and clenching (Bruxism), is a common condition that can lead to or exacerbate TMJ disorders (while the two conditions often co-exist, the exact causal link is still unclear). Bruxism often occurs during sleep, but some people also unknowingly clench their teeth during the day.
Symptoms of bruxism include:
– Teeth grinding or clenching, which may be loud enough to wake up sleeping partners
– Teeth that are flattened, fractured, chipped or loose
– Worn tooth enamel, exposing deeper layers of the tooth
– Increased tooth pain or sensitivity
– Tired or tight jaw muscles, or a locked jaw that won’t open or close completely
– Jaw, neck or face pain or soreness
– Pain that feels like an earache
– Dull headache originating in the temples
– Damage from chewing on the inside of your cheek
– Indentations on your tongue
Bruxism is most often caused by stress and anxiety, but can also be the result of an abnormal bite, crowding or positioning of the teeth, or a sleep disorder like sleep apnea. Lifestyle factors like smoking, caffeine, alcohol, and drug use may also play a role.
Treatment for bruxism includes dental approaches like night mouth guards (splints) as well as stress management, lifestyle modifications, and medication in some cases.
The Bottom Line
TMJ disorders can cause significant pain and interfere with your ability to eat, speak and even sleep. While the exact causes are often unclear, options are available to treat TMJ pain and restore jaw function.
If you think you may have a TMJ disorder, see your dentist for an evaluation. They can properly diagnose the problem and recommend the most appropriate treatment. Early intervention can not only relieve your symptoms but also prevent more serious dental health problems down the road.
At Beaches Dental Mona Vale, our experienced dentists are here to help you find relief from TMJ pain and get your oral health back on track. Call us at (02) 9997 8822 or request an appointment online to get started. Let us help you regain a healthy, pain-free smile.
