Temporomandibular Joint Disorder (TMD)

Authored By: Lesley Ranft

• TMD Treatments

Temporomandibular disorder (TMJ, TMJD or TMD) affects the temporomandibular joint, an area that includes the hinge jaw joint (the bridge for the lower jaw or mandible) and the temporal bone of the skull located in front of each ear, the muscles surrounding the jaw and the jaw itself.

This area of the face contributes to chewing, bite (occlusion) and jaw movement. Therefore, TMJ disorder compromises jaw flexibility and may cause pain at rest or during common movements such as talking, chewing and yawning.

The pain and discomfort caused by TMJ disorder may be severe, can be either intermittent or constant and may last for many years.

Causes of TMJ Disorder

TMJ disorder has often been portrayed as psycho-stress related, but in truth there are many different types of TMJ, any one of which may result from multiple causes.

The most common factor contributing to TMJ is a bite problem affecting the joint itself. Interferences in the structure of individual teeth may force displacement of the lower jaw, leading the muscles to position the joints out of their sockets to force the upper and lower teeth to fit together. Anatomical factors within the joint or surrounding muscles (such as the presence of scar tissue) may also interfere with the bite and cause TMJ disorder.

In other cases, TMJ may result from a jolting injury to the head or face. Also, wear and tear on the teeth due to aging or tooth grinding and clenching may cause uneven surfaces on the teeth, leading to interferences in the bite and improper jaw closure.

TMJ Symptoms and Diagnosis

The onset of TMJ symptoms is typically the first step toward diagnosis. Pain is TMJ disorder’s most common symptom. People with TMJ may experience severe pain and discomfort in the face, jaw joint, neck and shoulders. During a dental consultation to evaluate TMJ, your dentist will evaluate pain with a "clench test." If any one tooth, all teeth, or the jaw are in pain when you bite down during a clench test, your pain is probably related to a bad bite.

TMJ sufferers often experience jaw clicking, popping or locking during movement. In some cases, chewing is difficult, or the bite may not align properly (malocclusion). You may also experience swelling on the side of the face, toothaches, headaches, neck aches, earaches and hearing problems.

A dentist suspecting TMJ disorder will first evaluate your bite (occlusion). To study your jaw-to-bite relationship as well as the position and condition of the temporomandibular joint, your dentist will make mold impressions of your bite and mount them on an instrument called an articulator, a device that mimics the jaw's movement and joint closure. During this study, your dentist will determine if a structural disorder exists within the joint itself or if deflective interferences in the bite such as uneven teeth are affecting the joint's ability to close properly, thus causing the TMJ.

Temporary TMJ Symptom Relief

Many self-help remedies have been suggested to treat TMJ symptoms, but be aware that these remedies do not treat the cause. In fact, TMJ treatment through the right dentist may be less costly, less time intensive and can produce a fully satisfactory result.

Although the following self-help remedies do not treat TMJ long-term, temporary relief may be found:

Heat and Cold Packs: Heat and cold packs applied to the side of the face and temple for 10 minute intervals may reduce the intensity of the pain affecting the muscles and surrounding area of the jaw.

Limit Jaw Movement: It is important to avoid large movement of the jaw such as singing and wide yawning. Also, do not apply pressure with your hand against your jaw for an extended time period during sleep. Limit the pressure you apply with a phone receiver.

Diet: Choose soft food and stay away from foods requiring repetitive chewing or the mouth to open wide. In particular, avoid chewing gum, taffy, pretzels and raw carrots.

Dental Treatment: Continue to receive dental treatment for any teeth requiring restoration. Tooth decay may affect the bite, a contributing factor to TMJ.

Physical Therapy, Biofeedback, and Massage: In some cases, physical therapy, biofeedback and massage provide temporary relief from TMJ.

Medications: Some doctors or dentists may prescribe non-steroidal anti-inflammatory drugs (NSAIDs like ibuprofen), muscle relaxants, anti-anxiety medications and in some cases anti-depressants. The choice of medication depends on the intensity of the disorder and your medical history. However, the need for medication is greatly reduced when treatment is received by an experienced TMJ dental professional.

Dental Appliances: Your dentist may prescribe a dental appliance such as a mouth guard or splint to reduce the effects of tooth grinding and clenching. Such appliances may also help improve your bite and the ability for the lower jaw to fall properly into the temporomandibular joint socket.

• TMD Treatments

[Updated May 2008]

Back to Top