What is a TMJ disorder?
Temporomandibular joint and muscle disorders (TMJ disorders) are problems or symptoms of the chewing muscles and joints that connect your lower jaw to your skull.
There are two matching temporomandibular joints-- one on each side of your head, located just in front of your ears. The abbreviation "TMJ" literally refers to the joint but is often used to mean any disorders or symptoms of this region.
TMJ-related symptoms are caused by the effects of physical stress on the structures around the joint. These structures include:
- Cartilage disk at the joint
- Muscles of the jaw, face, and neck
- Nearby ligaments, blood vessels, and nerves
- Teeth
Causes
For many people with temporomandibular joint disorders, the cause is unknown. Some causes given for this condition include:
- A dysfunctional bite
- Clenching the teeth
- Tooth grinding
- Harmful habits such as, gum chewing and nervous popping of the jaw
- Factors that make TMJ symptoms worse are stress, poor diet, lack of exercise and lack of sleep.
- Other possible causes of TMJ-related symptoms include arthritis, fractures, dislocations, and structural problems present since birth.
Symptoms
Symptoms associated with TMJ disorders may be:
- Biting or chewing difficulty or discomfort
- Clicking, popping, or grating sound when opening or closing the mouth
- Dull, aching pain in the face
- Earache
- Headache, especially if located in the temple areas
- Jaw pain, tenderness or stiffness of the jaw
- Reduced ability to open or close the mouth
- A change in the way the upper and lower teeth fit together
Treatment
Simple, gentle therapies are usually recommended first.
- Learn how to gently stretch, relax, or massage the muscles around your jaw. Your doctor, orthodontist, dentist, or physical therapist can help you with these.
- Avoid actions that cause your symptoms, such as yawning, singing, and chewing gum.
- Try moist heat or cold packs on your face.
- Avoid eating hard foods and chewing gum.
- Learn relaxation techniques to reduce overall stress and muscle tension.
- Maintain good posture, especially if you work all day at a computer. Be sure your workstation is ergonomically correct. Pause often to change position, rest your hands and arms, and relieve stressed muscles
- Exercising several times each week may help
- Short-term use of acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or other non-steroidal anti-inflammatory drugs
- Muscle relaxant medicines or antidepressants
- Rarely, corticosteroid shots in the TMJ to treat inflammation
Mouth splints, also called mouth guards, bite guards or appliances, have been used since the 1930s to treat teeth grinding, clenching, and TMJ disorders. These splints are still commonly used today to treat various TMJ disorders. While many people have found them to be useful, the benefits vary widely because patient compliance varies widely. There are different types of splints. Some fit over the top teeth, while others fit over the bottom teeth.
Most cases can be successfully treated. In some cases, pain may subside without treatment. With or without treatment, TMJ-related pain may return again in the future. If the cause is nighttime clenching, treatment can be very tricky because it is a sleeping behavior that is hard to control. Most importantly, be patient! Many factors can contribute to TMD symptoms so the treatment is a process; not a single "magic" pill.
See your health care provider or orthodontist right away if you are having trouble eating or opening your mouth. Experts who are specially trained in this complex issue, like Dr. Spillers, can help diagnose and treat
TMJ disfunction.