Jaw joint dysfunction

About jaw joint dysfunction

Between one and two in ten people in the UK have symptoms of jaw joint dysfunction. It’s also known as temporomandibular dysfunction and temporomandibular joint dysfunction.

The medical name for your jaw joint is the temporomandibular joint. It’s located in front of your ear on both sides of your head. The joint allows your jaw bone (mandible) to move from side to side, backwards and forwards, and allows you to open and close your mouth.

Your jaw joint is one of the most complicated joints in your body, with several muscles and ligaments allowing different movements.

Symptoms of jaw joint dysfunction

Your symptoms may include:

  • pain, most likely around your jaw joint, but may also be around your cheek, ear and neck
  • restricted movement and locking of your jaw
  • joint noise, such as popping and clicking sounds, when you move your jaw
  • a headache
  • difficulty chewing
  • a change in the way your upper and lower teeth fit together

Your symptoms may be worse when you’re chewing or if you’re feeling stressed.

You probably won’t need to see your GP if you have these symptoms as you can usually manage them at home. However, if they get worse or don’t improve within a few days, see your GP for advice.

Causes of jaw joint dysfunction

There are three main causes of jaw joint dysfunction.

  • Myofascial pain is the most common jaw joint dysfunction – this involves pain or discomfort in your muscles or the tissue (myofascia) that surrounds the muscles in your jaw joint.
  • Disc displacement happens when the articular disc (a thin disc within the joint) is in the wrong position, you have dislocated your jaw, or your jaw joint has been injured.
  • Osteoarthritis is a disorder of synovial joints. It can affect your jaw joint, but is more common in the knees, hips and small joints of your hand.

It’s possible that you may have more than one of these at the same time.

Injuries can also trigger jaw joint dysfunction, such as a knock to your jaw, or overstretching when yawning, or during dental treatment.

Clenching your jaw or grinding your teeth (bruxism) may cause jaw joint dysfunction. However, many people with jaw joint dysfunction don’t grind their teeth and many people that do grind their teeth, don’t have jaw joint dysfunction. The crucial thing is the symptoms not the grinding of teeth.

Poor posture can also cause jaw joint dysfunction, for example, holding your head forward as you sit at a desk can strain the muscles in your face and neck.

Joint noises, such as clicking, cracking or popping can happen if the articular disc has moved out of its normal position. The disc sometimes slips forward and as it returns to its normal position between the bones of your jaw joint, a noise is made.

Diagnosis of jaw joint dysfunction

Your dentist will ask about your symptoms and examine you. He or she may also ask you about your medical history.

Because your jaw joint is complicated and there are many possible causes of jaw problems, it can be difficult to work out what is causing your symptoms. There is no one test that can be used to diagnose jaw joint dysfunction.

Your dentist may also examine your head, neck, face and jaw to see if there is any tenderness. You may be asked to move your jaw in all directions to make sure you can move it freely and find out if it’s painful when you move it.

Treatment of jaw joint dysfunction

Jaw joint dysfunction can often be treated successfully and doesn’t lead to other problems. Your treatment will depend on the type of jaw joint dysfunction you have.

Self-help

Your dentist may advise you to do one or more of the following.

  • Eat soft foods so you don’t have to chew food for too long.
  • Stop wide yawning, singing, chewing gum and biting your nails.
  • Stop any habits, such as clenching your jaw or grinding your teeth.
  • Massage affected muscles and apply a heat pad, such as a hot water bottle (filled with warm but not boiling water) wrapped in a cloth or towel.
  • Identify sources of stress and use relaxation techniques, such as massage.

Medicines

You may find over-the-counter painkillers, such as paracetamol or ibuprofen, can help to ease your pain. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Non-surgical treatment

If your dentist thinks that you’re clenching your jaw or grinding your teeth when you’re asleep, he or she may recommend wearing a bite guard. This is a cover made from plastic that fits over your upper or lower teeth and stops them coming into contact with each other.

These measures will probably relieve your symptoms, however, if your symptoms last for longer than four to six weeks, your dentist may refer you to an oral surgeon or a specialist jaw joint dysfunction dentist.

Surgery

Surgery for jaw joint dysfunction is very rare. Surgery may involve opening your jaw joint and operating on the bones, cartilages and ligaments. It’s important to discuss the risks and benefits of surgery with your oral surgeon.

If I have jaw joint dysfunction, can it cause arthritis in my jaw?

Answer

Some forms of jaw joint dysfunction may lead to you getting arthritis in your jaw joints (temporomandibular joints).

Explanation

Arthritis is a condition that causes inflammation (swelling) of your joints. There are several different types of arthritis. The most common types are osteoarthritis and rheumatoid arthritis. Both osteoarthritis and rheumatoid arthritis can affect your jaw joint, as well as infectious and traumatic arthritis.

If you have myofascial pain for a long period of time, it may cause secondary degenerative arthritis but this is uncommon. Secondary degenerative arthritis means that the arthritis is a result of another condition. If you have arthritis in your jaw joint, you may have pain on one side of your jaw and have difficulty opening your mouth. Your symptoms may repeatedly get worse and then better.

Your GP or dentist may refer you for an X-ray to diagnose if you have arthritis in your jaw. Treatment is generally the same as jaw joint dysfunction treatment and may include one or more of the following.

  • Eating soft foods so you don’t have to chew food for too long.
  • Stopping wide yawning, singing, chewing gum and biting your nails.
  • Stopping any habits, such as clenching your jaw or grinding your teeth.
  • Massaging affected muscles and apply a heat pad, such as a hot water bottle (filled with warm but not boiling water) wrapped in a cloth or towel.
  • Taking over-the-counter painkillers, such as paracetamol or ibuprofen.
  • Using a bite guard.

Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Can physiotherapy help to reduce the pain of jaw joint dysfunction?

Answer

Yes, physiotherapy can help to improve the symptoms of jaw joint dysfunction.

Explanation

There are several types of physiotherapy that may be helpful for jaw joint dysfunction.

Transcutaneous electric nerve stimulation (TENS) involves using a device that stimulates the nerves that don’t transmit pain. This is thought to block the painful impulses that you may be feeling.

Spray and stretch exercises can be helpful. Your dentist or physiotherapist sprays a cooling substance over your cheeks and temples, which allows him or her to stretch your jaw muscles.

Ask your dentist whether physiotherapy would be a suitable treatment for you.

Are there any medicines that I can take to help with my jaw joint problems?

Answer

Yes, medicines can be helpful for some people.

Explanation

Painkillers that you can buy over-the-counter, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help to relieve your pain. Always read the patient information leaflet that comes with your medicine, and if you have any questions, ask your pharmacist for advice.

If you're in a lot of pain, your dentist may prescribe a muscle-relaxing medicine to help reduce the tightness and pain in your jaw. Medicines to help treat depression, known as antidepressants, can also help to relieve pain. You will be prescribed a lower dose than what is usually given to treat depression. Antidepressants work by relaxing the muscles of your jaw joint.

If your symptoms are severe, your dentist may prescribe a drug called diazepam, which relaxes your muscles and can also reduce anxiety. Your dentist will usually only prescribe this if you're in a lot of pain and you can only take it for a short amount of time.