Temporomandibular joint disorders are problems affecting the jaw joint - usually pain or reduced movement of the joint. There are various causes but mostly it is not a serious condition, and often improves with simple treatments.
Temporomandibular joint disorders are problems which affect the jaw joint.
The jaw joint is located just in front of the ear canal, and it joins the jaw bone (mandible) to the skull near to the temple. The jaw joint is also called the temporomandibular joint (TMJ). Problems affecting this joint are usually known as TMJ disorders. However, there are various other medical terms for for this condition - for example, TMJ dysfunction, TMJ pain and myofascial pain disorder.
A joint is where two bones meet. Joints allow movement and flexibility between two bones. The jaw joint allows movement between the jawbone (mandible) and the skull. Muscles attached to the skull and jawbone cause the jawbone to move as the mouth is opened and closed.
Inside the jaw joint, there is a smooth material called cartilage, covering part of the bones. There is also a cartilage disc within the joint. The joint is lubricated by fluid called synovial fluid.
They are fairly common. About 1 in 10 people have symptoms in the jaw joint at some time in their lives. Of these people, only about 1 in 20 consult a doctor for this problem.
In general, TMJ disorders are thought to have a 'multifactorial' cause, meaning that there are usually a number of factors contributing to the cause. These factors can be grouped into two types: problems linked to the muscles working the joint, and problems inside the joint itself. The muscle problems are the most common type, particularly for younger people.
Problems with the muscles may be caused by:
Problems in the joint may be caused by:
Often, the diagnosis is made on the basis of your symptoms and a doctor's examination. In many cases, no tests are necessary if you are healthy and have symptoms that are typical of a TMJ disorder. Possible tests are:
Most problems in the jaw joint can be helped with simple treatments such as painkillers and advice on how to rest the joint. There are various treatments which are often used in combination:
You can rest the joint by eating soft food and not using chewing gum. Also, avoid opening the mouth very wide - so don't do too much singing, and try not to yawn too widely. Massaging the muscles and applying warmth can help.
Other treatments are relaxation and stress-reducing therapies - presumably because people tend to clench their jaw when they are stressed, or because stress makes pain worse.
Splints or bite guards are sometimes suggested. These cover the teeth at night to reduce clenching of the jaw, and can be made by dentists. There is no definite evidence from research trials that they work, but some people find them helpful.
Painkillers such as paracetamol, ibuprofen or codeine can help. If these are not enough, muscle relaxants or a small dose of a medicine called a tricyclic antidepressant can give added pain relief.
Physiotherapy treatments, such as ultrasound and gentle jaw exercises, can be helpful.
If there is an underlying condition - for example, a type of arthritis which is contributing to the TMJ disorder - this may need treating in its own right.
Generally the outlook is good. Most TMJ disorders improve over time and do not get worse. It is very rare to get any complications with this condition. Some people do have symptoms that last longer or come back (recur), but even these can usually be improved with the treatments described above. Most people do not need injections or surgery and will get better with simple treatments and time.