Temporomandibular Joint Syndrome (TMJ)

What Is TMJ?

The temporomandibular joint (TMJ) is the joint that connects your mandible (lower jaw) to your skull. The joint can be found on both sides of your head in front of your ears. It allows your jaw to move, enabling you to speak and eat.

Although TMJ refers to the joint, the abbreviation is also used to indicate problems that occur with the temporomandibular joint. TMJ disorders refer to a group of health problems that cause tenderness in the joint, facial pain, and difficulty in moving the joint. The National Institute of Dental and Craniofacial Research reports that as many as 10 million people suffer from TMJ disorders (NIDCR 2011).

What Causes TMJ?

The cause of temporomandibular joint disorders is unknown in many cases. Trauma to the jaw or joint may play a role in the development of TMJ disorders. In addition, there are other health conditions that may contribute to the development of these disorders. These include:

  • arthritis that develops in the joint
  • erosion of the joint
  • habitual grinding or clenching of the teeth
  • structural problems present at birth

Other factors are associated with the development of TMJ disorders. However, these factors have not been proven to cause these disorders. They include:

  • the use of orthodontic braces
  • poor posture that strains the muscles of the neck and face
  • stress
  • poor diet
  • lack of sleep

What Are the Symptoms of TMJ?

The symptoms of TMJ disorders will depend on the severity and cause of your condition. Pain in the jaw and surrounding muscles is the most common symptom of TMJ. Other symptoms typically associated with these disorders include:

  • pain that can be felt in the face or neck
  • stiffness in the muscles of the jaw
  • limited movement of the jaw
  • locking of the jaw
  • clicking or popping sound from the jaw
  • shift in the jaw, changing the way that the upper and lower teeth align

How Is TMJ Diagnosed?

TMJ disorders may be difficult for your doctor to diagnose. There are no standard tests to diagnose these disorders. Your doctor may refer you to a dentist or ear, nose, and throat (ENT) specialist to diagnose your condition.

If you have symptoms of a TMJ disorder, your doctor may examine your jaw to see if there is swelling or tenderness. In addition, your doctor may use several different imaging tests. These include:

  • X-ray of the jaw
  • CT scan of the jaw to see the bones
  • MRI of the jaw to see if there are problems with the structures of the jaw

How Is TMJ Treated?

In most cases, the symptoms of TMJ disorders can be treated through conservative self-care practices at home. To ease the symptoms of TMJ you can:

  • eat soft foods
  • use ice to reduce swelling
  • reduce jaw movements (such as chewing gum)
  • reduce stress
  • use jaw stretching exercises to help improve jaw movement

If your symptoms do not improve with these measures, you may need help from your doctor. Depending on your symptoms, your doctor may prescribe or recommend the following:

  • medications to help reduce the pain of the disorder (such as ibuprofen)
  • medications to relax the muscles of the jaw (such as Flexeril, Soma, and Valium)
  • medications to help reduce swelling in the jaw (corticosteroid drugs)
  • stabilization splints or bite guards to prevent teeth grinding
  • botox to reduce tension in the muscle and nerves of the jaw
  • cognitive-behavioral therapy to help reduce stress

In rare instances, your doctor may recommend surgery or other procedures to treat your condition. Procedures include:

  • corrective dental treatment to improve your bite and align your teeth
  • arthrocentesis, which removes fluid and debris from the joint
  • surgery to replace the joint

Procedures used to treat this condition may, in some cases, make your symptoms worse. Talk to your doctor about the risks of these procedures.

What Is the Prognosis for a Patient With TMJ?

If you develop a TMJ disorder, your prognosis will depend on the cause of the problem. In many patients, TMJ can be successfully treated with at-home remedies such a changing posture or reducing stress.

If your condition is caused by a chronic (long-term) disease such as arthritis, your prognosis will not be as good. Arthritis will result in destruction of the joint over time and increased pain. In these cases, more aggressive treatment such as surgery may be needed. Talk to your doctor about your options to determine what treatment is right for you.

How Can TMJ Be Prevented?

You may not be able to prevent TMJ from developing. If you notice symptoms of this disorder, you may reduce them by lowering your stress. If you grind your teeth, stopping this behavior may also be helpful.