TMJ: Causes, Symptoms, and Treatment

The temporomandibular joint (TMJ) is the joint on either side of your face that sits just in front of the ear and connects the lower jaw of the mandible to the temporal bone of the skull. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint control its position and movement. Disorders of this area (TMJ disorders) are problems or symptoms of the chewing muscles and joints that connect your lower jaw to your skull.

The abbreviation “TMJ” literally refers to the joint but is often used to mean any disorders or symptoms of this region.The joint is different from the body’s other joints. The combination of hinge and sliding motions makes this joint among the most complicated in the body. Also, the tissues that make up the temporomandibular joint differ from other load-bearing joints, like the knee or hip. Because of its complex movement and unique makeup, the jaw joint and its controlling muscles can pose a tremendous challenge to both patients and health care providers when problems arise.

Causes

• Trauma

Trauma to the jaw or temporomandibular joint plays a role in some TMJ disorders. But for most jaw joint and muscle problems, scientists don’t know the causes. Because the condition is more common in women than in men, scientists are exploring a possible link between female hormones and TMJ disorders.

• Stress and tooth grinding.

Many people with TMJ problems do not grind their teeth, and many who have been grinding their teeth for a long time do not have problems with their TMJ joint. For some people, the stress associated with this disorder may be caused by the pain as opposed to being the cause of the problem.

• Poor posture

Head and neck posture can also be an important factor in TMJ symptoms. For example, holding the head forward while looking at a computer all day strains the muscles of the face and neck.

• Other factors that might make TMJ symptoms worse are stress, poor diet, lack of sleep, arthritis, fractures, dislocations, and structural problems present since birth.

Symptoms

For many people, symptoms seem to start without obvious reason.

• Trigger Points

Many people end up having “trigger points” — contracted muscles in your jaw, head, and neck. Trigger points can refer pain to other areas, causing a headache, earache, or toothache.

• Biting or chewing difficulty or discomfort
• Clicking, popping, or grating sound when opening or closing the mouth
• Pain—Dull or aching pain in the face
• Locking of the jaw
• Difficulty opening or closing the mouth

Diagnosis

You may need to see more than one medical specialist for your TMJ pain and symptoms. Dr. Steve Bader at Ted Filandrianos DMD, FAGD & Associates is highly skilled and experienced with providing multi-faceted care to patients suffering from TMJ. He utilizes sophisticated computerized equipment to analyze your bite and determine the cause of your jaw pain.

He starts with a comprehensive examination and review of symptoms to make a proper diagnosis. The exam takes approximately one hour, and includes a tooth-by-tooth exam and measurements of each tooth, position and alignment.

A thorough examination may involve:

• A dental examination to show if you have poor bite alignment
• Feeling the joint and muscles for tenderness
• Pressing around the head to locate areas that are sensitive or painful
• Sliding the teeth from side to side
• Watching, feeling, and listening to the jaw open and shut
• X-rays or MRI of the jaw

Treatment

Simple, gentle therapies are usually recommended first.

• Learn how to gently stretch, relax, or massage the muscles around your jaw. Your doctor, 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.
• Learn stress-reducing techniques.
• Exercising several times each week may help you increase your ability to handle pain.

Based on this evaluation, Dr. Bader can advise you as to whether your problems may be helped by neuromuscular occlusal therapy. If you are a good candidate, the next phase of diagnosis consists of models, photographs, and electronic measurements of your jaw movement, TMJ, muscle tension and activity, and occlusion using the K7 Jaw Tracking computer.

Usually the most effective treatment involves coordination with other specialists including ENT (ear, nose, and throat), chiropractic, physical therapy, massage therapy practitioners. We will review treatment options after a description of the anatomy and pathology of this very complex area.