About Ask a Doctor
At UTHSC ENT, we understand that patients need clear, helpful answers to their questions. We also know that a flood of new information can be overwhelming.
That’s why we’ve started Ask a Doctor: an ongoing series of posts that tackle Frequently Asked Questions about common issues. We hope these articles give you a better understanding of your situation and an easy path to treatment.
Today, we’re discussing TMJ disorders:
Prepared by: Jocelyn Matheson
Reviewed by: Dr. M. Boyd Gillespie, MD, MSc, FACS
What is TMJ Disorder?
Temporomandibular joint disorders are problems with the jaw joint (the temporomandibular joint) and the surrounding muscles, collectively referred to as TMJ disorders. The jaw joint is located in front of the ear where the jawbone connects to your skull. A small disc separates the joint into two cavities; the upper part of the joint is responsible for gliding movement while the lower part acts as a hinge.
What are some causes of TMJ?
TMJ disorders can be caused by arthritis, stress, jaw clenching/teeth grinding especially during sleep (bruxism), trauma, and anything that strains the jaw joint and surrounding muscles.
Some people with TMJ may also have anxiety and depression which can contribute to pain, as well as a general increased sensitivity to pain.
What are the symptoms of TMJ?
* Localized jaw pain and tenderness
* Clicking or popping with mouth opening
* Pain with chewing, especially with hard foods or chewy foods
* Changes in bite alignment
* Inability to fully open the jaw
* Headache (typically frontal or temporal)
* Pain in neck, shoulder, or upper back
How are TMJ disorders diagnosed?
Your doctor will perform a history of your symptoms and physical exam which will help establish diagnosis. Most people will not need imaging, but if your doctor suspects a structural or dental cause of your symptoms, an X-ray can be done which will show jaw bone anatomy more clearly.
You will be asked about your symptoms, including the nature of any pain, location of the pain, and things that help either alleviate or exacerbate the pain.
You can also expect to be asked about previous jaw surgery or trauma to the jaw, a history of arthritis, headaches, and if you have habits such as gum chewing, jaw clenching, sources of stress, teeth grinding (particularly at night), or even playing musical instruments or singing.
What does the physical exam involve?
Your doctor will ask you to open and close your jaw as they assess for jaw deviation, protrusion, alignment of your teeth. You will also likely be asked to open your jaw as wide as you can so that your doctor may assess for pain, popping or crunching sounds with movement, and limited range of motion. Sometimes, there can be signs of wear on the teeth including cracking and enamel erosion which can signal teeth grinding. You may also have tenderness in the muscles of your neck and jaw, which will be assessed with gentle touch.
What are the treatments for TMJ disorders?
Education and Lifestyle Change: It is important to identify and avoid triggers for TMJ pain and manage stress. Adding softer foods to your diet and avoiding extreme jaw movements such as exaggerated yawning can be helpful.
Jaw Exercises: Many patients improve with conservative management with simple jaw exercises and physical therapy
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants can be helpful. Sometimes patients with TMJ can suffer from anxiety and depression which may contribute to jaw pain; these patients can benefit from TMJ relief with treatment of underlying depression
Devices: Patients who grind their teeth at night may benefit from bite plates which are fitted to the mouth, and help prevent nighttime grinding.
Most patients find relief from a combination of treatments but others may require more intensive therapy such as steroid injections to the jaw, or corrective surgery although this is rare.