The temporomandibular joint (TMJ) is a small joint located in front of the ear where the skull and lower jaw meet. It permits the lower jaw (mandible) to move and function. The TMJ is a hinge and gliding joint and is the most constantly used joint in the body.
TMJ (temporomandibular joint) disorders are a family of problems related to the complex jaw joint. Pain, limited mouth opening, a misaligned bite, “popping” or “clicking” sounds are symptoms of TMJ disorder. These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.
No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. The goal is to help you have a healthier and more comfortable jaw.
Trouble With Your Jaw?
TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TMJ. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disc, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position or can develop a hole or perforation. Whatever the cause, the results may include a misaligned bite, pain, clicking, popping, or grating noise when you open your mouth or trouble opening your mouth wide.
Do You Have A TMJ Disorder?
- Are you aware of grinding or clenching your teeth?
- Do you wake up with sore, stiff muscles around your jaws?
- Do you have frequent headaches or neck aches?
- Does the pain get worse when you clench your teeth?
- Does stress make your clenching and pain worse?
- Does your jaw click, pop, grate, catch, or lock when you open your mouth?
- Is it difficult or painful to open your mouth, eat, or yawn?
- Have you ever injured your neck, head, or jaws?
- Have you had problems (such as arthritis) with other joints?
- Do you have teeth that no longer touch when you bite?
- Do your teeth meet differently from time to time?
- Is it hard to use your front teeth to bite or tear food?
- Are your teeth sensitive, loose, broken or worn?
The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.
There are various treatment options that can be utilized to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, then the proper course of treatment can be determined. It is important to note that treatment always works best with a team approach of self-care joined with professional care.
The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:
- Resting your jaw
- Keeping your teeth apart when you are not swallowing or eating
- Eating soft foods
- Applying ice and heat
- Exercising your jaw
- Practicing good posture
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or mouthguard or nightguard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A splint helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relives pressure on parts of your jaw and aids in disc repositioning. It may be worn 24 hours per day to help your jaw heal. An orthotic stabilization appliance is worn 24 hours per day or just at nights to move your jaw into proper position. Appliances also help to protect from tooth wear.
Arthorcentesis is a minimally invasive procedure to flush out the inflammatory mediators from the joint space and possibly break up the scar tissue in the joint.
What About Bite Correction or Surgery?
If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work.
Surgical options such as arthroscopy and open joint repair restructuring are sometimes needed, but are reserved for severe cases. TMJ surgery is not considered unless the jaw cannot open, is dislocated and non-reducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.