Temporomandibular Joint Disorder (TMJ)

What is Temporomandibular Joint Disorder (TMJ)?

Temporomandibular joint disorder, also known as TMJ, is a painful condition that affects the joint connecting the jawbone to the skull. This joint is located just in front of the ear and can be felt when the jaw opens and closes. TMJ may also involve the surrounding muscles and soft tissues.

What are the signs and symptoms of the condition?

Temporomandibular joint disorders may cause a wide variety of complaints, including:

  • A clicking or popping noise heard in the joint when the jaw is opened and closed
  • Headaches
  • Jaw pain
  • Joint locking open or shut
  • Limited ability to open the mouth
  • Pain behind the eye
  • Pain that spreads to the shoulders, neck, and back
  • Spasm or pain in the muscles used for chewing

Certain other symptoms are often seen in people who have temporomandibular joint disorders. These symptoms may be part of the TMJ but are also found in other conditions, making the diagnosis potentially difficult. They include:

  • Dizziness
  • Ear pain
  • Hearing impairment
  • Ringing in the ears, also known as tinnitus
  • A feeling of fullness or fluid in the ears
  • Visual impairments, such as blurred vision
  • Ninety percent of people with TMJ are women in their childbearing years.

What causes TMJ disorders?

There are a large number of muscles, ligaments, and connective tissues at the base of the skull, upper spine and lower jaw that maintain the position of your head and jaw throughout the day. The pain from TMJ syndrome originates in these connective tissues. These activities create fatigue and even spasm of these connective tissues that people experience as pain. Frequently, TMJ is linked to inappropriate activities, such as:

  • Activities that cause the head to be held in an abnormal position, such as cradling a telephone on the shoulder
  • Clenching or grinding of the teeth
  • Oral habits, such as yawning with the mouth wide open or eating chewy foods
  • Poor posture, such as sitting improperly at a desk or computer station
  • Stress

Other causes of TMJ include:

  • Abnormal structure of the joint, present at birth
  • Dental procedures, such as root canals and tooth extractions
  • Diseases affecting the muscles
  • Injury, such as a motor vehicle accident or sports injury
  • Joint diseases, such as osteoarthritis
  • Poor alignment of the jaw or teeth

How is the condition diagnosed?

The results of a medical history and physical exam often cause a healthcare provider to suspect a temporomandibular joint disorder. Various tests may be ordered to make sure more serious diseases are not causing the symptoms. Dental X-rays can sometimes help make the diagnosis. Audiometric testing may be ordered to rule out ear disease as a cause of symptoms.

How is the condition treated?

Eliminating the cause of TMJ syndrome (if it can be identified) is the primary goal of therapy. Reduction of stress is helpful, but may be hard to accomplish. A soft diet, including eliminating hard, crunchy or chewy foods (especially chewing gum) is helpful. Management of jaw clenching and bruxism may require a dental appliance (“mouth guard” or ‘bite-block”) that can be worn at night to prevent nocturnal episodes. Acute episodes of pain respond to non-steroidal anti-inflammatory medications (ibuprofen, naproxen, etc.), as well as hot compresses. In severe cases, muscles relaxants can be prescribed.

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