All you need to know about TMJ (Temporomandibular Joint): Causes, symptoms and Treatment

Smiling, laughing, talking, chewing — these all are facial movements you make daily with little to no thought. But, if you have  those simple movements may cause you a lot of pain.

The temporomandibular joint (TMJ) acts like a sliding hinge, connecting your jawbone to your skull. You have one joint on each side of your jaw. TMJ disorders — a type of temporomandibular disorder or TMD — can cause pain in your jaw joint and in the muscles that control jaw movement.

The exact cause of a person’s TMJ disorder is often difficult to determine. Your pain may be due to a combination of factors, such as genetics, arthritis or jaw injury. Some people who have jaw pain also tend to clench or grind their teeth (bruxism), although many people habitually clench or grind their teeth and never develop TMJ disorders.

In most cases, the pain and discomfort associated with TMJ disorders is temporary and can be relieved with self-managed care or nonsurgical treatments. Surgery is typically a last resort after conservative measures have failed, but some people with TMJ disorders may benefit from surgical treatments.

Symptoms

Signs and symptoms of TMJ disorders may include:

• Pain or tenderness of your jaw
• Pain in one or both of the temporomandibular joints
• Aching pain in and around your ear
• Difficulty chewing or pain while chewing
• Aching facial pain
• Locking of the joint, making it difficult to open or close your mouth

TMJ disorders can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there’s no pain or limitation of movement associated with your jaw clicking, you probably don’t need treatment for a TMJ disorder.

Causes

The temporomandibular joint combines a hinge action with sliding motions. The parts of the bones that interact in the joint are covered with cartilage and are separated by a small shock-absorbing disk, which normally keeps the movement smooth.

Painful TMJ disorders can occur if:

• The disk erodes or moves out of its proper alignment
• The joint’s cartilage is damaged by arthritis
• The joint is damaged by a blow or other impact

In many cases, however, the cause of TMJ disorders isn’t clear.

Factors that may increase the risk of developing TMJ disorders include:

• Various types of arthritis, such as rheumatoid arthritis and osteoarthritis
• Jaw injury
• Long-term (chronic) grinding or clenching of teeth
• Certain connective tissue diseases that cause problems that may affect the temporomandibular joint.

How is TMJ dysfunction diagnosed?

In most cases, TMJ dysfunction is diagnosed during Your healthcare provider will:

• Observe the range of motion when you open and close your mouth.
• Press on your face and jaw to determine areas of discomfort.
• Feel around your jaw joints as you open and close your mouth.

In addition, radiographs (X-rays) may be taken to view the jaw joints and determine the extent of damage. These may include:

• Panoramic X-rays. This type of dental X-ray shows a broad overview of your teeth, jawbone and TMJs.
• CBCT scans. Cone beam computed tomography (CBCT) scans capture thousands of images of your teeth, jaws, facial bones and sinuses. These pictures are then stitched together for a detailed 3-D image. Dental CT scans give your healthcare provider a more detailed view of your facial anatomy.
• MRI scans. In some cases, may be used to view soft tissues in and around the jaw joints. These images show the position of the disk, inflammation and possible jaw locking. This can tell your healthcare provider if the TMJ disc is functioning properly and in good condition.

Treatment:

Maintain the resting position of your jaw

To help alleviate TMJ pain, minimize wide jaw movements, such as chewing, yawning, singing, and yelling. Do your best to keep your muscles as relaxed as possible.

Correct your posture

Sitting in an unideal position for long periods of time can cause you to feel more pain in your jaw.

When working, choose a chair with back support and take frequent breaks to improve your posture. While driving, set your seat to be as upright as possible, and while doing leisure activities, such as watching TV or reading, choose a space that allows you to sit upright and place a pillow behind your back for support.

Hearn suggests the following exercise to correct your sitting or standing posture: Raise your chest bone, pull your shoulders back and gently squeeze your shoulder blades to straighten your back muscles.

Get a good night’s sleep

Sleep is important for many aspects of good health. To help minimize TMJ pain, sleep on your back and use pillows to support your neck. You should avoid sleeping on your stomach, and if sleeping on your side, do not place your hand on your jaw.

Use a hot or cold compress

Ice helps reduce swelling and pain, while heat can increase blood flow and relax your jaw muscles. Apply a hot or cold compress to your jaw for 15 to 20 minutes at a time using a light layer between the compress and your skin.

Reduce stress

Try  techniques to help loosen and relax your jaw. Yoga practices can also help put less stress on your muscles, and gardening is a great activity to try to calm your mind and relax your face.

Exercise your jaw

Jaw exercises can help increase mobility in your joints. There are three types of jaw exercises that can be used together to relieve pain:

• Stretch exercises
• Relaxation exercises

Take notice of bad habits

You may have a few tendencies that can cause TMD pain. Such habits include:

•  Nail biting
• Chewing cheeks and lips
• Resting your jaw in your hand
• Clenching your teeth
• Grinding your teeth
• Clenching jaw muscles pushing the tongue against your teeth
• Take note of your daily patterns and jot them down to discuss with your doctor. Keep in mind how often you do them.

Avoid certain activities and foods

Specific activities and foods can cause you to open your mouth forcefully or move your jaw in an extreme way. Try to avoid the following:

• Yawning or yelling
• Crunchy or hard foods
• Taking large bites of food
• Foods that require prolonged chewing
• Chewing gum

In some cases, the symptoms of TMJ disorders may go away without treatment. If your symptoms persist, your doctor may recommend a variety of treatment options, often more than one to be done at the same time.

Medications

Along with other nonsurgical treatments, these medication options may help relieve the pain associated with TMJ disorders:

• Pain relievers and anti-inflammatories. If over-the-counter pain medications aren’t enough to relieve TMJ pain, your doctor or dentist may prescribe stronger pain relievers for a limited time, such as prescription strength ibuprofen.
• Tricyclic antidepressants. These medications, such as amitriptyline, are used mostly for depression, but in low doses, they’re sometimes used for pain relief, bruxism control and sleeplessness.
• Muscle relaxants. These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders created by muscle spasms.

Therapies

Nondrug therapies for TMJ disorders include:

• Oral splints or mouth guards (occlusal appliances). Often, people with jaw pain will benefit from wearing a soft or firm device inserted over their teeth, but the reasons why these devices are beneficial are not well-understood.
• Physical therapy. Along with exercises to stretch and strengthen jaw muscles, treatments might include ultrasound, moist heat and ice.
• Counseling. Education and counseling can help you understand the factors and behaviors that may aggravate your pain, so you can avoid them. Examples include teeth clenching or grinding, leaning on your chin, or biting fingernails.

Frequently Asked Questions

Can TMJ disorder go away on its own?

In some cases, yes, but it depends on the cause. For example, if you’ve had a TMJ flare-up due to a temporary period of stress, your symptoms will likely subside once the stress is no longer a factor. However, if your TMJ pain is due to jaw misalignment or the way your teeth fit together, you will likely have chronic problems that will only improve with treatment.

What happens if TMJ disorder is left untreated?

Left untreated, TMJ disorder can lead to significant health problems, including chronic pain and inflammation. It can also cause bite issues, tooth erosion and long-term conditions such as sleep apnea, insomnia, depression and anxiety.

How do I permanently get rid of TMJ disorder?

With proper intervention, TMJ dysfunction can be successfully treated. The first step is seeing your healthcare provider for an evaluation. It’s best to treat the condition early on before symptoms worsen.

A note from Cleveland Clinic

Jaw pain may not seem like a big deal, especially if it comes and goes. However, left untreated, TMJ dysfunction can seriously hinder everyday functions like biting, chewing and speaking. If you think you may have TMJ symptoms, call your healthcare provider and schedule a consultation. Prompt treatment can help you manage the condition and improve your overall quality of life.