Patient education: Temporomandibular joint (TMJ) disorders (The Basics)

What are temporomandibular joint disorders? — 

Temporomandibular joint disorders (often just called "TMJ") are problems with the jaw joint and the muscles around it.

The jaw joint, called the "temporomandibular joint," is located in front of the ear where the jawbone connects to the head. To feel the joint, place your finger on your cheek just in front of your ear and then open and close your mouth.

TMJ disorders can be caused by many problems, including arthritis. Sometimes, TMJ is due to a combination of stress, jaw clenching, teeth grinding, and other things that strain the jaw joint and the muscles around it. Some people with TMJ also have anxiety, depression, or a general increased awareness of pain.

What are the symptoms of TMJ? — 

The main symptom is a dull pain on just 1 side of the face, near the ear. Sometimes, the pain also affects the ear, jaw, or back of the neck. Some people also get headaches. The pain of TMJ is typically constant, but can come and go. It is usually worse when moving the jaw.

People with TMJ might hear a clicking or popping sound or experience a "crunching feeling" in the joint when they open and close their mouth.

Should I see a doctor or nurse? — 

If the pain in your face or jaw is bothering you and does not go away, see your doctor or nurse.

What tests might I need? — 

There is no single test that can show if you have TMJ. Your doctor or nurse should be able to tell if you have it by asking about your symptoms and doing an exam.

Unless the doctor suspects something unusual, most people will not need X-rays or an MRI (an imaging test that creates pictures of the inside of the body). But in some cases, your doctor might order a special X-ray called a "panoramic radiography of the jaw." This can show the TMJ shape and bone structure, the teeth, and the sinuses. (The sinuses are hollow areas in the bones of the face.) This test can look for other things that can cause jaw pain.

How is TMJ treated? — 

No single treatment works for everyone. Most of the time, medicines and simple lifestyle changes can help. Most patients get better over time, even without treatment, so it's important to be patient.

Your doctor or nurse will help you find the right mix of treatments for you. They might refer you to a dentist who specializes in TMJ.

Treatment options include:

●Education and self-care – This includes following instructions from your doctor about how to avoid things that trigger TMJ pain. It also involves learning different ways to help you relax and manage stress. Some people might also improve with simple jaw exercises. These can be done with a physical therapist (exercise expert), or you can do them on your own.

●Medicines to relieve pain and relax the muscles – There are several types of medicines used to treat TMJ. These include NSAIDs, muscle relaxants, and certain medicines used for depression. (Medicines for depression can relieve pain even in people who are not depressed.) Your doctor will decide which medicine or group of medicines is best for you.

●Devices called "bite plates" or "occlusal splints" – These fit in your mouth and keep you from grinding your teeth at night. They are made out of either a hard or soft plastic and might be made specially to fit your mouth.

If these treatments don't help, your doctor might suggest you see a specialist, such as an oral surgeon. They might be able to give you injections (shots) of medicine to the area to treat pain. It is rare that people need surgery for TMJ.

More on this topic

Patient education: Chronic pain (The Basics)
Patient education: Coping with worry and stress (The Basics)