Tmj (Temporomandibular Joint Disease)



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TMJ (Temporomandibular Joint Disease)

The Temporomandibular Joint (TMJ) connects the lower jaw (mandible) to the skull. It is a small joint with a disc of cartilage separating the bones that allows you to open your mouth. Damage to this complex, triangular structure in front of your ear can cause considerable pain.



Where is the Temporomandibular Joint?

You can locate this joint by putting your finger on the triangular structure in front of your ear. Then move your finger just slightly forward and press firmly while you open your jaw all the way and close it. You can also feel the joint motion in your ear canal.




What causes TMJ pain?

In most patients, pain associated with the TMJ is caused by movement of the cartilage disc between the jaw and the skull that causes pressure and stretching of the joint and surrounding nerves. The popping or clicking occurs when the disk snaps into place when the jaw moves. In addition, the chewing muscles may spasm, not function efficiently, and cause pain and tenderness.


What causes damage to the TMJ?

• Major and minor trauma to the jaw • Teeth grinding


• Excessive gum chewing • Stress and other psychological factors
• Improper bite or malpositioned jaws • Arthritis
What are the symptoms?

• Ear pain • Sore jaw muscles


• Temple/cheek pain • Jaw popping/clicking
• Locking of the jaw • Difficulty in opening the mouth fully
• Frequent head/neck aches

The pain may be sharp and searing, occurring each time you swallow, yawn, talk, or chew, or it may be dull and constant. It hurts over the joint, which is in front of the ear, but the pain can also spread elsewhere. It often causes spasms in the muscles that are attached to the bones of the skull, face, and jaws. Then pain can be felt at the side of the head (the temple), the cheek, the lower jaw, and the teeth.

A very common focus of pain is in the ear. Many patients come to the ear specialist quite convinced their pain is from an ear infection. TMJ problems are a very common cause of earache with a normal eardrum and no associated hearing loss.

TMJ problems can also cause popping, clicking, or grinding sounds when the jaws are opened wide or the jaw may locks open (dislocated). At the other extreme, TMJ can prevent the jaws from opening fully. Some people get ringing in their ears from TMJ.



How is TMJ pain treated?

• Rest the muscles and joints by eating soft foods.


• Do not chew gum.
• Avoid clenching or tensing.
• Relax muscles with moist heat (1/2 hour at least twice daily).
Relaxation techniques and stress reduction, patient education, non-steroidal anti-inflammatory drugs (NSAID), and muscle relaxants are also beneficial.

Other treatments for advanced cases may include an occlusal splint to prevent wear and tear on the joint, improving the alignment of the upper and lower teeth, and surgery.



Dentists, oral surgeons, physical therapists, and chiropractors are also involved in treating TMJ.
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