The jaw houses one of the most vital yet complex joints in the human body. It is responsible for many everyday functions, such as eating, talking and yawning. However, this joint is also susceptible to several disorders that can cause pain and dysfunction.
One such disorder is temporomandibular joint (TMJ) dysfunction, which affects 31 percent of adults and 11 percent of children and adolescents. By knowing about this disorder and its causes, you can find ways to prevent the condition or alleviate the symptoms.
What is the Temporomandibular Joint (TMJ)?
Temporomandibular joints (TMJs), also known as jaw joints, are the joints that connect your jawbone to your skull. You have one TMJ on each side of your head, and by placing your fingers just in front of your ears and opening your mouth, you can feel these jaw joints at work.
The temporomandibular joints are unique because they are the only joints in your body that allow hinging and gliding motions. This feature enables you to control jaw movement, from up and down and side-to-side movements. The TMJs are also the most frequently used joints in your body, as they are involved in every oral activity.
Because of their constant use, the jaw joints and the muscles surrounding them can be subject to strain and injury. When this happens, the jaw joint and jaw muscles can become stiff, causing a condition known as temporomandibular disorder (TMD).
What are Temporomandibular Disorders (TMD)?
Inflamed tissue in the jaw joints can lead to temporomandibular disorder. It is a group of 30 or more conditions that can cause pain in the jaw, face and neck. Aside from chronic facial pain, TMD is characterized by three main classes:
Joint and Disc Disorder
When the TMJ’s cushioning disc erodes or moves out of place, it can cause pain and tenderness in the joint. Jaw clicking and popping may also be experienced. As a result, the joints may lock, making it difficult to open or close the mouth.
Muscle Disorder
The muscles that control the movement of your jaw can become strained from clenching or grinding your teeth, leading to TMD. You may feel pain in your temples, lower chewing muscles, or neck and shoulders.
Nerve Disorder
If your jaw bones begin rubbing against each other, it can damage the nerves surrounding the TMJ. Nerve injury can result in facial pain, ear ringing (tinnitus), and dizziness.
What Causes Temporomandibular Joint Disorders?
There is no single cause of TMD. In many cases, it is the result of a combination of factors. The most common include:
Genetics
You may be more likely to develop TMD if you have a family member with the condition. According to research, 112 genes can be directly associated with TMD. Gene mutation can lead to changes in proteins that are essential for the development and function of TMJ and can also affect how a person responds to pain.
Jaw Trauma
Direct trauma to the jaw or face can damage the TMJs. Neck surgery, for example, can lead to TMD if not done correctly. Whiplash, dislocated jaw, and other head and neck injuries can also cause TMD.
Psychological Factors
People under a lot of stress are more likely to develop TMD. Many people with TMD report having higher levels of stress, anxiety, and depression. More so, psychological conditions can lead to teeth grinding (bruxism), which is a common cause of TMD.
Aging
The natural wear and tear of the TMJs can lead to brittle bones and thinning of the joint’s cartilage. Degenerative joint disease is a common cause of TMD in older adults. As a result, it makes the joints more susceptible to injury and damage.
What are the Most Common TMD Symptoms?
TMD symptoms come in many forms. By knowing the early signs of TMJ disorder, you can seek medical help early on and prevent the condition from worsening.
Pain in Facial Muscles
TMJ pain often starts as a dull ache in the facial muscles. It can radiate to the neck, shoulders, and earlobes. The pain is usually worse in the morning because the facial muscles have been inactive all night.
Clicking or Popping Sound When Moving the Jaw
A clicking sound when moving the jaw can be an early sign of TMD. It is caused by the cartilage in the TMJ rubbing against each other. In some cases, the clicking may be accompanied by pain.
Jaw Pain
The TMJs are located just in front of the ear canal. As such, pain in the jaw muscles can feel like an earache. It can also cause pain in the temples and neck. Jaw discomfort is usually worse when chewing, yawning, or opening the mouth wide.
Jaw Locking
The TMJs may lock when they are out of alignment. It can make it difficult to open or close your mouth. Jaw locking is often accompanied by pain and clicking sounds that come from the TMJ.
Tension Headaches
TMD can cause tension headaches. Pain spreading from the TMJ to the temples is one of the most common TMJ symptoms and can be a sign of myofascial pain points. It’s a chronic facial pain that’s aggravated by moving the jaw muscles.
Ringing in the Ears (Tinnitus)
Your inner ear canal is connected to your TMJ. As such, TMD can cause ringing in the ears (tinnitus). The clicking and popping sounds from the TMJ can also be amplified and cause ear pain.
Dental Problems
The way your upper and lower teeth fit together is determined by the shape of your TMJ. If the TMJ is not functioning correctly, it can cause dental problems such as teeth grinding (bruxism), tooth wear, and gum recession.
How is TMJ Dysfunction Diagnosed?
If you suspect that you have TMD, it’s best to see a doctor or dentist so they can properly diagnose the condition. Although there is no single test for TMD, the following diagnostic tests might be used:
Medical History and Physical Examination
Your doctor will ask about your symptoms, medical history, and family history. You will also be asked about your current medications, stress levels, diet, and sleep habits. Aside from that, they will also perform a physical examination of your face, neck, and jaws to check for any tenderness or swelling. Doing so will help them rule out other conditions causing your symptoms.
Imaging Tests
Your doctor or dentist might order imaging tests to get a better look at your TMJ and surrounding structures. These tests can help them see if there are any problems with the jaw bone, joints, or muscles.
Some of the most common imaging tests used to diagnose TMD include the following:
- X-rays – With this test, high-energy waves create images of your bones on film. It can help your doctor or dentist see if there are any problems with the jaw bone or teeth.
- Computed tomography (CT) scans – A CT scan takes multiple X-rays to create 3D images of your bones and soft tissues. This test can provide more detailed information than a regular X-ray.
- Magnetic resonance imaging (MRI) scans – An MRI uses magnetic fields and radio waves to create detailed images of your bones and soft tissues. This test can help your doctor or dentist see if there is any damage to the TMJ or surrounding structures.
Jaw Track Record
In this test, you will be asked to move your jaw in different directions while your doctor or dentist observes the movement. This test can help them see if there are any pain or clicking sounds when moving the jaw muscles.
What Treatments are Available for TMJ Disorders?
Many people don’t seek medical help for temporomandibular disorders because they think it’s a minor problem that will go away on its own. However, leaving TMD untreated can lead to more severe problems. Luckily, there are many treatment options available for TMD, and below are some of the most common ones:
Home Remedies
Many home remedies can help control pain from TMJ symptoms, such as applying ice or heat to the jaw and massaging the temporal bone and jaw muscles. You can also use ingredients like eucalyptus oil and peppermint oil to make a mouthwash that can help soothe the muscles and remove inflamed tissue.
Pain Medication
If lifestyle changes and home remedies don’t work, your healthcare provider might prescribe medications to help relieve pain and inflammation. Some of the most common drugs used for TMD include over-the-counter pain relievers, particularly nonsteroidal anti-inflammatory drugs such as ibuprofen and acetaminophen. Your healthcare provider might prescribe stronger pain medications, such as muscle relaxants or tricyclic antidepressants, for pain relief of severe pain.
Intraoral Appliances
In some cases, your dentist might recommend wearing an intraoral appliance, also called a mouth guard, at night to prevent teeth grinding. This appliance can also help with jaw pain and muscle spasms. When the jaw is closed, the device will hold your lower jaw in a forward position, which can help relieve muscle and joint tension.
Complementary Treatment
These are non-mainstream practices used in addition to conventional medical treatment. Some examples include acupuncture, transcutaneous electrical nerve stimulation (TENS), and biofeedback. These treatments can help with pain management by stimulating the release of endorphins, the body’s natural painkillers.
Surgical Treatment
The last resort for treating TMD is surgery. It is usually only recommended if other treatments haven’t worked and the patient is experiencing severe pain. Surgery can be used to correct problems with the jaw, such as alignment or TMJ problems.
How to Manage TMD Pain
While it’s essential to see a healthcare professional so they can properly address and treat the condition, there are also many things you can do on your own to control TMD.
Below are some self-care options for managing pain:
Lifestyle Changes
Most temporomandibular disorders can be treated with simple lifestyle changes. If you’re starting to feel the symptoms of TMD, try to be gentle on your jaws and eat soft foods, minimize chewing gum and avoid extreme jaw movements. These changes will relieve pressure and stress on the TMJ.
Physical Therapy
Exercises that stretch and strengthen the muscles around the jaw can help to relieve pain from TMD. Your healthcare provider or physical therapist can show you some specific exercises that will work best for you.
You can also work on your posture and try to keep your head and shoulders in alignment. Many websites and online resources can provide you with the best practices in posture training.
Diet Changes
Eating a healthy diet is essential for overall health, but it can also help reduce pain from TMD. Irritable bowel syndrome is a common problem that can be aggravated by stress, and it can cause abdominal pain that can radiate to the jaw. Eating a diet that is high in fiber and low in sugar can help reduce symptoms of IBS.
Probiotics are also effective in reducing inflammation throughout the body, and they can be found in many fermented foods like yogurt, sauerkraut and kimchi.
Behavioral Approach
Stress is a common trigger for TMD pain. When you’re feeling stressed, your muscles tense up, leading to significant jaw pain. Although it’s not always possible to eliminate stress from your life, stress management behavior can provide relaxation techniques that relieve TMD symptoms. You can also relieve stress by getting regular exercise, spending time in nature, and practicing meditation or yoga.
How Can TMD Be Prevented?
According to the National Institute of Dental and Craniofacial Research, there are several things you can do to prevent TMD.
And although there is no guaranteed way to prevent the condition, these tips may help:
- Wear a mouth guard at night to reduce teeth grinding
- Do range-of-motion exercises for neck and facial pain
- Take a restful sleep to relieve soreness in muscles
- Stop teeth clenching during stressful situations
- Get regular dental checkups for early detection of dental problems to fix them before they become worse
- Practice proper movement of the jaw, limited mouth motions, and stretching to prevent unnecessary strain on the jaw muscles
Whether you’re just starting to experience the symptoms of TMD or you’ve been living with the condition for years, it’s never too late to seek treatment. With the help of a qualified healthcare professional, you can develop a treatment plan that will work for you. And with some self-care and lifestyle changes, you can reduce your pain and live a more comfortable life.
