Temporomandibular joint dysfunction
When a person begins to have problems with the jaw or with the muscles in the face that control the jaw, it is called temporomandibular joint dysfunction. It is also known as TMJ or TMD. Symptoms include a grating sensation or clicking sound when chewing or opening the mouth.
Definition & Facts
The temporomandibular joint connects the jaw to the temporal bones. The temporal bones are located in front of each ear. This hinge allows the jaw to move up and down and from side to side, enabling chewing and talking for example. Temporomandibular joint dysfunction involves problems with this joint and resulting symptoms. People with the highest risk of temporomandibular joint dysfunction are women between the ages of 20 and 40, but TMD can occur at any age.
Symptoms & Complaints
- Pain or tenderness in the jaw
- The joint locking up, making it difficult to open or close the mouth
- An achy pain around or in the ear
- An achy pain of the face typically near the jaw
- Discomfort or pain while chewing or having difficulty chewing
A doctor should be seen if there is persistent pain in the jaw or the person is not able to open or close his or her mouth all the way.
The temporomandibular joint acts like a hinge combined with a sliding motion. The areas of the bone that connect in the joint have cartilage covering them and have a shock-absorbing disc which is supposed to keep the jaw's movements smooth. While in many cases there is no clear cause, known causes have included:
- The shock-absorbing disc moves from its proper location or erodes away
- The cartilage of the joint becomes damaged due to arthritis
- A blow or other type of impact causes damage to the joint
Diagnosis & Tests
When an individual begins to have issues with the jaw or jaw muscles, he or she will probably talk with his or her regular doctor first. The doctor may suggest different treatments, but if the treatments do not work, the doctor will probably refer the patient to a doctor that specializes in temporomandibular joints. There are a number of questions the doctor or specialist may ask including:
- Is it a consistent pain or does the pain come and go?
- Are there any activities that trigger the pain?
- Is there any clicking or popping when the jaw is moved? If so, is it painful?
- Is normal opening of the mouth difficult to do?
Other than asking questions, the doctor will do a physical examination. During the exam the doctor will:
- Observe what the range of motion of the jaw is and if it is normal
- Listen to and feel the jaw while it is opened and closed
- Push on areas of the jaw to determine if there is any pain or discomfort in any specific areas
Additional tests may include:
Treatment & Therapy
There are some cases where the temporomandibular joint dysfunction will not need to be treated and will go away on its own. If the symptoms continue, the doctor may recommend different treatment options. Medications that may be used to help relieve the pain that is felt include:
- Pain medication - If over-the-counter pain relievers are not enough to relieve the pain, the doctor may prescribe a pain reliever to help.
- Muscle relaxers - These are sometimes prescribed to help relieve pain and discomfort that is felt.
- Tricyclic antidepressants - This type of drug has been used to help treat depression, but are now used sometimes to help relieve pain.
- Sedatives - A sedative may be prescribed if the pain is made worse by teeth-clenching at night.
Along with medications, there are other treatments that may be used, including:
- Physical therapy - This type of treatment could include heat and ice, therapeutic ultrasound, and exercises that are designed to stretch and strengthen the muscles in the jaw.
- Bite guard - A bite guard is a device that one typically wears at night to help adjust the jaw bite.
Additional therapies may include:
- Injections - Corticosteroid injections can help to relieve the pain of temporomandibular joint dysfunction.
- Arthrocentesis- This procedure involves needles being inserted into the joint so fluid can be flushed through the joint to remove any debris.
- Surgery - If other types of treatment do not relieve the pain and it appears that there are other structural problems causing issues with the joint then surgery may be used to repair and possibly replace the joint.
Prevention & Prophylaxis