As humans we usually try to avoid pain. After all, it hurts! Pain has a purpose, though. It lets us know that something is wrong with a part of the body and that part needs to be tended to, protected. It is particularly troubling when pain occurs in a part of the body that is necessary for life sustaining functions such as eating. This is a concern for people with jaw pain caused by conditions like temporomandibular joint disorder, also known as TMJ.
What is TMJ?
TMJ, or, more accurately, TMJD, is an inflammation of the temporomandibular joint, or jaw, that causes pain and stiffness in that area. The joint connects the jaw to the skull and acts as a hinge that slides in the socket to facilitate movement. The end of the jaw bone sits in a groove in the skull and is cushioned by a tiny fluid filled disc. When the joint is injured, stressed, or damaged, it can result in pain in that area, also known as TMJ.
This disorder is estimated to affect between 5% and 12% of the population. Women are twice as likely as men to experience it. One unusual characteristic of TMJ is that it tends to have a higher prevalence among younger people – an uncommon trait for chronic pain conditions.
What are the Symptoms of TMJ?
The symptoms of TMJ disorder tends to center on pain but may also include a lack of mobility in the area of the jaw accompanied by pain. While the pain tends to be localized, it can lead to other conditions such as headaches or even migraines. The more common symptoms of TMJ include:
- Tenderness or pain in the general area of the jaw, on one or both sides
- Achiness or dull pain around or in the ear
- Facial pain that is described as aching
- Pain in the temporomandibular joints, on one or both sides
- Pain while chewing or opening and closing the mouth
- Difficulty while chewing or opening and closing the mouth
- Clicking or popping sound when the jaw moves, such as in chewing
- Locking or catching of the joint which makes it difficult to close or open the mouth
- Low range of motion in the jaw joint
- Facial swelling on the sides around the joint area
- Grating sensation when chewing or opening and closing the mouth
If the mobility issues (locking or catching of the joint or limited range of motion of the jaw) are not accompanied by pain, then the problem is not likely to be a TMJ disorder.
If your jaw pain or tenderness in that area are persistent, or if you are unable to completely open or close your jaw, you need to seek medical attention. Your dentist or doctor can diagnose the problem and work with you to develop an appropriate treatment plan.
What Causes TMJ?
There are a number of conditions and even personal habits that can contribute to or cause TMJ disorder. Some of the most common issues that lead to TMJ include:
- Stress that results in clenching of the jaw and increased muscle tension, particularly in the neck
- Poor posture, particularly in the upper back and neck area which can cause neck strain and lead to abnormal jaw muscle function
- Injury or trauma to the jaw area
- Bruxism, or teeth grinding
- Conditions like chronic inflammatory arthritis
- Teeth that are poorly positioned
In many cases, the joint itself is affected. In other words, the pain tends to come from a structural problem, whether the joint is overstressed or damaged, or the disc within the joint is damaged. While there may be some muscular inflammation and pain as a result of the condition, TMJ affects the joint and that is the primary source of the pain.
How is TMJ Diagnosed?
A TMJ diagnosis typically involves both a physical examination and imaging such as X-rays. When you see your dentist or doctor about your jaw pain, he or she will feel your jaw while you open and close your mouth while listening to see if they can hear any popping or clicking. They will also assess your range of motion in the jaw and press on various areas to determine the exact location of the discomfort or pain. You may also be asked questions about your lifestyle and habits, including any stressful situations you are experiencing or experience on a regular basis.
If your dentist or doctor suspects that you may have a structural problem, such as injury to the joint or a problem with your teeth, they will probably order dental X-rays, an MRI, or a CT scan in order to gain a more detailed view of the bone and disc.
In some cases, your healthcare provider may choose TMJ arthroscopy to diagnose your TMJ. This is a simple procedure, performed by a doctor in the office. A cannula (small, thin tube) is inserted into the joint space. An arthroscope (tiny camera) is then fed through the cannula, allowing the doctor to see directly into the joint and get a better view of the area in order to make a diagnosis.
What are the Treatments for TMJ?
There are several ways that TMJ is treated, although sometimes the symptoms may resolve on their own without any medication or therapies. If your symptoms persist, get worse, or significantly inhibit your range of motion, your dentist or doctor may recommend several treatment options.
Medications for TMJ can range from over the counter anti-inflammatories and pain relievers like ibuprofen or naproxen sodium, to prescription medications like muscle relaxants and tricyclic antidepressants. Amitriptyline is a common tricyclic antidepressant that can be used to relieve pain.
Nondrug options for TMJ include physical therapy and chiropractic. Sometimes, counseling may be recommended, especially if you are under a great deal of stress and need to learn how to manage it better. One of the most common therapies used for TMJ is the occlusal appliance which includes oral splints and mouth guards. These are typically recommended in addition to using medication and sometimes even other therapies.
When other treatment options don’t work, the dentist or doctor may advise surgery. There are several types of surgery for TMJ, including injections and open joint surgery. However, these are usually recommended once other, less invasive treatments have been exhausted and were unsuccessful.
How do Bite Guards Work?
The most common cause of TMJ is tension in the jaw. This usually comes from grinding the teeth or excessive clenching of the jaw. A bite guard can help when your TMJ is caused, at least in part, by these issues. It can be made of soft or hard plastic and fit on either the top or bottom teeth. Your dentist can help you determine which type is best for you.
A bite guard helps to prevent teeth grinding by:
- Helping your jaw muscles relax which reduces spasms
- Allows the muscles in the jaw to properly align
- Provides cushion for the teeth, preventing damage from clenching or grinding
- Eases the tension in the jaw muscle that causes the persistent ache
- Prevents wear on the teeth
You don’t have to live with TMJ pain. You do have treatment options available that are very effective. Talk to your dentist to find a treatment plan that works best for you, so you can live pain free.
to schedule your next preventive care exam or to request an evaluation of your symptoms.