(TMD; Temporomandibular Joint Disorder; Temporomandibular Joint Dysfunction; TMJ Syndrome; TMJ Osteoarthritis)
by Jenna Hollenstein, MS, RD
Temporomandibular disorder (TMD) is a painful condition in the joint that opens and closes the mouth. These temporomandibular joints are the small joints in front of each ear. They attach the lower jaw (mandible) to the skull. The disorder may affect the jaw joint or the muscles surrounding it. The disorder can include:
The exact cause of TMD is often unclear. Possible causes include:
Risk Factors TOP
TMD is more common in women aged 30-50 years old. Other factors that increase your chance of TMD include:
Symptoms may include:
The doctor will ask about your symptoms and medical history. A physical exam will be done. The physical exam may include:
Tests may include:
Usually the least invasive measures will be tried first. Treatment may include:
The most commonly used medications include:
Some medication may be injected into the jaw such as:
Physical Therapy TOP
To help reduce pain and allow muscles to relax:
Stress Reduction TOP
Some may benefit from counseling to learn stress management and relaxation techniques, such as:
Dental Procedures TOP
A splint or mouth guard can be made to relax your jaw muscles. This will prevent clenching and grinding of your teeth. The guard is usually worn at night. Correction of bite abnormalities by a dentist or orthodontist is sometimes needed.
Surgical Procedures TOP
Surgical correction is a last resort. Many of the available procedures have not been well-studied for their effectiveness.
There are no current guidelines to prevent TMD.
Canadian Dental Association
Canadian Society of Otolaryngology—Head & Neck Surgery
Borodic GE, Acquadro MA. The use of botulinum toxin for the treatment of chronic facial pain. J Pain . 2002;3(1):21-27.
Haley DP, Schiffman EL, Lindgren BR, Anderson Q, Andreasen K. The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain. J Am Dent Assoc . 2001;132(4):476-481.
National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/oralhealth/topics/tmj . Updated March 21, 2013. Accessed July 12, 2013.
Temporomandibular joint (TMJ) dysfunction . EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what . Updated May 31, 2013. Accessed July 12, 2013.
DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what : Turner JA, Mancl L, Aaron LA. Short- and long-term efficacy of brief cognitive-behavioral therapy for patients with chronic temporomandibular disorder pain: a randomized, controlled trial Pain . 2006;121(3):171-172.
Last reviewed July 2013 by Peter Lucas, MD; Brian Randall, MD
Last Updated: 5/11/2013