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Temporomandibular Disorder

(TMD; Temporomandibular Joint Disorder; Temporomandibular Joint Dysfunction; TMJ Syndrome; TMJ Osteoarthritis)

Definition

Temporomandibular disorder (TMD) is a painful problem of the jaw joints. These are the small joints in front of each ear. They attach the lower jaw to the skull. TMD problems may be in the joint in the jaw or the muscles around it.

The Temporomandibular Joint
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Causes

The cause of TMD is often not clear. It may be due to:

  • An injury of the jaw or face
  • Too much tension in the jaw muscles
  • Displacement or poor position of the jaw joint or cartilage disc inside it
  • The upper and lower teeth not being in line
  • Disturbed movement of the jaw joint
  • Arthritis or a swelling in the joint
  • Too much or not enough motion of the joint

Risk Factors

TMD is more common in women aged 30 to 50. Other things that may raise the risk are:

  • An injury of the jaw and neck
  • Clenching or grinding of teeth
  • Poorly fitting dentures or crowns
  • Stress
  • Smoking

Symptoms

TMD may cause:

  • Pain in the jaw or face
  • Pain that may be worse with chewing, yawning, or opening and closing the mouth
  • Clicking, popping, or grating sounds with movement of the jaw
  • A feeling of the jaw catching or locking briefly while attempting to open or close the mouth, or while chewing
  • Headache
  • Earache
  • Neck or shoulder pain

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the jaw, teeth, face, and head.

Pictures may be needed of the jaw. This can be done with:

Treatment

The goal of treatment is to manage symptoms. Choices are:

  • Lifestyle changes, such as ice or heat packs and avoiding gum chewing
  • Counseling to learn how to manage stress
  • Physical therapy to stretch and strengthen the jaw
  • Dental devices to relax the jaw muscles and prevent the teeth from clenching and grinding
  • Medicine, such as:
    • Pain relievers like ibuprofen
    • Muscle relaxants
    • Antidepressants to ease pain
    • Cortisone injections to ease swelling and pain
    • Botulinum toxin (Botox) injections to ease tension in the jaw

Some people may need surgery when other methods are not helpful. This is not common.

Prevention

Avoid these habits to lower the risk of this problem:

  • Jaw clenching
  • Nail biting
  • Teeth grinding
  • Excessive chewing of hard foods, gum, or the lip
RESOURCES:

Mouth Healthy—American Dental Association
http://www.mouthhealthy.org

The TMJ Association
http://www.tmj.org

CANADIAN RESOURCES:

Canadian Dental Association
http://www.cda-adc.ca

Canadian Society of Otolaryngology—Head & Neck Surgery
http://www.entcanada.org

REFERENCES:

Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015 Mar 15;91(6):378-386.

Temporomandibular disorders. American Association of Oral and Maxillofacial Surgeons website. Available at: https://www.aaoms.org/docs/practice_resources/clinical_resources/tmd_disorders.pdf. Accessed October 28, 2020.

Temporomandibular joint (TMJ) dysfunction . EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/temporomandibular-disorders. Accessed October 28, 2020.

TMJ. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/t/tmj. Accessed October 28, 2020.

TMJ. ENThealth—American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/tmj. Accessed October 28, 2020.

TMJ (temporomandibular joint and muscle disorders). National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/TMJ. Accessed October 28, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 5/4/2021