The Symptoms and Treatment of Temporomandibular Joint Disorders (TMJ, TMD)

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Temporomandibular Joint DisordersOur daily activities require some jaw movement. Talking, eating, laughing, or even yawning involves our jaw joint. The jaw joint known as the temporomandibular joint connects our mandible (lower jawbone) to our temporal bone (right beneath our temple). The TMJ is responsible for side to side movement of our lower jaw, opening and closing, and even our facial symmetry.

Sometimes, due to stress, individuals experience nighttime grinding or clenching their teeth.  This is known as bruxism and can contribute to temporomandibular joint disorder (TMD). When bruxism is ongoing without intervention, popping or clicking (crepitus) may develop when opening the mouth.  Bruxism can also lead to jaw pain, or pain in facial muscles upon waking. Migraines or headaches are also associated with this parafunctional habit.

Trauma resulting from car accidents, blows to the orofacial area, or sport related injuries can lead to TMD. It is important to have a dental  examination after any such trauma. Arthritis, which affects several joints can affect the temporomandibular joint as well.

Symptoms can range from mild discomfort to being unable to close one’s mouth upon opening. There are noninvasive treatment options available depending on the severity of symptoms. For someone who usually wakes up with tension in their facial muscles, a mouth guard will alleviate their discomfort.  Over the counter anti-inflammatory drugs such as aspirin or ibuprofen can help reduce joint inflammation. Cold packs or moist heat should be applied to the area of discomfort a few times a day for relief.

However, if noninvasive measures do not resolve TMD, jaw surgery may be required. The surgery may include removing or repositioning the TMJ disc in order to reduce pain.  Jaw surgery may also involve repositioning the jaw bone to change the bite or facial profile.

Other methods used to relieve TMD include arthrocentesis. This is when a needle is inserted into the joint to remove fluid, or inject medicine such as steroids or an anesthetic. Fluid may be removed to relieve the pressure in the joint space.  Botox is one of the drugs that is being studied for TMJ treatment.  However, the Food and Drug Administration has not approved Botox for use in TMJ disorders. The research on using Botox for TMD is inconclusive.

Much like all other conditions in our health, TMD can be prevented from worsening if great care is taken in the early stages. Checking the jaw joint is a critical part of every dental evaluation.