TMJ (Temporomandibular Joint Disease)

Temporomandibular Joint Disease

What are temporomandibular joint disorders? — Temporomandibular joint disorders are problems with the jaw joint and the muscles around it. The jaw joint, called the "temporomandibular joint," is located in front of the ear where the jawbone connects to your head. To feel the joint, place your finger on your cheek just in front of your ear and then open and close your mouth.
When doctors refer to temporomandibular joint disorders, they often use the term "TMJ" for short. TMJ disorders can be caused by many problems, including arthritis. Sometimes TMJ is due to a combination of stress, jaw clenching, teeth grinding, and other things that strain the jaw joint and the muscles around it. Some people with TMJ also have anxiety, depression, or an increased awareness of pain.
What are the symptoms of TMJ? — The main symptom of TMJ is a dull pain on just 1 side of the face, near the ear. Sometimes the pain also affects the ear, jaw, or back of the neck. Some people have headaches with TMJ. The pain of TMJ is typically constant, but may come and go. It is usually worse with jaw movement. People with TMJ might hear a clicking or popping sound or have a "crunchy feeling" in the joint when they open and close their mouth.
Should I see a doctor or nurse? — If the pain in your face or jaw is bothering you and does not go away, you should see your doctor or nurse.
What tests might I need? — There is no single test that can show if you have TMJ. Your doctor or nurse should be able to tell if you have TMJ by learning about your symptoms and doing an exam.
Unless the doctor suspects something unusual, most people will not need X-rays or an MRI (an imaging test that creates pictures of the inside of your body). But in some cases, your doctor might order a special X-ray called a "panoramic radiography of the jaw." This can show the TMJ shape and bone structure, the teeth, and the sinuses. (Your sinuses are hollow areas in the bones of your face.) This test can look for other things that can cause jaw pain.
How is TMJ treated? — No single treatment for TMJ works for everyone. Most of the time, medicines and simple lifestyle changes can help. Most patients get better over time, even without treatment, so patience is important.
Your doctor or nurse will help you find the right mix of treatments for you. He or she might refer you to a dentist who specializes in TMJ. Treatment options include:
Education and self-care – This includes following instructions from your doctor about how to avoid things that trigger TMJ pain. It also involves learning different ways to help you relax and manage stress. Some people might also improve with simple jaw exercises they can do on their own.
Medicines to relieve pain and relax the muscles – There are several types of medicines used to treat TMJ. These include nonsteroidal antiinflammatory drugs (NSAIDs), muscle relaxants, and certain medicines used for depression. (Medicines for depression can relieve pain even in people who are not depressed.) Your doctor will decide which medicine or group of medicines is best for you.
Devices – These are called "bite plates" or "occlusal splints." They fit in your mouth and keep you from grinding your teeth at night. They are made out of either a hard or soft plastic and might be made specially to fit your mouth. If you have sleep apnea, be sure to tell your doctor as the bite plate or splint might make your sleep apnea worse.
If these treatments don't help, your doctor might suggest that you see a specialist, such as an oral surgeon. The specialist might use medicines given by injection (shots) to treat the pain. It is rare that people need surgery for TMJ.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 82988 Version 13.0
Release: 28.2.2 - C28.105
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