Temporomandibular joint disorder (TMJ)

TMJ disorders comprise a set of medical conditions affecting either one or both jaw joints and, potentially, their associated muscles and other tissues. The two temporomandibular joints are located in front of the left and right ears, connecting the lower jaw (also known as mandible) to the temporal bone of the skull (that supports the temple and is the place where the organ of hearing is located). The TMJ acts like a ‘sliding hinge’, allowing for various movements to take place, having a significant role in speech production, eating, and various other actions such as singing, or yawning.

Causes

There isn’t one known identifiable factor causing it, but its occurrence is mainly due to an improper alignment between the cartilage and small shock-absorbing disk that are both present in the tissue covering the parts of the bones that interact during the ‘sliding hinge’ movement

Any disturbance of said parts may cause TMJ disorders:

Erosion of the disk

Arthritis damaging the cartilaginous tissue

Any types of jaw injuries

Symptoms and signs

Feelings of pain or tenderness in the jaw

 

Pain in and around the ear

 

Difficulty when chewing or swallowing

 

Acute facial pain

 

A ‘locking’ of the joint, making it difficult to properly open or close the mouth

 

Possible clicking sound or grating sensation when eating or simply opening the mouth

 

Persistent headaches

Advice

People experiencing mild or periodic symptoms may wait for them to improve on their own in a matter of weeks or months, with the aid of home remedies:

Eating soft foods

Applying ice or moist heat to relieve pain

Avoiding painful jaw movements: yawning, loud singing, gum chewing

Recommended only in aggressive episodes:

Medications for relieving pain:

Over-the-counter pain medications or prescription drugs

Tricyclic antidepressants (used in the past for treating depression, now used for pain relief as well, by blocking the function of pain receptors)

Muscle relaxants

Sedatives for those with the habit of nighttime teeth clenching

Surgical procedures:

Arthrocentesis – the process of inserting needles into the joint to allow its irrigation with fluid in order to remove debris or inflammatory byproducts

Injections – cases of corticosteroid injections have been reported successful in easing pain, cases of botulinum toxin injections have been reportedly alleviating pain as well

Surgery – if the symptoms do not ameliorate by use of conservative therapies, and the cause is deemed a structural one, then a replacement or repairing of the joint will be performed (The National Institute of Dental and Craniofacial Research considers such a procedure to be avoided as much as possible)

Nonpharmaceutical procedures:

Bite guards (oral splints) – a device (of either soft of firm texture) is inserted into the mouth of the patient, covering the teeth – though an explanation for why it seems to alleviate pain has not yet been found

Physical therapy:

Ultrasound

Moist heat and ice

Exercises to stretch and strengthen jaw muscles

Counseling in cases of teeth clenching or grinding, and nail biting

MISCONCEPTIONS
  • Not many people suffer from TMJ

    TMJ is not a major medical condition

    Headaches are not indicative of TMJ

    TMJ can be easily cured – it is in fact a chronic condition that usually necessitates life-long management

    Surgery is necessarily needed

Statistics

TMJ disorders usually occur in women between the ages of 20 and 40, but may occur at any age

 

The most severe chronic and painful TMJ disorders manifest in a ratio of females-to-males of almost 9:1

 

Estimates suggest TMJ affecting over 10 million Americans, with a prevalence of 5% to 12%

Did you know?

Complementary and alternative medicine techniques have been successful to a certain degree in ameliorating symptomatology:

Acupuncture

Relaxation techniques

Biofeedback – monitoring the rigidity of the muscles involved via electronic devices can effectively determine whether a specific relaxation technique is actually of use

 

In the past, people who suffered from TMJ disorders were usually referred to dentists for corrective dental or jaw surgeries that, at times, worsened symptomatology

 

Actor Burt Reynolds and singers Iggy Azalea and LeAnn Rimes have had to manage TMJ episodes