Temporomandibular Joint Disorders (TMJ & TMD): Overview

Written by WebMD Editorial Contributors

Medically Reviewed by Evan Frisbee, DMD on October 31, 2021

• What Causes TMD?
• What Are the Symptoms?
• How Is TMD Diagnosed?
• Home Treatments for TMD
• Traditional Treatments
• Other Treatments
• Surgery for TMD
• More

Your temporomandibular joint is a hinge that connects your jaw to the temporal bones of your skull, which are in front of each ear. It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn.

Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD). But you may hear it wrongly called TMJ, after the joint.

We don’t know what causes TMD. Dentists believe symptoms arise from problems with the muscles of your jaw or with the parts of the joint itself.

Injury to your jaw, the joint, or the muscles of your head and neck — like from a heavy blow or whiplash — can lead to TMD. Other causes include:

• Grinding or clenching your teeth, which puts a lot of pressure on the joint
• Movement of the soft cushion or disc between the ball and socket of the joint
• Arthritis in the joint
• Stress, which can cause you to tighten facial and jaw muscles or clench the teeth

TMD often causes severe pain and discomfort. It can be temporary or last many years. It might affect one or both sides of your face. More women than men have it, and it’s most common among people between the ages of 20 and 40.

Common symptoms include:

• Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
• Problems when you try to open your mouth wide
• Jaws that get “stuck” or “lock” in the open- or closed-mouth position
• Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.
• A tired feeling in your face
• Trouble chewing or a sudden uncomfortable bite — as if the upper and lower teeth are not fitting together properly. Learn more about the pros and cons of teeth alignment surgery.
• Swelling on the side of your face

You may also have toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).

Many other conditions cause similar symptoms — like tooth decay, sinus problems, arthritis, or gum disease. To figure out what’s causing yours, the dentist will ask about your health history and conduct a physical exam.

They’ll check your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. They’ll also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Plus they’ll test your bite and check for problems with your facial muscles.

Your dentist may take full face X-rays so they can view your jaws, temporomandibular joints, and teeth to rule out other problems. They may need to do other tests, like Magnetic resonance imaging (MRI) or computer tomography (CT). The MRI can show if the TMJ disc is in the proper position as your jaw moves. A CT scan shows the bony detail of the joint.

You may get referred to an oral surgeon (also called an oral and maxillofacial surgeon) for further care and treatment. This doctor specializes in surgery in and around the entire face, mouth, and jaw area. You may also see an orthodontist to ensure your teeth, muscles, and joints work like they should.

There are things you can do on your own to help relieve TMD symptoms. Your doctor may suggest you try some of these remedies together.

Take over-the-counter medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen, can relieve muscle pain and swelling.

Use moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple jaw stretches (if your dentist or physical therapist OKs them). When you’re done, hold a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.

Eat soft foods. Add yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans, and grains to your menu. Cut foods into small pieces so you chew less. Skip hard, crunchy foods (like pretzels and raw carrots), chewy foods (like caramels and taffy), and thick or large bites that require you to open wide.

Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) to a minimum and don’t yell, sing, or do anything that forces you to open wide.

Don’t rest your chin on your hand. Don’t hold the phone between your shoulder and ear. Practice good posture to reduce neck and facial pain.

Keep your teeth slightly apart as often as you can. This will relieve pressure on your jaw. Put your tongue between your teeth to control clenching or grinding during the day.

Learn relaxation techniques to help loosen up your jaw. Ask your dentist if you need physical therapy or massage. Consider stress reduction therapy as well as biofeedback.

Talk to your dentist about these tried-and-true treatments for TMD:

Medications. Your dentist can prescribe higher doses of NSAIDs if you need them for pain and swelling. They might suggest a muscle relaxer to relax your jaw if you grind or clench your teeth. Or an anti-anxiety medication to relieve stress, which may bring on TMD. In low doses they can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.

A splint or night guard. These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position. What’s the difference between them? You wear night guards while you sleep. You use a splint all the time. Your dentist will tell you which type you need.

Dental work. Your dentist can replace missing teeth and use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem. Learn more about what causes an overbite, as well as when an overbite is considered normal.

If the treatments listed above don’t help, your dentist may suggest one or more of the following:

Transcutaneous electrical nerve stimulation (TENS). This therapy uses low-level electrical currents to provide pain relief by relaxing your jaw joint and facial muscles. It can be done at the dentist’s office or at home.

Ultrasound. Deep heat applied to the joint can relieve soreness or improve mobility.

Trigger-point injections. Pain medication or anesthesia is injected into tender facial muscles called “trigger points” to give relief.

Radio wave therapy. Radio waves stimulate the joint, which increases blood flow and eases pain.

Low-level laser therapy. This lowers pain and inflammation and helps you move your neck more freely and open your mouth wider.

If other treatments can’t help you, surgery is an option. Once it’s done, it can’t be undone, so get a second or even third opinion from other dentists.

There are three types of surgery for TMD. The type you need depends on the problem.

Arthrocentesis is used if you have no major history of TMJ but your jaws are locked. It’s a minor procedure that your dentist can do in their office. They’ll give you general anesthesia, then insert needles into the joint and wash it out. They may use a special tool to get rid of damaged tissue or dislodge a disc stuck in the joint, or to unstick the joint itself.

Arthroscopyis surgery done with an arthroscope. This special tool has a lens and a light on it. It lets your doctor see inside your joint. You’ll get general anesthesia, then the doctor will make a small cut in front of your ear and insert the tool. It’ll be hooked up to a video screen, so they can examine your joint and the area around it. They may remove inflamed tissue or realign the disc or joint. This type of surgery, known as minimally invasive, leaves a smaller scar, has fewer complications, and requires a shorter recovery time than a major operation.

Open-joint surgery. Depending on the cause of the TMD, arthroscopy may not be possible. You may need this type of surgery if:

• The bony structures in your jaw joint are wearing down
• You have tumors in or around the joint
• Your joint is scarred or full of bone chips

You’ll get general anesthesia, then the doctor will open up the entire area around the joint so they can get a full view and better access. You’ll need longer to heal after open-joint surgery, and there is a greater chance of scarring and nerve injury.

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TMJ (Temporomandibular Joint) Disorders: Symptoms and More

The temporomandibular joint (TMJ) is the joint that connects your mandible (lower jaw) to your skull. The joint can be found on both sides of your head in front of your ears. It allows your jaw to open and close, letting you to speak and eat.

The abbreviation “TMJ” has also been used to refer to a group of health conditions related to your jaw. However, this is becoming more commonly abbreviated as “TMD” or “TMJD” to distinguish the temporomandibular joint itself from TMJ disorders.

These disorders can cause:

• tenderness at the joint
• facial pain
• difficulty moving the joint

According to the National Institute of Dental and Craniofacial Research, as many as 10 million Americans suffer from TMJ disorders. They are more common among women than men.

These disorders are treatable, but they have many different possible causes. This can make diagnosis difficult.

Keep reading to learn more about TMJ disorders. You should discuss any concerns with your doctor.

The symptoms of TMJ disorders depend on the severity and cause of your condition. The most common symptom of TMJ disorders is pain in the jaw and surrounding muscles.

According to 2021 research, other symptoms typically associated with these disorders include:

• pain that can be felt in the face or neck
• stiffness in the muscles of the jaw
• limited movement of the jaw
• locking of the jaw
• clicking or popping sound from the TMJ site
• dental issues, such as the wearing down of teeth
• tinnitus (ringing in the ear)
• vertigo
• headaches
• shift in the jaw, changing the way that the upper and lower teeth align (called malocclusion)

Symptoms may show up on just one side of the face or both.

Because TMJ disorders can have a variety of causes, there are also a variety of ways to treat them.

Physicians will typically advise starting with home treatments first. This is because many of the more complicated treatments still need more studies to prove their efficiency.

Home treatments

In a lot of cases, the symptoms of TMJ disorders can be treated with self-care practices at home. To ease the symptoms of TMJ at home, you can:

• Eat soft foods.
• Use ice to reduce swelling.
• Reduce jaw movements.
• Avoid chewing gum and tough foods (like beef jerky).
• Take measures to reduce stress.
• Use jaw-stretching exercises to help improve jaw movement.

Medication

If you find that your TMJ is not eased by using home treatments, some medications — both over-the-counter and prescribed by a doctor — may provide more relief.

Some of these medications include:

• nonsteroidal anti-inflammatory drugs (NSAIDs)
• corticosteroids
• muscle relaxers
• antidepressants
• local anesthetics

Your doctor will help you decide which medication is best for you, based on your personal condition and health history.

Therapies

Occasionally, your doctor may recommend physical therapy. Depending on the area that needs attention, your therapy could include:

• heat therapy
• cooling therapy
• acupuncture
• tissue mobilization
• resistance exercises
• stretches

If you and your doctor believe your TMJ disorder may be caused by stress, talk therapy or stress management exercises are additional options.

Surgery or other procedures

If your symptoms don’t improve with the methods listed above, your doctor may decide that your condition requires serious treatment.

Botox injections are one such treatment. Typically, these injections are done for painful trigger points or chronic teeth grinding. The evidence behind this treatment is still lacking, however.

In very rare cases, your doctor may recommend surgery to treat your condition. Procedures can include:

• corrective dental treatment to improve your bite and align your teeth
• arthrocentesis, which removes fluid and debris from the joint
• surgery to replace the joint

Procedures used to treat this condition may, in some cases, make your symptoms worse. Talk with your doctor about the potential risks of these procedures.

In many cases, it’s not known what causes TMJ disorders. Trauma to the jaw or joint may play a role. There are also other health conditions that may contribute to the development of TMJ disorders.

These include:

• arthritis
• erosion (wearing away) of the joint
• habitual grinding or clenching of the teeth
• structural jaw issues present at birth
• growth disorders

Risk factors

While there are some factors that are often associated with the development of TMJ disorders, they haven’t been proven to be a direct cause.

Some of these include:

• female hormones (it’s theorized that estrogen may play a role in the development of TMJ)
• poor posture that strains the muscles of the neck and face
• prolonged stress
• joint hypermobility

TMJ disorders can be difficult to diagnose. There are no standard tests to diagnose most of the disorders that fall under that title. A doctor may refer you to a dentist, or an ear, nose, and throat (ENT) specialist to diagnose your condition.

A healthcare professional may examine your to see if there is swelling or tenderness. They may also use several different imaging tests.

These can include:

• X-rays. X-rays of the jaw and teeth usually involve you biting down on a small mouthpiece as your dentist moves an imaging machine around your head. These X-rays will allow your dentist to see the bones in and around your jaw, as well as your teeth placement.
• CT scan. A CT scan of the jaw allows your doctor to see the bones and joint tissues in a more advanced way than a regular X-ray.
• MRI. An MRI of the jaw will reveal if there are problems with the structure of the jaw. An MRI, or magnetic resonance imaging scan, uses a magnetic field to show detailed images of organs and tissues.

You may not be able to prevent TMJ disorder from developing, but you might be able to reduce symptoms by lowering your stress levels, employing physical therapy and exercises, and working with a dentist or doctor if you often grind your teeth at night.

Possible solutions for teeth grinding include wearing a mouth guard at night and occasionally taking muscle relaxants.

Can TMJ disorder be cured?

TMJ can be caused by a variety of issues, such as trauma to the jaw or persistent stress, so curing the symptoms is directly connected to curing, or easing, the condition that caused them.

However, many individuals find that their TMJ symptoms improve or even go away on their own within weeks or months if home remedies are employed.

Are TMJ disorders serious?

While many people find their TMJ symptoms go away on their own after addressing the root cause, other individuals may deal with more serious symptoms that can affect their quality of life.

Even when someone is dealing with a more serious case of TMJ disorder, it’s recommended to avoid aggressive treatments such as surgery whenever possible, because there is still not enough evidence to show that these irreversible methods work.

There are a wide variety of treatments available for TMJ disorders. If one doesn’t work for you right away, work with your doctor to find one that does.

What will happen if TMJ disorder is not treated?

TMJ isn’t life threatening, but if it’s not treated, it can cause pretty persistent discomfort and tension in and around your jaw. It’s also possible that the affected joints could become inflamed, and there may even be damage to your teeth.

You don’t have to deal with the pain and discomfort of TMJ alone. Talk with your doctor or dentist about your symptoms.

The outlook for TMJ disorders depends on the cause of the condition. TMJ disorders can be successfully treated in many people with at-home remedies, such as changing posture or reducing stress.

If your condition is caused by a chronic (long-term) disease such as arthritis, lifestyle changes may not be enough. Arthritis can wear down the joint over time and increase pain. There are, however, many treatments to help with the symptoms of arthritis itself.

Most cases of TMJ disorder warrant changes in lifestyle habits, possibly combined with medications to ease pain and discomfort. Aggressive treatments are rarely needed.

Talk with your doctor about your options to determine what treatment is right for you.

Temporomandibular joint dysfunction (TMJ): symptoms and treatment

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What is Temporomandibular Joint Dysfunction (TMJ)?
Temporomandibular joint dysfunction means that the joint that connects the upper and lower jaws does not function properly. This joint is one of the most complex joints in the human body, it is responsible for the movement of the lower jaw forward, backward and from side to side. Any disease that prevents this complex system of muscles, ligaments, cartilage, and bones from working properly is called temporomandibular joint dysfunction. Often with TMJ dysfunction, there is a feeling that the jaw clicks, clicks, or even “jams” for a moment. It is often impossible to determine the exact cause of this disorder.

What are the symptoms of TMJ dysfunction?
TMJ dysfunction disorders have many signs and symptoms. It is often difficult to accurately determine the presence of TMJ dysfunction, since one or more of its symptoms may be a manifestation of another disease. Your dentist can make an accurate diagnosis by reviewing your medical and dental records, performing a clinical examination, and taking the necessary x-rays.

The most common symptoms of TMJ dysfunction include:

• Headache (often migraine-like), pain in the ears, and pain and pressure behind the eyes.
• Clacking or clicking sound when you open or close your mouth.
• Pain when you yawn, open your mouth wide or chew
• If the jaws “stuck”, they do not open or “pop out”
• Jaw muscle weakness
• Suddenly the upper and lower jaws begin to close differently

How is TMJ dysfunction treated?
Although there is no single treatment for TMJ dysfunction, there are various treatments that can significantly reduce your symptoms. Your dentist will be able to recommend one or more of the following methods for you.

• Try to relieve muscle spasm and pain by applying hot compresses or taking medications such as muscle relaxants, aspirin or other over-the-counter pain relievers, or anti-inflammatory medications.
• Reduce the adverse effects of squeezing and grinding by wearing an apparatus sometimes referred to as a bite block or splint. Made to fit your mouth, this appliance covers your upper teeth and prevents them from rubbing against your lower teeth.
• Learn relaxation techniques to control jaw muscle tension. Your dentist may suggest that you go to a training session or a consultation where you can learn how to manage stress.

If the joints of the jaw are out of order and other treatments fail, a jaw joint surgery can be recommended.

This article is intended to increase knowledge and understanding of general oral health issues. The article does not replace the professional medical advice of a specialist, and cannot be used to make a decision on making a diagnosis and prescribing treatment. Always seek the advice of a dentist or other qualified professional for all questions regarding your health condition and treatment.

Does your jaw move correctly?

Often problems with teeth turn into a constant “headache”, and in the truest sense of the word. A migraine, frequent discomfort when opening the jaw, eating, nighttime snoring settles in the life of a healthy person. For many, it remains a secret that the essence of the problem – dysfunction of the temporomandibular joint – is a consequence of malocclusion. We talked with Ramil Nailevich Gimadeev, chief physician of the City Dentistry dental complex on Vosstaniya, about how to find out that when such problems appear, you first need to go to the dentist.

How can TMJ problems be diagnosed?

Clicking, crunching in the jaw area, headaches, neck pain and the presence of snoring – all this can be associated with problems of the temporomandibular joint. The main difficulties that arise with the temporomandibular joint are associated with occlusion, in our understanding – bite. They lead to problems with the temporomandibular joint, so to speak, to its dysfunction. And dysfunction already leads to headaches, neck pain, and hearing loss.

Do I need to take any tests I have done to my doctor’s appointment? X-rays, for example?

To get started, you just need to come to the clinic and tell about your complaints. What research to do, the doctor decides on the spot. In this case, this is necessarily an x-ray examination, a computed tomogram, an orthopantomogram, a cephalometric image in a lateral, direct projection – this is again as necessary. We also need to make diagnostic models, on which we conduct a complete analysis of the state of bite today. There is no need to prepare pictures in advance, we will prompt and determine what is needed on the spot. But, of course, if any studies have already been carried out before, we can use them in our work, subsequently doing what we lack for a complete picture.

What are the pathologies of the TMJ?

The main problem is dysfunction, which includes an extended state and two more pathologies: arthritis and arthrosis. As we know, arthritis is a disease in which complaints of pain of varying intensity appear, ranging from a feeling of awkwardness, discomfort in the area of ​​the affected joint, and up to the complete shutdown of its function. One of the early and persistent symptoms of inflammatory arthritis is morning stiffness. Stiffness also occurs at other times of the day after a more or less long period of rest of the jaw. Arthrosis is a chronic dystrophic disease of the articular surfaces and meniscus of the temporomandibular joint, accompanied by pain in the masticatory muscles.

In any case, if you have the slightest manifestations of temporomandibular joint dysfunction or you are concerned about particular manifestations: someone snores heavily or grinds your teeth in your sleep, you can be advised to contact specialists who apply the technique of neuromuscular dentistry. And if your orthodontist, in addition to braces, uses methods to eliminate TMJ dysfunction, consider yourself lucky. An optimal bite will not only create a perfect smile and keep your teeth healthy, but also ensure proper posture and normal functioning of muscles and joints.

What methods of treatment of TMJ pathologies are used in the clinics of the City Dentistry network?

One of the methods of treatment of the temporomandibular joint is to achieve the correct occlusion, as we have already said – bite. To find the correct physiological state of the lower jaw in relation to the upper jaw, we use our diagnostic equipment that records the movement of the joint – this is gnathography, electromeography, selfography, it is by these parameters that we can diagnose the pathology of the TMJ – is there a perforation of the disc, some others changes, and from here a further treatment plan is already being built. In general, all ongoing activities are in any case an integrated approach that begins with sanitation – treatment of the entire oral cavity, orthodontics, if indicated, and leads, as a result, to the restoration of the lost bite height.

How long will it take to eliminate the existing pathology of the TMJ?

The minimum duration of treatment is from three to six months. But you need to understand that situations are different, so there are different methods of treatment and restoration of the physiological state of the TMJ. But, it is worth noting that the improvement in the quality of life comes much faster than the patient himself expects. Everything here depends on how quickly the diagnosis is carried out, and then the issue of restoring the final type of occlusion will be decided: this is the reconstruction of the bite or already orthodontics – the correction of various dentoalveolar anomalies using bracket systems of various functional effects.

One of the first to discover the connection between ear pain and impaired function of the temporomandibular joints was otolaryngologist Dr. James Costen, who worked in the 30s in the United States. He wrote a series of works in this direction, after some time, the term Costen’s syndrome was firmly established behind the problems associated with the TMJ joints.