You have probably heard of TMJ but may have questions about what it is, what the symptoms are, and possible treatments for it. Our team of dental professionals at Sninski & Schmitt Family Dentistry are experienced with diagnosing and treating “TMJ” with many of our patients. In this article, we clarify what TMJ is,  five common signs that you may have it, and treatments.

What is TMJ?

What is commonly called TMJ is actually TMD, which stands for Temporomandibular Joint Disorder. This disorder is sometimes erroneously called TMJ but that is the specific joint involved with the disorder. TMD is a painful condition that can cause problems chewing, closing your mouth properly, speaking, and yawning. The temporomandibular joint is actually a hinge that connects the jaw to the temporal bones of your skull that are in front of each ear. These joints, along with muscles, slide and move allowing the mandible (the lower jaw) to move up and down, side to side, and forward and back. When your mandible and joints are aligned as they should be, you experience smooth muscle actions. However, when these (muscles, ligaments, disk, jaw bone, temporal bone) are not aligned properly, you can have several problematic issues.

Problems Associated with TMD

When you have TMD, the jaw muscles, temporomandibular joints, and the nerves associated with chronic facial pain are all affected. The TMJs are some of the most complex joints in the body. You can have one or more of the following conditions individually or concurrently, as classified by The National Institute of Dental and Craniofacial Research:

  • Myofascial pain: Myofascial pain is the most common form of TMD, resulting in discomfort or pain in the connective tissue that covers the muscles (fascia) as well as the muscles that control jaw, neck, and shoulder function.
  • Internal derangement of the joint: When this occurs, you may have a dislocated jaw or a displaced disk, or injury to the condyle. The disk is the cushion of cartilage between the head of the jaw bone and the skull. The condyle is the rounded end of the jaw bone that articulates with the temporal skull bone.
  • Degenerative joint disease: Degenerative joint disease includes osteoarthritis or rheumatoid arthritis in the jaw joint.

What Causes TMD?

It isn’t clear exactly what causes TMD. It is believed that symptoms result from problems with the muscles in your jaw or with parts of the joint. The disorder can be caused by injury or excessive strain to the jaw joints and the surrounding tissues, or trauma to the muscles in your head and neck from something like a heavy blow or whiplash.

Other possible causes of TMD include:

  • Habitual clenching or grinding of the teeth, called bruxism
  • Trauma to the jaw, the head, or the neck
  • Arthritis and displacement of the jaw joint disks
  • Movement of the soft cushion or disc between the ball and socket of the joint
  • Stress that causes you to tighten facial and jaw muscles
  • An improper bite

Painful medical conditions such as fibromyalgia or irritable bowel syndrome can come together and worsen the pain of TMD. The National Institute of Dental and Craniofacial Research recently identified clinical, psychological, sensory, genetic, and nervous system factors that can put a person at higher risk for developing TMD.

Five signs that are the most common TMD symptoms include:

  • Clicking, grating, or popping in the jaw joint as you open or close your mouth
  • Jaws that lock up or get stuck when the mouth is either open or closed
  • Clenching or grinding the teeth
  • Limited mouth motions that cause trouble when chewing
  • Headaches

Other common symptoms of TMD include:

  • Jaw discomfort or soreness that is most prevalent in the morning or late afternoon
  • Ear aches or ringing in the ears that is not caused by infection of the inner ear
  • An uncomfortable bite as if the upper and lower teeth are not fitting together correctly
  • Swelling on the side of the face
  • Dizziness
  • Sensitivity of the teeth when there is no presence of an oral health disease
  • Numbness or tingling sensation in the fingers

How is TMD Diagnosed and What is the Treatment?

Diagnosis

Other conditions like tooth decay, sinus problems, and gum disease can present similar symptoms to TMD, making a proper diagnosis critical. Your dentist can determine the cause by performing a physical exam and obtaining information about your health history. 

First, your dental professional will check your jaw joints for pain or tenderness as he/she listens for sounds as you move your mouth. Next, they will check for proper jaw movement without locking. They will also check for problems with your bite that can involve facial muscles. The dentist may take full face X-rays in order to view the jaws, temporomandibular joints, and teeth in order to eliminate other problems. In some cases, an MRI or computer tomography (CT) is performed to show whether the TMJ disc is in the correct position when your jaw moves. A CT scan shows the skeletal detail of the joint.

Depending on the diagnosis, you may get referred to an oral and maxillofacial surgeon for further care and treatment. Another possibility is getting referred to an orthodontist when it  is indicated that there is a problem with your teeth, muscles, and joints working properly.

TMJ Treatments

Any of these treatments may be prescribed by your dental professional:

  • Resting the temporomandibular joint
  • Medicine including pain relievers
  • Relaxation techniques and stress management
  • A splint or night guard to lessen the effect of clenching or grinding by correcting your bite
  • Dental work to replace missing teeth, create crowns, create bridges and dentures, or braces to balance the biting surfaces when you have an improper bite
  • Using ice and hot packs
  • Eating soft foods in small pieces to aid in chewing

Here are additional treatments when the ones listed above don’t help:

  • Transcutaneous electrical nerve stimulation (TENS) using low-level electrical currents to provide pain relief by relaxing the jaw joint and facial muscles
  • Ultrasound that applies deep heat to the joint, relieving soreness and mobility
  • Trigger-point injections that provide pain relief in the facial muscles
  • Radio wave therapy to stimulate the joint
  • Low-level laser therapy to lower pain and inflammation

In extreme cases, surgery is an option but be sure to get second and third opinions from several dentists before going this route.

Contact Our Dentists in Cary and Holly Springs Today

If you are experiencing facial pain around the temporomandibular joint, contact us to schedule an appointment. Don’t wait to get a correct diagnosis and start a treatment plan. You don’t need to be in pain longer than is necessary, hoping it will get better on its own. Our dentists can check to see what the problem causing the pain is. Call us at our Holly Springs dentist office at (919) 600-6262 and our Cary, NC dentist office at (919) 467-2203, or fill out our contact form to schedule an appointment.