The temporomandibular joint (TMJ) attaches the jaw bone, also known as the mandible, to the bones of the skull on each side of the head in front of the opening to the ear. This joint works in tandem with the muscles of the head and neck to facilitate chewing, speaking and swallowing. The TMJ moves in a silent, flexible and fluid manner when healthy. When difficulties opening or closing this joint occur, the result can be both frustrating and painful to the person. The potential causes of jaw pain are manifold. TMJ disorder is reported by more women than men and may occur on one or both sides of the face.
Symptoms of TMJ Disorder
In addition to pain in the joint areas itself, symptoms of TMJ discomfort include headaches, clicking or popping in the jaw area on one or both sides, earaches and stiffness or soreness in the neck. These symptoms can be acute, stemming from one instance of jaw strain. This pain can occur following a long dental procedure during which the person’s mouth is open for an extended amount of time; or chronic pain can occur, caused by more degenerative changes for one or more reasons. In the case of an acute jaw pain incident, resting the jaw and using an over-the-counter anti-inflammatory painkiller and ice application may be helpful. In more chronic cases, it may be necessary to seek a specific diagnosis and treatment plan.
Causes of TMJ Disorder
Some of the causes of chronic TMJ discomfort include osteoarthritis or rheumatoid arthritis inflammation, overstress from missing permanent chewing teeth, chronic pain from bruxing (grinding and clenching of the teeth) at nighttime, a history of jaw injury and certain progressive middle ear or bone diseases. The problem with many chronic TMJ discomfort cases is that both the muscles and parts of the joint can be affected, creating a situation in which cases vary from person to person. Since symptoms vary, treatment options also vary, and what is effective for treatment of one person’s symptoms may not necessarily work for another person.
What Doctors Look For in TMJ Disorder Diagnosis
To properly diagnose TMJ Disorder, the dentist may request that certain X-rays be taken to evaluate the jaw joint and surrounding structures. He may also palpate and study the musculature and other tissues of the head and neck to test for inflammation. Certain exercises and movements may be administered, and referral to an oral and maxillofacial surgeon for further studies may be recommended.
Treatment of TMJ Disorder
According to the National Institute of Dental and Craniofacial Research, due to insufficient studies on safety and effectiveness, experts recommend the most conservative, reversible treatments possible for TMJ disorders. A short-term treatment of TMJ discomfort is through the use of reversible splinting options. Bite splints can be worn either at night or throughout the day depending on the severity of the condition and the level of compliance from the patient. These splints attempt to remove pressure from the joint itself, relaxing the surrounding musculature and putting the joint in a more relaxed state and restful position. This can result in improved sleep and improved function for the jaw in the long term. Low-level laser stimulation and injections to relax the jaw are also included in treatment options, along with more invasive routes such as bite reconstruction and surgeries. These can be pursued as more aggressive treatment options if deemed necessary after other methods for relief have failed.
Jaw pain can be debilitating and interfere with routine daily life. Recognizing the causes of jaw pain early will expedite treatment, resolving soreness and returning the patient to regular activities.