Temporomandibular joint (TMJ) syndrome facts
- The temporomandibular joint is the joint that connects your jaw to your skull. When this joint is injured or damaged, it can lead to a disorder called temporomandibular joint (TMJ) syndrome.
- Causes of temporomandibular joint (TMJ) syndrome include injury to the teeth or jaw, misalignment of the teeth or jaw, teeth grinding, poor posture, stress, arthritis, and gum chewing.
- Signs and symptoms of temporomandibular joint (TMJ) syndrome include pain in the jaw joint, clicking of the jaw, ear pain, popping sounds in ears, headaches, stiff or sore jaw muscles, pain in the temple area, or locking of the jaw.
- Temporomandibular joint (TMJ) syndrome often responds to home remedies, including ice packs to the joint, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), avoiding chewing gum, massage or gentle stretches of the jaw and neck, and stress reduction.
- When home treatment does not work, medical treatment for temporomandibular joint (TMJ) syndrome includes dental splints, Botoxinjections, physical therapy, prescription medications, and in severe cases, surgery.
- The prognosis for TMJ syndrome is generally good as the disorder can usually be managed with self-care and home remedies.
What is temporomandibular joint (TMJ) syndrome?
Temporomandibular joint (TMJ) syndrome is a disorder of the jaw muscles and nerves caused by injury to the temporomandibular joint. The temporomandibular joint is the connection between the jawbone to the skull. The injured temporomandibular joint leads to pain with chewing, clicking, and popping of the jaw; swelling on the sides of the face; nerve inflammation; headaches; tooth grinding (bruxism); Eustachian tube dysfunction; and sometimes dislocation of the temporomandibular joint. Temporomandibular joint syndrome is also known as temporomandibular joint disorder.
What are the risk factors for TMJ syndrome?
There are several risk factors for TMJ syndrome:
- Poor posture in the neck and upper back muscles may lead to neck strain and abnormalities of jaw muscle function.
- Stress may increase muscle tension and jaw clenching.
- Women 18-44 years of age have increased risk.
- Patients with other chronic inflammatory arthritis have increased risk.
- People with jaw trauma or poorly positioned teeth have increased risk.
- People who have a genetic predisposition to pain sensitivity and increased stress responses may be more susceptible.
What causes TMJ syndrome?
The causes of TMJ syndrome are not completely understood. Multiple factors contribute to the muscle tightness and dysfunction that characterize this condition. It is not clear whether some of these causes directly lead to TMJ syndrome or if they are a result of the disorder. Causes may include
- misalignment (malocclusion) of or trauma to the teeth or jaw,
- teeth grinding (bruxism),
- poor posture,
- stress or anxiety
- arthritis and other inflammatory musculoskeletal disorders,
- excessive gum chewing.
What are TMJ syndrome symptoms and signs?
The main symptom of TMJ syndrome is pain in the jaw joint. This joint is located just in front of the ear, and pain associated with TMJ syndrome may involve the face, eye, forehead, ear, or neck. Signs and symptoms of TMJ syndrome include the following:
- Pain in the jaw, especially at the area of the joint
- Popping/clicking of the jaw
- Ear pain or sounds of cracking in the ears
- Ringing or popping sounds in the ears (tinnitus) or a sense of fullness in the ears
- Blurred vision
- Tight, stiff, or sore jaw or neck muscles
- Facial pain, cheek pain, or chin numbness or tingling
- Pain at the base of the tongue
- Pain, swelling, or a lump in the temple area
- Shoulder pain
- Locking or dislocation of the jaw (usually after widely yawning), referred to as lockjaw
- Dizziness or vertigo
How is TMJ syndrome diagnosed?
A doctor will diagnose TMJ syndrome by taking the patient’s medical history and doing a physical exam to find the cause of the symptoms. There is no specific test to diagnose TMJ syndrome. A doctor may send the patient to an oral and maxillofacial specialist, an otolaryngologist (also called an ear, nose, and throat doctor or ENT specialist), or a dentist specializing in jaw disorders to confirm the diagnosis. Sometimes an MRI of the temporomandibular joint may be ordered to detect damage to the cartilage of the jaw joint and to rule out other medical problems.
A condition that may have some similar symptoms to TMJ syndrome is trigeminal neuralgia. The trigeminal nerve supplies nerve impulses to the temporomandibular joint, and when irritated, it can also cause facial pain. Other causes of face or neck pain include swollen lymph nodes (swollen glands), giant cell arteritis, salivary gland disease, sore throat, ill-fitting dentures, or dental braces.
What is the treatment for TMJ syndrome? Are there any home remedies that provide TMJ pain relief?
Many symptoms of TMJ syndrome can respond well to home remedies or stress reduction and relaxation techniques. The following home remedies may provide some relief:
- Ice or cold packs to the area of the joint
- Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve)
- Eating soft foods and avoiding chewing gum
- Massage or gentle self-stretching of the jaw and neck muscles (a doctor or physical therapist can recommend appropriate stretches)
- Relaxation techniques and stress reduction
When home remedies are not effective, medical treatment options may be necessary. These include the following:
- Dental splint (occlusal splint or stabilization splint or bite guard), which is a dental appliance placed in the mouth that keeps the teeth in alignment and prevents tooth grinding. This resembles a mouth guard and is usually prescribed and fitted by a jaw specialist.
- Botox may be used to relax the muscles of the jaw. However, this is not currently an FDA-approved treatment for TMJ syndrome.
- Physical therapy with jaw exercises can strengthen muscles, improve flexibility, and range of motion.
- In states where medical marijuana is legal, it may be prescribed to help with severe TMJ pain.
- In severe cases, surgery on the jaw or dental surgery may be necessary.
- TMJ arthroscopy is a minimally invasive procedure usually done in an outpatient setting. Recovery time for this procedure is about a week.
- Sometimes a total joint replacement is needed. This generally requires a stay in the hospital for several days, and recovery time is four to six weeks.
- Prescription-strength pain medicines, muscle relaxers, anti-inflammatory medications, or steroids may be necessary.
What is the prognosis for TMJ syndrome?
The prognosis for TMJ syndrome is generally good. There are numerous causes for TMJ syndrome, so the outlook depends on the cause, if known. Most people can manage the discomfort with self-care and home remedies.
Complications of long-term TMJ syndrome include chronic face pain or chronic headaches. In severe situations, where pain is chronic, or associated with other inflammatory disorders, long-term treatment may be necessary.
Is it possible to prevent TMJ syndrome?
Symptoms of TMJ syndrome tend to be episodic and related to stress and lifestyle.
Prevention of TMJ syndrome symptoms can often be achieved using self-care at home, such as
- eating soft foods;
- avoiding chewing gum;
- maintaining proper posture;
- practicing stress reduction and relaxation techniques;
- using dental splint appliances as recommended by a jaw care professional;
- while exercising, working, or participating in sports, using proper safety equipment to prevent jaw fractures and dislocations.