Dentist discusses what you need to know about your jaw joint

In honor of National Temporomandibular Joint (TMJ) Awareness Month, Dr. Seema Kurup, associate professor and division chair of Oral Medicine and Orofacial Pain at the UConn School of Dental Medicine, the most frequently asked questions about TMJ and temporomandibular disorders (TMD).

What is the TMJ or temporomandibular joint made of?

The temporomandibular joints are the two joints that connect the jawbone (lower jaw) to the skull and are located in front of each ear. This complex joint, along with muscles, ligaments, and disc (soft tissue in the joint space), allows the jaw to move smoothly for speaking, chewing, and other jaw movements.

What are Temporomandibular Disorders or TMD?

Temporomandibular disorders are a group of more than 30 conditions that cause pain and dysfunction in the temporomandibular joint and surrounding muscles that control jaw movement. “TMDs” refers to the disorders and “TMJ” refers to the jaw joint itself.

What are the most common symptoms of TMD?

Common symptoms of TMD include:

• Joint pain or tenderness
• Difficulty or pain when chewing, and sometimes bite changes
• Clicking, popping, or grating sounds in the jaw
• Limited jaw movement or locking
• Pain in and/or around the neck, head or face
• Ringing, feeling of “fullness or pressure” in the ears

What are the main causes of TMD?

TMD can develop based on a wide range of factors that manifest in unique ways for each individual. Because these factors often interact and reinforce each other, it is challenging to isolate a single root cause.

Some of these contributing factors include:

• Physical or pathological: injury to the jaw or face, arthritis, joint degeneration, inflammation and rarely malignancy
• Behavior: Habits such as grinding teeth (bruxism), clenching the jaw or poor posture put extra pressure on the joint
• Psychological and sleep-related: Stress and anxiety can lead to muscle tension, especially in the jaw and neck, worsening symptoms
• Anatomical variations: Developmental abnormalities of the joints or bite alignments that make them more susceptible to TMD

Is there a way to prevent TMD?

While there is no guaranteed way to prevent TMD, awareness of contributing factors, habits, and health conditions can help reduce your risk. Here are some tips:

• Avoid excessive use of the jaw: go easy on hard, chewy foods and limit chewing gum.
• Reduce stress: Practice relaxation techniques to prevent clenching or grinding.
• Maintain good posture: Good posture relieves tension on the neck and jaw.
• Consider a mouthguard: A custom-made mouthguard can protect against nighttime grinding.
• Prioritize quality sleep: Use good sleep hygiene to improve sleep quality.
• Be careful at the dentist: take breaks if your mouth is open for a long time and let your dentist know if you hear joint noises.

What are the most effective treatment options?

Treatment options for TMD can vary depending on the severity of the condition and include:

• Self-care practices (soft diet, jaw exercises, hot or cold compresses)
• Medications (NSAIDS, anti-inflammatories, muscle relaxants)
• Physiotherapy
• Diaphragmatic breathing, yoga, medication and/or mindfulness
• Mouthguards for bruxism, other occlusal appliances
• Injections for trigger points, Botox
• Surgery (in severe cases where other treatments have failed)

Who should someone with TMD go to for diagnosis and treatment? Are there TMD specialists?

For the diagnosis and treatment of TMD, it is best to contact orofacial pain (OFP) specialists. These are dentists with advanced training in treating TMD and other conditions involving jaw, facial and headache disorders. For severe cases that require surgical intervention as a last resort, an oral surgeon may be called in. If TMD is related to systemic causes such as arthritis, nerve problems, and/or other chronic pain conditions, the orofacial pain specialist typically works with a rheumatologist, neurologist, or pain management physician.

Provided by the University of Connecticut