Temporomandibular joint disorder, or TMJ, is a complex condition that often worsens over time. The term T.M.J. disorder is a collective term that includes a number of issues that involve the head, neck, and temporomandibular/jaw joints. 

Typically caused by the misalignment of the teeth, TMJ can erode the joint capsule between the skull and the jawbone. It is tricky to diagnose, and some people suffer for years.

Epidemiological studies have shown that approximately 75% of the population has at least one sign of temporomandibular dysfunction. 

What are the symptoms of T.M.J? 

1. Pain in the head, neck, or jaw

When the teeth are not properly aligned, the jaw muscles try to compensate. Pain in the jaw or ear while chewing is common. Some people also experience pain when yawning or speaking.

2. Inability or difficulty to move the jaws easily or smoothly

3. A bad bite or teeth that do not fit together properly

Since the jaw is out of alignment, many people with TMJ have trouble chewing. Your muscles will try to compensate, but this may be impossible if the misalignment is severe. 

4. Frequent headaches and other pain

TMJ can cause referred pain in the form of headaches, neck pain, shoulder aches, and even toothaches. The pain may worsen when moving the jaw, but it can sometimes be felt even at rest.

5. Clicking sound in the jaw joints

Clicking or popping sounds in the jaw is a common symptom. You might have difficulty opening your mouth wide or closing it again. When you do get it to move, your jaw will likely pop into place with a loud click.

6. Locking of the jaws

You might have difficulty opening your mouth wide or closing it again. This is likely when the clicking or popping symptom will be evident. 

What are some causes?

  • Trauma from a motor vehicle accident or blow to the jaw 
  • A bad bite/malocclusion or poorly fitting teeth 
  • Bruxism or grinding of the teeth 
  • Diseases such as arthritis
  • Psychological factors such as stress, anxiety or depression

Let’s talk about treatment!

The treatment of T.M. disorders involves a team approach involving several health care specialists. The basics of T.M. treatment involves: 

  • Patient education and self-care, including resting the jaw, eating soft foods and limiting jaw movement; applying ice and heat, and gentle exercise.
  • Medications, including pain relievers, anti-inflammatory medications, and muscle relaxants.
  • Physical therapy, including massage, physiotherapy, and chiropractic.
  • Stress management, including relaxation therapy, biofeedback and counselling.
  • Occlusal splint therapy or night guard treatment which separates the jaws to allow
    neuromuscular relaxation.
  • Bite correction therapy which could involve adjusting or correcting the bite,
    orthodontic therapy or braces to reposition the teeth, restorative or crown and
    bridge treatment to rebuild or replace missing teeth to provide a proper bite.
  • Surgical therapy which could involve corrective jaw surgery or joint restructuring.

Who should you see for T.M.J. treatment? 

  • Your family dentist and a doctor/physician
  • A dental specialist who treats temporomandibular joint disorders including some
    orthodontists, oral surgeons, and most prosthodontists
  • A physiotherapist or chiropractor who treats temporomandibular joint disorders

What can you do now?

Be aware of how your jaw moves. Notice any contact your teeth make and positions your jaw continually returns to. Notice any clenching, grinding, gritting, tapping of teeth or tensing of jaw muscles.  Take note of when tooth contacts or the jaw muscle tension most often occurs such as during driving, studying, reading, social situations, conversation, fatigue, overwork, stress, emotional upsets, work, etc. Also, be aware of whether you are able to eat on both sides.

  • Modify your diet and stick with softer foods since they place less stress on the jaw muscles and joints.
  • Avoid wide jaw openings: Excessive movement(s) of the jaw will place stress on the joint and the muscles when they are stressed.

It is very important to not test the jaw!

We know this is hard to resist! You may want to periodically move your jaw around to check whether you are making progress and see if the soreness is resolving. To do this, people usually open and swing the jaw from the side to side beyond the comfortable range of motion. When you move your jaw to the point where you produce pain and discomfort, you have added to the stress on your muscles and joint and this can cause a continuation of the problems you are trying to eliminate.

Support the jaw during yawning.

Place your index finger and thumb on your chin to provide some extra stability to the lower jaw during yawning. 

Use moist heat to the sides of the face

  • Place 2 towels in HOT water.
  • Wrap one under the chin, on both sides of the face extending along the side of
    the head.
  • Alternate towels as the one applied to the head loses its heat.
  • Do this at least twice per day, 10 minutes each time.

Do your best to get adequate sleep, maintain good nutrition and try to avoid taking on additional stress that can adversely affect your present problem or that would infringe on your ability to manage your jaw problem. 

If you feel you are experiencing any discomfort described here please speak to your dentist so they can assess and determine if you are indeed dealing with a T.M.J disorder and an appropriate treatment plan can be discussed.