If you experience pain in the joints of the jaw, do not just succumb to teasing about eating or talking too much. You could have TMJ disease. TMJ stands for temporomandibular joint, also known as the jaw joint.
TMJ Awareness Month in November provides an opportunity to learn more about this small but important joint and the complex set of conditions that can interfere with its proper functioning. The information presented here by the Medical Society of the State of New York is based on data from the TMJ Association and the National Institute of Dental and Craniofacial Research of the National Institutes of Health.
The TMJs are located in front of each ear and attach the lower jaw, or mandible, to the skull. To locate and feel the joint on each side of your head, place your fingers just in front of your ears and open your mouth. Although small, these joints are important and useful, allowing you to open and close your mouth and to speak, swallow and chew.
TMJ problems not clearly understood
TMJ diseases and disorders are a complex and poorly understood set of conditions characterized by pain in the jaw and its muscles and by limitations in the ability to speak, make facial expressions, eat, chew and swallow. The causes of TMJ diseases and disorders are not yet clearly defined. Conditions such as arthritis and trauma that routinely affect other joints of the body can also affect the TMJ. Some people report experiencing TMJ problems after dental procedures, the insertion of a breathing tube in preparation for surgery or stress associated with clenching or grinding the teeth. It is not clear, however, whether stress is the cause of the clenching and grinding and subsequent jaw pain or the result of dealing with chronic jaw pain and dysfunction. Researchers continue to explore how behavioral, psychological and physical factors might combine to cause TMJ disorders.
Symptoms associated with TMJ include the following:
• Facial pain
• Pain in the jaw and surrounding areas, including the ear
• Inability to open the mouth completely or comfortably
• Bite not quite right or uncomfortable
• Jaw locking open or closed
• Neck, shoulder and back pain
Swelling on the side of the face
Popping and clicking sounds have sometimes been considered to be symptoms of TMJ problems, but these sounds can also occur in normal joints. Unless there are other symptoms, such as pain and locking of the jaw, clicking sounds do not usually require treatment. Occasional discomfort in the jaw joint or chewing muscles is common and is generally not a cause for concern.
Because the exact causes and symptoms of TMJ disorders are not clear, diagnosing these disorders can be confusing. At present, there is no widely accepted standard test to correctly identify TMJ disorders. In approximately 90 percent of cases, however, the patient’s description of symptoms, combined with a simple physical examination of the face and jaw, provides information useful for diagnosing these disorders. Checking the patient’s dental and medical history is very important. In most cases, this evaluation provides enough information to locate the pain or jaw problem, to make a diagnosis and to start treatment to relieve pain or jaw locking.
One of the most important areas of TMJ research is developing clear guidelines for diagnosing these disorders. Once scientists agree on what these guidelines should be, it will be easier for physicians to correctly identify TMJ disorders and to decide what treatment, if any, is needed.
Treatments are usually conservative and reversible
Because most TMJ problems are temporary and do not get worse, simple, conservative treatment is all that is usually needed to relieve discomfort. Self-care practices—for example, eating soft foods, applying heat or ice packs and avoiding extreme jaw movements (such as wide yawning, loud singing and gum chewing)—are sometimes useful in easing symptoms. Learning special techniques for relaxing and reducing stress might also help patients deal with pain that often comes with TMJ problems. Other conservative, reversible treatments include exercises you can do at home, which focus on gentle muscle stretching and relaxing, and short-term use of muscle-relaxing and anti-inflammatory drugs.
An oral appliance called a splint or bite plate, which is a plastic guard that fits over the upper or lower teeth, can help reduce clenching or grinding and thus ease muscle tension. An oral splint should be used only for a short time and should not cause permanent changes in the bite. If a splint causes or increases pain, stop using it and return to your doctor.
Other types of treatment, such as surgery or injections, invade the tissues and are being studied to see if they are helpful over time. Surgical treatments are often irreversible and should be avoided where possible.