You may not have heard of it, but you use it hundreds of times every day. It is the Temporomandibular Joint (TMJ), the joint where the mandible (the lower jaw) joins the temporal bone of the skull, immediately in front of the ear on each side of your head. A small disc of cartilage separates the bones, much like in the knee joint, so that the mandible may slide easily; each time you chew you move it. But you also move it every time you talk and each time you swallow (every three minutes or so). It is, therefore, one of the most frequently used of all joints of the body and one of the most complex.
Temporomandibular joint diseases and disorders, commonly called TMJ, are a collection of poorly understood conditions characterized by pain in the jaw and surrounding tissues and limitations in jaw movements. Injury and conditions that routinely affect other joints in the body, such as Arthritis, also affect the temporomandibular joint.
The National Institute of Dental and Craniofacial Research (NIDCR) of the National Institutes of Health (NIH) states that over 10 million people in the United States suffer from TMJ problems at any given time. While both men and women experience TMJ problems, the majority of those seeking treatment are women in their childbearing years.
You can locate temporomandibular joint by putting your finger on the triangular structure in front of your ear. Then move your finger just slightly forward and press firmly while you open your jaw all the way and shut it. The motion you feel is the TMJ.
You can also feel the joint motion in your ear canal. These maneuvers can cause considerable discomfort to a patient who is having TMJ trouble, and physicians use these maneuvers with patients for diagnosis.
Pain is the most common TMJ symptom. TMJ pain is often described as a dull aching pain in the jaw joint and nearby areas, including the ear, which comes and goes. Some people, however, report no pain, but still have problems using their jaws. Severe TMJ symptoms can include:
- Ear pain
- Being unable to open the mouth comfortably
- Clicking, popping or grating sounds in the jaw joint
- Temple/cheek pain
- Locking of the jaw when attempting to open the mouth
- A bite that feels uncomfortable or “off”
- Neck, shoulder and back pain
- Swelling on the side of the face
TMJ may cause ear pain, ringing in the ears (tinnitus), and hearing loss. Sometimes people mistake TMJ pain for an ear problem, such as an ear infection, when the ear is not the problem at all.
Pain in the facial muscles and jaw joints may radiate to the neck or shoulders. Joints may be overstretched. You may experience muscle spasms from TMJ. You may feel pain every time you talk, chew, or yawn. Pain usually appears in the joint itself, in front of the ear, but it may move elsewhere in the skull, face, or jaw.
When the joints move, you may hear sounds, such as clicking, grating, and/or popping, it is severe TMJ symptom. Others may also be able to hear the sounds. Clicking and popping are common. This means the disc may be in an abnormal position. Sometimes no treatment is needed if the sounds give you no pain.
Causes of TMJ
Not all causes of TMJ are known. Some possible causes or contributing factors are injuries to the jaw area, various forms of Arthritis, dental procedures, genetics, hormones, low-level infections, auto-immune diseases, stretching of the jaw as occurs with inserting a breathing tube before surgery, and clenching or grinding of the teeth. TMJ causes can be:
- Bruxism (grinding your teeth in your sleep).
- Sleeping in a way that mis-aligns the jaw or creates tension in the neck.
- Stress-induced muscle tension in the neck and shoulder.
- Incorrect or uneven bite.
TMJ Disorder Diagnosis
Diagnosing TMJ diseases and disorders can be difficult and confusing. For example, facial pain can be a symptom of many conditions, such as sinus or ear infections, decayed or abscessed teeth, various types of headache, and facial neuralgia (nerve-related facial pain).
A dentist can help identify the source of the pain with a thorough exam and appropriate x-rays. Often, it’s a sinus, toothache or an early stage of periodontal disease. But for some pain, the cause is not so easily diagnosed.
The pain could be related to the facial muscles, the jaw or temporomandibular joint, located in the front of the ear. Treatments for this pain may include stress reducing exercises, muscle relaxants, or wearing a mouth protector to prevent teeth grinding. They’ve been successful for many and your dentist can recommend which is best for you.
There are several ways the TMJ disorders may be treated. Your dentist will recommend what type of treatment is needed for your particular problem or recommend that you be referred to a specialist. Treatment may involve a series of steps. The step-by-step plan is in your best interest because only minor, relatively non-invasive treatment may be needed.
TMJ may or may not require professional treatment. This should, however, be evaluated by a dentist. Many dentists specialize in the diagnosis and treatment of TMJ. They may prescribe anti-inflammatory medicine, tranquilizers or muscle relaxants for a short period of time, braces to correct the bite or a bite plate to wear when sleeping. Some doctors recommend surgery to correct TMJ, but you should get more than one opinion before consenting to a surgical remedy.
Also there can be home treatment of TMJ, but whatever you should consult your dentist.
- Rest the muscles and joints by eating soft foods.
- Do not chew gum.
- Avoid clenching or tensing.
- Relax muscles with moist heat (1/2 hour at least twice daily).
In cases of joint injury, ice packs applied soon after the injury can help reduce swelling. Relaxation techniques and stress reduction, patient education, non-steroidal anti-inflammatory drugs, muscle relaxants or other medications may be indicated in a dose your doctor recommends.
Because most common jaw joint and muscle problems are temporary, lasting only weeks or months, simple care is all that is usually needed to relieve the discomfort. Self-care TMJ practices are useful in easing symptoms.
Unfortunately, TMJ treatments are based largely on beliefs that are not grounded in thorough scientific research. As a result, some patients are made worse by these treatments.
Taking Control of TMJ with Help of Diet
There’s a whole list of diet changes that can help avoid TMJ pain problems. Here included a few of the diet tips that can help prevent TMJ:
- Cutting back on salicylates.
- Cutting back on wheat and dairy.
- Avoiding foods and supplements with a lot of vitamin C or iron.
- Avoiding foods with sugar, yeast and preservatives.
- Eating more fat, especially moderate amounts of saturated fat.
- Eating more red meat.
- Eating organ meat on occasion.
- Eating vegetable soup with a lot of greens (for magnesium) and broth made from animal parts (bones, tendons, etc. for hyaluronic acid.)
Follow your doctor’s specific instructions for taking any medication prescribed and for home care with compresses or gentle jaw exercise.