TMD and Jaw Pain

A Conversation with Orthodontist Dr. Rebecca Chen

Temporomandibular joints (TMJ) are joints that connect your lower jaw to your skull. TMJs are among the most complex joints in the body. These joints, along with several muscles, allow the mandible (lower jaw) to move up and down, side to side, and forward and back. When the mandible and the joints are properly aligned, smooth muscle actions, such as chewing, talking, yawning, and swallowing, can take place. When these structures are not aligned, nor synchronized in movement, several problems may occur.

What is temporomandibular disorder (TMD)?

Temporomandibular disorders (TMD) are disorders of the jaw muscles, TMJ, and the nerves associated with chronic facial pain. Any problem that prevents the complex system of muscles, bones, and joints from working together in harmony may result in pain causing TMD. Myofascial pain is the most common form of TMD. It results in discomfort or pain in the fascia and muscles that control jaw, neck and shoulder function. Two other forms of TMD include internal derangement of the joint (dislocated jaw or displaced disk) and degenerative joint disease, including osteoarthritis or rheumatoid arthritis in the jaw joint. You can have one or more of these conditions at the same time.

What causes TMD?

In many cases, the actual cause of this disorder may not be clear. Sometimes the main cause is excessive strain on the jaw joints and the muscle group that controls chewing, swallowing, and speech. This strain may be a result of bruxism. This is the habitual, involuntary clenching or grinding of the teeth. Trauma to the jaw, the head, or the neck may also cause TMD. Arthritis and displacement of the jaw joint disks can also cause TMD pain as well. In other cases, another painful medical condition such as fibromyalgia or irritable bowel syndrome may overlap with or worsen the pain of TMD. Recent studies identified clinical, psychological, sensory, genetic, and nervous system factors that may put a person at higher risk of developing chronic TMD.

What are the signs and symptoms of TMD?

The most common signs and symptoms of TMD includes: jaw discomfort or soreness (often most prevalent in the morning or late afternoon); headaches, pain spreading behind the eyes, in the face, shoulder, neck, and/or back; earaches or ringing in the ears (not caused by an infection of the inner ear canal); clicking or popping of the jaw; locking of the jaw; limited mouth motions; clenching or grinding of the teeth; dizziness; sensitivity of the teeth without the presence of an oral health disease; numbness or tingling sensation in the fingers; and changes in the way the upper and lower teeth fit together. Symptoms of TMD may often resemble other medical conditions or problems therefore it's best to see a dentist or a doctor for diagnosis. 

What are the treatments for TMD?

Your dentist/doctor will figure out the best treatment based on your age, overall health and medical history, how well you can handle specific procedures or therapies, and how long the condition is expected to last. Treatment may include: resting the TMJ, medicine or pain relievers, relaxation techniques and stress management, behavior changes to reduce or stop teeth clenching, physical therapy, orthopedic appliances or mouthguard worn in the mouth (to reduce teeth grinding), posture training, and diet changes (to rest the jaw muscles).

Information Source: American Association of Orthodontics, Johns Hopkins University School of Medicine, The National Institute of Dental and Craniofacial Research, Dear Doctor Dentistry & Oral Health