Temporomandibular joint (TMJ) disorders

TMJ disorders cause pain, stiffness and clicking in the jaw joint and muscles. Although TMJ disorders are common, there’s little evidence for how to treat them. For most people, symptoms go away in time or with conservative therapies.  

If a TMJ disorder is affecting your life, ear, nose and throat (ENT) specialists at Atrium Health Floyd and Harbin Clinic can help guide your care so you can find relief.

What are TMJ disorders?

Temporomandibular joint (TMJ) disorders affect the joints between your lower jaw and skull. These joints sit in front of each ear and are made up of several types of tissues, such as:

• Articulated disks cushion the bones.
• Cartilage covers the surfaces of the bones.
• Ligaments attach the bones together.
• Muscles move your jaw.

The complex structure of the joint means many things can go wrong. Recent estimates suggest that TMJ disorders affect one in three adults.

Causes of TMJ disorders

An injury to the jaw can cause TMJ disorders. But for most people, the cause is unknown. Doctors think genetics, stress and a person’s perception of pain affect the disease process. Differences in joint structure and mechanics, especially between females and males, may also play a role.

Researchers have not found a link between TMJ disorders and a bad bite or orthodontic braces.

TMJ types

There are more than 30 conditions that fall under the umbrella of TMJ disorders. The three main groups are:

• Disorders of the joints and discs
• Disorders of the chewing muscles
• TMJ-related headaches

TMJ symptoms

The most common symptom of TMJ disorder is pain in the joints and muscles of the jaw. You may also have painful clicking, popping or grating when you open and close your mouth. Clicking and popping without pain or minor jaw discomfort do not usually indicate a TMJ disorder.

Other symptoms include:

• Changes in your bite (how your teeth fit together)
• Earache or ringing in your ears (tinnitus)
• Frequent headaches
• Jaw pain that radiates to your face or neck
• Locked jaw
• Stiffness or limited movement of your jaw

TMJ diagnosis

Diagnosing TMJ disorders is often challenging, due to the lack of standard tests. You may see an ear, nose and throat (ENT) doctor or a dentist. The evaluation typically includes a review of your symptoms and medical history and an examination of your jaw, face and neck.

Your doctor will check your bite and how your jaw moves. They may watch, feel and listen to your jaw as it opens and closes. An X-ray or MRI of the joint may also be part of the evaluation, as well as other tests to rule out similar conditions.

TMJ treatment 

TMJ disorders often go away on their own. Opinions vary on how to treat TMJ disorders due to limited evidence demonstrating their effectiveness. Doctors typically recommend conservative strategies first, such as: 

• Apply moist heat or cold packs to your face 
• Explore complementary treatments, such as acupuncture
• Avoid habits that can cause symptoms, such as chewing gum and clenching your jaw 
• Eat soft foods 
• Participate in stress-reduction activities 
• Perform exercises to stretch the muscles around your jaw 
• Take over-the-counter medications to reduce pain and inflammation 
• Try cognitive behavioral therapy 

Your doctor may also recommend using a mouthguard (also called a splint or oral appliance). These devices cushion your teeth and prevent grinding, but they don’t change your bite.

If conservative approaches don’t work, it doesn’t necessarily mean you need more aggressive treatment. Use caution when considering irreversible treatment methods that change your bite, such as orthodontics or surgery.

Reconstructive surgery of the jaw or joint replacement is rarely necessary. In fact, studies show that the results are often worse after surgery.

Diagnostic tools

Imaging

MRI