TMJ can be a confusing term. It’s short for TemproMandibular Joint which is your jaw joint. You have2 TMJs (one on each side) and they connect your lower jaw to your skull, allowing opening, closing, and side to side movements of your mouth.
The initials TMJ are sometimes also used when there is a problem with the joint. Another term used for this is TMD (TemproMandibular Dysfunction). TMJ problems can include or be caused the joint itself, your jaw muscles, or your teeth(bite). Your neck muscles may also play a role because they can affect your jaw muscles.
We aren’t really sure what causes TMJ problems but grinding your teeth, clenching your teeth, biting your cheeks, tapping your teeth together, and frequent gum chewing can overload the joint and muscles, leading to pain and other symptoms.
Inflammation can cause symptoms too. And sometimes it is a combination of factors can also cause problems—ex. Mechanical forces from grinding and clenching along with systemic issues can lead to degenerative arthritic changes which can affect the muscles, which can in turn change the bite.
Symptoms that you or someone else may notice if you have TMD:
- Pain or soreness around the joint or in the jaw muscles
- Pain in neck
- Limited movement of jaw
- Locking of jaw
- Noises (clicking, popping, grinding) with opening and/or closing mouth
- Jaw muscle stiffness
- Changes in bite
- Referred pain from chewing muscles (pain is felt in a different location than source) (Ex. Ear pain, sinus pain, tension headaches, migraines (the two headaches are also triggered by teeth grinding and clenching), tinnitus, and dizziness
Some questions your dentist may ask while diagnosing whether you have TMD:
- Is pain coming from the joint or muscle?
- How much is your bite contributing?
- Is it painful when pressed on?
- Can it stand any pressure, weight, or force without pain?
- Is range of motion of neck and/or jaw limited
- Panoramic x-ray. MRI or CT scan may be indicated also.
Treatment may be performed by your dentist, but you may also be referred to a rheumatologist if systemic disease is suspected or to a psychologist for behavioral therapy or to learn stress management techniques or to a physical therapist or medical massage therapist for treatment or exercises.
We recommend starting with conservative treatment. Often an intraoral splint (also called a nightguard) is used to try to reduce the mechanical compressive forces on teeth and to protect them from damage from clenching or grinding of the teeth. If your bite is a factor, occusal equilibration adjusts how your teeth come together
Physical therapy or medical massage therapy (which is different from relaxation massages) is often helpful if muscles are involved. Psychosocial help to reduce stress and anxiety may help long-term as can changing medications that may cause teeth grinding as a side effect (Zoloft, Prozac, Lexapro etc.)
Some things you can try on your own are taking NSAIDs (ibuprofen or aleve) to possibly provide temporary relief from inflammation, self-help therapies to reduce daytime clenching and not eating any chewy or tough foods and avoiding chewing gum.
Reducing your pain and symptoms may take 9-12 months to become fully effective. If by then, symptoms are still bothersome, you can consider arthroscopy or arthrocentisis which are more conservative than the last resort of an open surgical procedure/total joint replacement.
To summarize the top 3 recommendations:
1.limit grinding or clenching during the day
2.Ask your dentist to look for wear on your teeth that indicate you’re clenching or grinding at night—if so, wear a professionally made night guard when you sleep to reduce the load on your TMJ
3.Limit gum chewing
You can also learn more about this topic here: TMD
Dr. Jennifer Robb is a general dentist who treats adults and children at her office located at 1320 Cooper Foster Park Rd., Lorain, OH 44053. Call 440-960-1940.