Patient information: Temporomandibular joint (TMJ) disorders (The Basics)
Written by the doctors and editors at UpToDate
What are temporomandibular joint disorders?
— Temporomandibular joint disorders are problems with the jaw joint and the muscles around it. The jaw joint, called the “temporomandibular joint,” is located in front of the ear where the jawbone connects to your head. To feel the joint, place your finger on your cheek just in front of your ear and then open and close your mouth.
When doctors refer to temporomandibular joint disorders, they often call it “TMJ,” for short. TMJ can be caused by many problems, including arthritis. More often it is due to a combination of stress, jaw clenching, teeth grinding, and other things that strain the jaw joint and the muscles around it.
What are the symptoms of TMJ?
— The main symptom of TMJ is a dull pain in the jaw muscles that doesn’t go away. The pain is often on just one side of the face, near the ear. Sometimes the pain also affects the ear, jaw, or back of the neck. It is usually worse when chewing. Some people just have headaches with TMJ. Others might hear a clicking or popping sound or have a “crunchy feeling” in the joint when they open and close their mouth.
Should I see a doctor? — If the pain in your face or jaw is bothering you and does not go away, you should see your doctor.
What tests might I need?
— There is no single test that can show if you have TMJ. Your doctor should be able to tell if you have TMJ by learning about your symptoms and doing an exam.
Unless the doctor finds something unusual in the exam, most patients will NOT need X-rays or an MRI (an imaging test that creates pictures of the inside of your body).
How is TMJ treated?
— No single treatment for TMJ works for everyone. Most of the time, medicines and simple lifestyle changes can help. Most patients get better over time, even without treatment, so patience is important.
Your doctor will help you find the right mix of treatments for you. He or she might refer you to a dentist who specializes in TMJ. Treatment options include:
●Medicines to relieve pain and relax the muscles – There are several types of medicines used to treat TMJ. These include nonsteroidal antiinflammatory drugs (NSAIDs), muscle relaxants, and certain medicines used for depression. (Medicines for depression can relieve pain even in people who are not depressed.) Your doctor will decide which medicine or group of medicines is best for you.
●Jaw exercises – There are simple jaw exercises that seem to help some people. Ask your doctor to show you how to do them.
●Bite plates/splints – These are special devices that fit in your mouth and keep you from grinding your teeth at night. They are made out of either a hard or soft plastic and might be made specially to fit your mouth. If you have sleep apnea, be sure to tell your doctor as the bite plate or splint might make your sleep apnea worse.
If these treatments don’t help, your doctor might suggest that you see a specialist, such as an oral surgeon. The specialist might use medicines given by injection (shots) to treat the pain. It is rare that people need surgery for TMJ.
Is there anything I can do on my own to feel better?
— Yes. You might feel better if you:
●Avoid doing things that make the pain worse, such opening your mouth too wide.
●Eat soft foods that don’t require a lot of chewing.
●Practice relaxing – You can learn methods to relax your body, such as doing deep breathing exercises. Ask your doctor or nurse about these methods. Relaxing the mind can help with how the body feels pain. People can learn to quiet their pain or make it less bothersome.
●Use ice packs to ease the pain – Use a bag of ice, bag of frozen peas, or cold gel pack once every 2 hours, for 20 minutes each time. Put a towel or cloth between the ice and your skin. Do not put the ice directly on your skin.
●Put heat on the painful area – Wet a clean washcloth with warm water and put it on the area. When the washcloth cools, reheat it with warm water and put it back on. Repeat these steps for 10 to 15 minutes every few hours.
●Avoid stimulants, such as coffee, tea, colas, or decongestant medicines, since these can make your anxiety worse.