TMJ: Symptoms, Treatment, Pain Relief
According to the National Institute of Dental and Craniofacial Research, more than 10 million Americans suffer from some form of TMJ.
TMJ is an abbreviation for temporomandibular joint, the joint in front of your ears that connects each side of the lower jaw to the skull. We owe talking, chewing, and yawning to the function of the TMJ joint.
TMJ is also commonly used to refer to temporomandibular joint disorders, but the correct term is TMD. When someone references a temporomandibular disorder, he or she is usually referring to pain in the jaw and the muscles that control jaw movement. TMJ disorders may develop if there has been an injury or trauma to the joint or the muscles of the head and neck, or if arthritis has damaged the joint’s cartilage.
Those with certain pre-existing conditions may be at a higher risk of developing TMD, including those with osteoarthritis, rheumatoid arthritis, a history of jaw clenching or teeth grinding, or some connective tissue diseases such as rheumatoid arthritis and lupus.
According to the Mayo Clinic, the most common symptoms of TMJ include:
- Pain or tenderness of the jaw
- Pain on one or both sides of the temporomandibular joint
- Pain in and around the ear
- Difficult or painful chewing
- Facial ache or pain
- Difficulty opening or closing the mouth
- Clicking sound when chewing
- Clicking sound when opening and closing the mouth
Causes of TMD
An exact cause of TMD is unknown, but possible causes and risk factors include:
- Undue pressure on the teeth from grinding and clenching
- Arthritis in the TMJ joint, which damages cartilage
- Stress, which causes tightening of the facial and jaw muscles
- Erosion or movement of the disc
- Damage to the joint/jaw from injury or impact
- Various connective tissue diseases
TMJ disorders may be diagnosed by a primary care physician or by a dentist. A physical exam is required to make a diagnosis. The health care provider will examine the jaw joint and jaw muscles to pinpoint any painful spots. He or she will test the patient’s range of motion in the jaw and will listen as the patient opens and closes the mouth. In some cases, the physician or dentist may order images to assist with or confirm a TMJ disorder diagnosis. These images may include X-rays, CT scans, or MRIs of the mouth and jaw.
Sometimes TMJ symptoms go away on their own after a few weeks without any kind of treatment. If there is no joint pain and no limitation to the jaw’s movement or ability to chew or talk, then treatment is usually not prescribed. However, even if the jaw is fully functional, jaw pain may be present and may be severe enough to require treatment. In those cases, physicians will recommend a treatment plan based on the severity of the facial pain and the disorder.
Home TMJ Treatments
Sometimes TMJ pain relief may be achieved by making simple changes to diet or doing some at-home care. The TMJ Association recommends trying the following home treatments:
- Eat soft foods
- Avoid chewing gum
- Apply ice packs or moist heat to the jaw
- Over-the-counter pain relievers, muscle relaxants, and anti-inflammatories
- Jaw exercises
- Meditation and relaxation techniques
When home remedies don’t do the trick and pain is persistent and reducing the quality of life for the patient, then physician intervention may be necessary. Common physician-prescribed treatments include:
- Medications such as:
- Pain relievers
- Muscle relaxers
- Physical therapy
If your TMD is unresponsive to the above treatments, your dentist may recommend the following:
- Transcutaneous electrical nerve stimulation (TENS): Low-level electrical currents help to relax your facial muscles and jaw joint, thereby providing pain relief.
- Ultrasound: Applying deep heat by way of ultrasound can help ease a sore jaw and increase movement.
- Trigger-point injections: Tender facial muscles called trigger points are treated with injections of pain medications or anesthesia to offer some relief.
- Radio wave therapy: Radio waves improve blood flow and ease pain in the joint.
- Low-level laser therapy: This therapy is used to help reduce inflammation and severe pain and increase mobility in the neck and mouth.
If medications and other non-surgical treatments don’t work, physicians may consider additional approaches to TMJ treatment. These may include surgical intervention or other procedures such as corticosteroid injections or various kinds of surgeries. It's important to note that this surgeries are irreversible, and warrant a second and third opinion.
- Arthrocentesis: This surgery is prescribed if you are experiencing lock jaw and have no prior history of TMJ. It requires general anesthesia to numb the pain from the insertion of needles into the joint. Aimed at clearing out the joint and eliminating damaged tissue or disentangling a disc stuck in the joint, this surgery can be done by your dentist in office.
- Arthroscopy: An arthroscope, which features a lens and light, gives your doctor a clear view of the inside of the jaw joint. This type of surgery also involves general anesthesia, as the doctor inserts the arthroscope through a small cut in front of your ear. During this minimally invasive surgery, any inflammation is removed and your disc or joint is realigned.
- Open-joint surgery: This more invasive type of surgery is typically done when your jaw joint begins to wear down, there are tumors, or your joint is scarred or packed with bone chips. While you're under general anesthesia, the doctor will open up the entire region surrounding the joint. The recovery time is extensive, and there is a higher risk of nerve injury and scarring.
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