BY AMY CAMPBELL, MS, RD, LDN, CDCES | MAY 17
If you have or have ever had pain in your jaw, difficulty chewing, or locking of your jaw, you might have what is called a temporomandibular joint (TMJ) disorder. About 12 million people in the U.S. have pain in their TMJ joint, and TMJ disorders are twice as common in women (especially those between 35 and 44 years of age) as in men. The set of joints in the jaw are among the most used and most necessary joints in the body, needed for eating, talking, and breathing. Read on to learn more.
What is TMJ?
The TMJ is the temporomandibular joint, or jaw joint. There are two joints, located on either side of the face, in front of the ears. These joints connect your jaw to the side of your head. When the joints work as they should, they enable you to talk, chew, and yawn.
What are TMJ disorders?
TMJ disorders are a group of conditions that can cause pain and dysfunction in the jaw joint and muscles that control jaw movement, according to the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health.
There are different disorders that affect these joints, including disorders of the joints, disorders of the muscles used for chewing, and headaches associated with a TMJ disorder. These disorders can last a short time and then go away, but sometimes they become chronic. They can also occur along with other conditions such as headaches, back pain, sleep problems, fibromyalgia, and irritable bowel syndrome.
What are the symptoms of a TMJ disorder?
Symptoms of a TMJ disorder can affect one or both sides of the face. The most common symptoms of a TMJ disorder include:
- Pain that travels through the face, jaw, or neck
- Stiff jaw muscles
- Limited movement or locking of the jaw, or difficulty opening the mouth wide
- Painful clicking, popping, or grating in the jaw when opening or closing the mouth
- A change in the way the upper and lower teeth fit together
- Ringing in the ears, hearing loss, or dizziness
However, clicking or popping sounds in the jaw without pain are normal and usually don’t need treatment.
What causes a TMJ disorder?
The exact cause of a TMJ disorder isn’t always clear. Some people may develop symptoms for no apparent reason. However, causes may be:
- An injury to the jaw or jaw joint
- An infection
- An autoimmune condition
- Dental procedures, including prolonged mouth opening during a procedure
- Teeth grinding or clenching
- Stress
- Arthritis
- Insertion of a breathing tube before surgery
The TMJ Association states that “there are genetic, hormonal, and environmental factors that can increase the risk for TMJ.”
Are people with diabetes more likely to have a TMJ disorder?
Inflammation is part of the immune response that causes type 1 diabetes; inflammation also occurs in the development of type 2 diabetes. Consistently high blood sugars sustain the body’s inflammatory response.
Some health experts believe that TMJ disorders may be more common in people who have diabetes compared to those who don’t. Chronic inflammation that stems from diabetes can affect many areas of the body, including the mouth, gums, and jaw. If inflammation does occur in the jaw, it can cause pain, swelling, and stiffness, which, in turn, leads to problems with eating, chewing, and talking.
How is a TMJ disorder diagnosed?
Your health care provider will ask you about the symptoms you’ve been having and will examine your head, neck, face, and jaw when you open and close your mouth. They will feel and listen for clicking or popping, and ask you about pain or tenderness.
You may need imaging tests, such as X-rays, an MRI, and/or a CT scan to examine the teeth and jaw. These tests may also be done to rule out other conditions that could be causing your symptoms.
What is the treatment for a TMJ disorder?
Many jaw problems are temporary and will go away on their own. Simple treatments are often recommended, at least initially, such as:
- Eating soft foods (yogurt, cottage cheese, scrambled eggs, soup, mashed potatoes) and avoiding hard, crunchy foods
- Avoiding chewing gum
- Applying moist heat or cold packs in combination with exercises to gently stretch and strengthen the jaw muscles
- Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or aspirin
If these treatments aren’t sufficient or are not helping to reduce symptoms, other approaches can include:
- Physical therapy to improve movement and function
- Prescription medication, such as antianxiety, antidepressant, antiseizure, or muscle relaxant medications
- An oral appliance such as a splint or a nightguard
- Acupuncture
- Transcutaneous electrical nerve stimulation (TENS)
- Meditation and relaxation techniques
- Cognitive-behavioral therapy (CBT)
- Biofeedback
Other procedures that are more complex include:
- Dental procedures that modify how the teeth fit together, such as the use of crowns, grinding down the teeth, or using other orthodontic treatments.
- Botulinum toxin (Botox) injections.
- Prolotherapy, which involves injection a solution into the TMJ area. This causes irritation, prompting the body to respond by repairing the joint.
- Arthrocentesis, in which a needle is used to push liquid into the TMJ, removing scar tissue and substances that cause inflammation.
- Arthroscopy, in which a tiny camera is inserted into the jaw joint to remove adhesions or reposition the joint’s disc.
- Other surgical procedures, including TMJ implants.
Because some of these procedures are not proven to be effective (and may even worsen the problem), including the use of splints and night guards, make sure you talk with the doctor or dentist to understand the procedure and ask if it will help your particular TMJ disorder. It’s also worthwhile getting a second opinion.
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