TMJ: Everything You Need To Know

Do you have pain in your jaw or facial muscles?

Have you been told you might have TMJ?

The temporomandibular joint is like a hinge connecting the jaw to the skull’s temporal bones. They’re the bones that lie underneath the temples (the two spots on each side of the head that you massage when you have a headache).

The temporal bones form the bottom and sides of the skull. If you touch your head behind your ears, you’ll feel your temporal bones underneath the skin. These unique bones make things like yawning, chewing, and talking possible, and they’re responsible for moving the jaw side to side and up and down. In some ways, it’s a lot like the hip bones or the shoulder capsule – because it’s also a “ball and socket” joint. 

Many people refer to problems with these bones as “TMJ” when in fact, the proper name is Temporomandibular disorders (TMD), not TMJ. TMJ is the name of the socket joint involved: the temporomandibular joint (TMJ).

Temporomandibular disorder specifically refers to pain in the TM joint or other muscles of the face and jaw. 

What Causes TMJ Problems And TMD?

There is no confirmed cause of TMD, but any trauma to the neck or head muscles, the joint area, surrounding muscles, or the jaw itself can cause TMD.  

Some other common causes of TMD and TMJ problems are: 

  • Pressure on the joint from clenching or grinding the teeth – either during sleep or because of generalized anxiety disorder
  • Chronic tightening of the facial muscles due to high levels of stress
  • Misalignment of the disc or soft cushion between the TM joint’s ball and socket
  • Arthritic joints in the face or jaw

What Are The Symptoms Of TMJ Problems?

TMD can occur temporarily – causing pain for a couple of days that resolves itself quite quickly. Or it becomes chronic and leads to excessive pain and discomfort to be present constantly. It may affect one or both sides. It is prevalent between 20-40-year-olds, and it’s more common in women than men. 

The most frequently reported symptoms of Temporomandibular joint disorders are:

  • Swelling at the side of a face
  • Problems or pain when opening the mouth wide
  • A feeling of discomfort and tiredness in the face
  • The jaw gets locked or stuck when open or closed 
  • Difficulty while chewing with the upper and lower teeth not aligning properly
  • A grating, popping, or clicking sound in the joint of the jaw while chewing or opening or closing the mouth
  • Tenderness or pain in the shoulders, neck, side of the face, or jaw joints around the ear while speaking, opening the mouth, or chewing 

Other symptoms include tinnitus (ringing in the ears), hearing issues, headaches, earache, and tooth pain.  

How is TMD diagnosed?

For those who haven’t seen many cases, TMJ problems can be pretty tricky to diagnose. Several other medical conditions present with similar issues, such as gum infections and gingivitis, various forms of arthritis, sinus problems, and tooth decay.

So, to determine the exact cause, a dentist or physical therapist will usually examine the patient and check their entire medical history. Next, they examine the jaw joints for tenderness, any kinds of unusual sounds, or pain when the jaws move. Finally, they examine the jaw to confirm the movements are normal, check the facial muscles, and test your bite force.    

Usually, we can diagnose the condition after completing these tests. But we might recommend x-rays of the face to examine the temporomandibular joints, teeth, and jaws for any other issues. You may also need to get a CT scan or MRI scan. The CT scan reveals the joint’s bones – and any associated problems.

At the same time, the MRI shows if the TMJ disc is in the correct position for pain-free jaw movement. Depending on the results of these scans. You may also get a referral to an oral and maxillofacial surgeon for further treatment or an orthodontist. They will check if the joints, muscles, and teeth are in proper working order. But if everything appears to be in working order and you still have pain: physical therapy can help. 

What Can I Do to Relieve The Pain of TMJ Problems?

  • Try using heat therapy in the form of heat wraps or ice packs (depending on your preference) on your temples and the sides of your face. Do this a couple of times per day to reduce any inflammation and reduce the pain. But remember: Don’t apply heat or ice directly to the skin. 
  • Try jaw stretching exercises a couple of times per day, as recommended by your dentist or physical therapist.
  • NSAIDs (Nonsteroidal anti-inflammatory drugs) like ibuprofen or naproxen are helpful to alleviate swelling and pain.
  • If eating and chewing motion exacerbate your symptoms. Add soft foods that don’t require much chewing to your diet – like cooked vegetables, yogurt, soup, fish, jello, mashed potatoes, scrambled eggs, or cheese. Chop fruits into small pieces to make chewing easier and avoid hard, crunchy foods like crusty bread and crackers while the issue remains.
  • Avoid extreme or unnecessary jaw movements like chewing gum or yawning widely and enthusiastically.
  • Avoid holding your cellphone between your ear and shoulder. Instead, hold it properly and maintain good posture to prevent neck, face, or jaw pain.
  • Whenever possible, keep the jaw and the teeth slightly apart. This position helps relieve jaw pressure, which can exacerbate TMJ problems. 
  • Avoid clenching or grinding of the jaw while sleeping or as a reaction to stress and anxiety. You can do this by consciously placing the tongue between the teeth.   
  • Practice meditation and other relaxation techniques to help keep the jaw muscles loose and relaxed instead of tense and tight.
  • Ask your dentist whether physical therapy would be helpful.

How To Treat TMJ Problems and TMD

A night guard or splint: Dentists usually recommend that you use a nightguard are while sleeping and a splint during the day. These dental devices are made of plastic and cover both the lower and upper teeth to keep them apart and prevent them from touching or grinding together. They’re helpful for TMJ problems because they reduce the impact of clenching your jaw and correct the position of the teeth.  

Medication: Depending on the severity of your TMJ issues and in case of inflammation or swelling, your dentist may recommend over-the-counter anti-inflammatory drugs, like Advil. If you clench or grind your teeth, you may also need a muscle relaxant to prevent this from happening. But we would recommend Physical Therapy before you commit to these types of drugs, especially long term.

If TMJ problems are caused by Generalized Anxiety Disorder or PTSD, your doctor may also recommend anti-anxiety medication. These medications help control and reduce pain and inflammation. Unfortunately, however, anti-anxiety medicine, muscle relaxants, and antidepressants do come with side effects, in most cases, and they’re only available on prescription. So, try physical therapy first.  

Dental Work: Depending on the root cause of your TMD and your TMJ issues, you may need to have some dental work carried out to make sure your jaw is aligned correctly and not causing you pain. This work may include replacing missing teeth, bridges, braces, or crowns to perfect your bite surface.

Other Types of Treatment For TMJ Problems

If the treatments mentioned above do solve your problems and reduce your pain, your dentist or physical therapist may suggest one or more of the following treatments: 

Laser therapy (low-level): Laser therapy helps to reduce inflammation and pain and supports healing. It also assists in more relaxed neck movements and opening the mouth wider with greater ease. 

Radio wave therapy: In this procedure, radio waves are used for joint stimulation, relieving pain, and improving blood circulation in the TMJ area. 

Trigger-point injections: Your doctor can inject anesthesia or pain-relieving medication into specific facial muscles known as trigger points. These injections offer targeted pain relief. 

TENS (Transcutaneous electrical nerve stimulation): This type of treatment involves low-level electrical impulses. They help to reduce pain through relaxation of the facial muscles and joints of the jaw. This therapy can be carried out by a Physical Therapists or at a dental surgery. 

Ultrasound: Ultrasound therapy in TMJ problems involves applying deep heat to the TMJ joint specifically to reduce soreness and improve jaw mobility. 

Opting for TMD surgery:

Panoramic dental X-Ray photo of middle aged man one teeth missing

Surgery is always a last resort. So many problems that medical doctors consider surgery for can be rectified with physical therapy. But in rare cases when more conservative treatments don’t work, TMJ surgery is an option. It’s not one that we would recommend. Please come and see us first.

We offer all new patients a free 30-minute telephone consult or Discovery Visit at the clinic to explain how we can help you with TMJ problems. If you’re interested, book your complimentary appointment here. But if you’re considering TMJ surgery, we would always suggest that you consult with at least two different dentists to get a second opinion before making your final decision. 

Andrew Vertson