Temporomandibular Joint Disorder

Jaw Pain
Woman With Jaw Pain. Digital Vision/Getty Images

What is TMJ?

The temporomandibular joint (TMJ) is the joint that joins your jaw to your skull. This joint is in front of the ears; you can easily locate it by opening and closing your mouth and feeling the joint with your fingers. This joint differs from most joints, in that it is called a diarthrotic joint. This type of joint has two joints that function independently; in this case both the left and right joint of the mandible.

When there is a problem with the joint, muscles or the ligaments around this joint, the condition is often mistakenly called TMJ or TMJ disorder. TMJ really just refers to the joint and temporomandibular disorder (TMD) is more accurate for any dysfunction related to the function of the TMJ. To keep the terminology consistent and not confuse anyone, we will refer to TMD as TMJ disorder.

People who have TMJ disorder may have some of the following symptoms:

  • facial pain
  • pain while chewing
  • popping or clicking of the jaw
  • headaches
  • earaches
  • difficulty opening and closing the mouth
  • locked jaw
  • generalized pain and tenderness around the joint
  • tinnitus
  • a history of poor sleep or a diagnosed sleep disorder

Who Gets TMJ Disorder?

TMJ disorders are more common in women than in men, and more common in white people than in African-Americans. Other disorders or conditions that have been associated with TMJ include:

  • rheumatoid arthritis
  • degenerative joint diseases
  • anxiety or other psychiatric disorders that lead to chronic jaw clenching or teeth grinding
  • dental malocclusion
  • tongue tie (ankylosis)
  • bruxism
  • some birth defects

What Causes TMJ Disorder?

It was originally thought that TMJ disorders were due to misalignment of the upper and lower teeth.

While this still does have a role in causing TMJ disorders, there are many more factors that can cause this painful disorder including:

  • trauma to the jaw or joint
  • anxiety, stress, or depression
  • posture of the head and neck
  • grinding teeth
  • chewing gum (when excessive)

How Is TMJ Disorder Diagnosed?

TMJ disorder is usually diagnosed by an otolaryngologist (ENT). Many individuals seek the help of an ENT because the jaw pain leads them to believe they have an ear infection. The doctor will perform a physical exam, which could include looking inside your mouth for signs of wear on your teeth from grinding and clenching; assessing your neck muscles for spasms; and signs of joint tenderness. The physician may also measure how far you are able to open your mouth. Sometimes, your doctor will request a CT or MRI scan to get a better look at any damage to the joint.

How Is TMJ Treated?

Treatment is based on the severity of the disorder. For minor cases, ice and rest may be the best bet, along with over-the-counter pain relievers such as ibuprofen and acetaminophen.

People with a TMJ disorder should avoid chewing gum, grinding teeth and clenching their jaw. Sometimes a bite guard can help with this.

Relaxation techniques at least 30 minutes a day can help. Some people may benefit from physical therapy, muscle relaxants, steroids, friction massage and ultrasonic treatment. If symptoms still persist after aggressive anti-inflammatory medications and other techniques have been tried, occlusal therapy may also be tried. Occlusal therapy aims to protect your bite and prevent severe clenching and grinding that can damage the teeth. To determine if this is an option, you should consult your dentist.

In severe cases surgery may be necessary. However, surgery alone will not fix TMJ disorders unless you engage in therapy both before and after surgery.


American Academy of Otolaryngology Head and Neck Surgery. TMJ. Accessed: November 5, 2015 from http://www.entnet.org/content/tmj.

Goldenberg, David; Goldstein, Bradley J. Handbook of Otolaryngology Head and Neck Surgery. 2011. p 73-77.

Medline Plus. TMJ disorders. Accessed: December 21, 2011 from http://www.nlm.nih.gov/medlineplus/ency/article/001227.htm.

Rotter, BE. (2015). Cummings Otolaryngology: Temporomandibular Joint Disorders. Accessed on August 14, 2016 from http://www.clinicalkey.com (Subscription Required)

Scrivani, S.J. & Mehta, N.R. (2015). Temoromandibular disorders in adults. Accessed on November 5, 2015 from http://www.uptodate.com.

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