Temporomandibular joint dysfunction

What is the temporomandibular joint (TMJ)?

The temporomandibular joint (TMJ) is the joint that connects the jaw to the skull. There is a TMJ on each side of the face, in front of each ear. These joints allow the movements needed for speaking, eating and facial expression.

TMJ dysfunction can cause pain, abnormal jaw movements and joint noises. They are quite common.

What are the symptoms of TMJ dysfunction?

If you have TMJ dysfunction, you may have:

• discomfort or pain in the jaw, especially when eating
• an aching pain in front of your ear, which may spread to your face
• ‘locking’ of the jaw, making it difficult to open or close your mouth
• a clicking or grating noise when you open your mouth or chew
• an uncomfortable or uneven bite
• headache (especially in the temples, under the eyes and at the sides of the lower jaw)
• earache
• neck or shoulder pain

What causes TMJ dysfunction?

TMJ dysfunction can be caused by a number of different things, including:

• dental (tooth) issues — for example, if you have new fillings or dentures causing an uneven bite
• wear and tear of the joint, usually caused by osteoarthritis
• an injury
• jaw clenching and teeth grinding, which may be linked to stress
• other diseases, such as rheumatoid arthritis, fibromyalgia or gout
• injury to the jaw
• head or neck injury

Sometimes, people have TMJ dysfunction without any obvious cause.

When should I see my doctor?

If you think you might have TMJ dysfunction and it is bothering you, see your doctor or dentist. They will do a physical examination. You might be asked to have an x-ray, CT or MRI scan.

How is TMJ dysfunction treated?

TMJ pain may go away without any treatment. In the meantime, there is plenty you can do to relieve the symptoms of TMJ pain:

• eat soft food
• avoid chewing gum
• cut all food into small pieces
• avoid clenching your jaw
• avoid opening your mouth wide
• wear a mouthguard while you sleep to prevent jaw clenching or teeth grinding

You can also try relaxation techniques to relieve stress. Gentle jaw-strengthening exercises might also help.

It is not known which medications are effective for TMJ dysfunction. However, medications that may be tried include pain relief medication, medications that treat inflammation, and muscle relaxants.

In most cases, TMJ dysfunction improves over time. Very few people need surgery.