By Kathy Hubbard
Put your fingers just in front of your ears and open your mouth. Feel that? That’s your temporomandibular (TMJ) joint. It’s a flexible joint that allows the jaw to move smoothly up and down and side to side, allowing us to talk, eat and yawn. When doing any of those things produces pain, it could be a TMJ disorder.
“When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along with the joint socket of the temporal bone,” the National Institutes of Health explains. “The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the condyle and the temporal bone. This disc absorbs shocks to the jaw joint from chewing and another movement.”
The joint is a combination hinge and slider makes it one of the most complicated joints in our bodies. Because of its complex movement, the joint and its controlling muscles can challenge patients and healthcare providers when problems occur.
Problems can include pain or tenderness in the jaw; pain in one or both of the temporomandibular joints; aching pain in and around your ear; difficulty chewing or pain while chewing; aching facial pain, or locking of the joint making it difficult to open or close your mouth.
A clicking sound or grating sensation when you open and close your mouth may also be a sign of TMJ disorder, but if there’s no pain, it’s not something to worry about.
Mayo Clinic says that TMJ disorders can occur if “the disk erodes or moves out of its proper alignment; the joint’s cartilage is damaged by arthritis, or the joint is damaged by a blow or other impact.” So, you’ll know if someone or something hits you in the jaw, but otherwise, symptoms start without any known cause.
“Because the condition is more common in women than in men, scientists are exploring a possible link between female hormones and TMJ disorders,” NIH says. They also say that research doesn’t support the theory that a bad bite or wearing orthodontic braces can trigger TMJ disorders.
However, the American Dental Association says that tooth and jaw alignment can be a possible cause of TMJ disorder. You can add stress and teeth grinding to the list of possible causes. Your dentist will check the joints and muscles for tenderness and, depending on what’s suspected, may recommend you see a physician.
NIH says that consulting with a physician can rule out other causes for the pain. “Facial pain can be a symptom of many conditions, such as sinus or ear infections, various types of headaches, and facial neuralgias (nerve-related facial pain). Ruling out these problems first helps in identifying TMJ disorders.”
Each report I read stresses a conservative approach to treatment because most common jaw joint and muscle problems are temporary. They typically don’t get worse, and the main objective will be to reduce the pain.
They recommend eating soft foods, applying ice packs, avoiding extreme jaw movements such as wide yawning, loud singing, and gum chewing. They also recommend using techniques to relax and reduce stress. Your healthcare provider or a physical therapist can recommend exercises that include gentle jaw stretching and relaxing exercises that may increase jaw joint movement. An over-the-counter analgesic may be taken to alleviate pain.
If all that fails, NIH says that “your physician or dentist may recommend an oral appliance, also called a stabilization splint or bite guard, which is a plastic guard that fits over the upper or lower teeth. Stabilization splints are the most widely used treatment for TMJ disorders.
“Studies of their effectiveness, however, have been inconclusive. If a stabilization splint is recommended, it should be used only for a short time and should not cause permanent changes in the bite.”
NIH points out that there is no certified specialty in either dentistry or medicine for TMJ disorders and acknowledges that finding the right care can be difficult. Remember, for the most part, TMJ disorders will go away by themselves.
“If irreversible treatments are recommended, be sure to get a reliable, independent second opinion,” NIH says. I’ll second that motion.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at email@example.com.