The temporomandibular joint connects the lower jawthe mandibleto the temporal bone at the side of the head. You can feel the joint move when you place your fingers just in front of your ears and open your mouth.
Pain associated with the temporomandibular joint was formerly called temporomandibular joint (TMJ) syndrome and temporomandibular joint dysfunction, but has been renamed temporomandibular disorders (TMD). The new name, it was hoped, would more accurately reflect the complexity of the disorder. All the terms refer to a grinding or clicking sound, plus pain or discomfort, when you open your moutha feeling that your jaw has come unhinged.
In most people TMD is not serious, but it can persist painfully. For unknown reasons 90 percent of TMD sufferers are women.
Symptoms of TMD
- Sore jaw muscles, difficulty chewing, and pain that spreads to the facial and neck muscles and persists around the clock; in some cases difficulty speaking or singing
- Painful clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth
- Headaches, toothaches, and earaches may also be part of the syndrome
What Causes TMD?
What causes TMD has been a matter of disputeemotional stress is often citedbut there is probably no single cause. The bones, ligaments, and muscles of the jaw hinge are a complicated mechanism, and many factors can adversely affect the joint, particularly in combination.
- Teeth grinding (bruxism) and clenching can cause muscle spasm, or be caused by it—and muscle spasm, in turn, produces still more spasm. Many experts think this (and the emotional stress that sometimes leads to teeth clenching and grinding) is at the root of most TMD cases.
- Malocclusion (teeth that don’t fit together properly) can throw the jaw out of line.
- Internal derangement of the jaw or other orthopedic problems of the joint (such as arthritis, degeneration of the bone, injury, or developmental disorders) can play a role.
- Postural problems, particularly thrusting the chin forward, can strain the neck muscles and those of the jaw. Beware also of gripping a phone between your shoulder and cheek during a long conversation, or of carrying a heavy shoulder bag for long periods on the same shoulder. Strained neck and shoulder muscles can affect the muscles in your jaw.
- A blow to the jaw can result in TMD, as can whiplash.
- Chewing gum or too many chewy foods (bagels, beef, candies, or dried fruits) can promote or aggravate TMD.
What If You Do Nothing?
For most people, the discomfort from TMD is occasional and temporary; the pain will eventually go away with little or no treatment. However, many people who develop symptoms of TMD consult a physician or dentist to rule out other conditions.
Home Remedies for TMD
The first line of treatment for TMD is simple self-care. For nearly everyone, the following measures will cure or control TMD.
- Try a soft diet. Going on a soft diet for a few days can help. Good food choices include cereals, soups, and pastas. Also, chew more slowly and eat smaller bites. Avoid steak and other hard-to-chew foods.
- Use pain relievers. Aspirin, ibuprofen, or acetaminophen can reduce pain and muscle spasm. Cold or hot compresses to the jaw may also help. Experiment to see which is best for you, or apply ice and then moist heat to the jaw.
- Rest your jaw as much as you can. If you chew gum, stop. Excessive chewing will only exacerbate or prolong the problem. Also, squelch cavernous yawns (hold your chin in place with your fingers).
- Improve your posture. Correct any poor postural habits that may be contributing to your problem. Try gentle exercises to relax your neck muscles: roll your head in circles, or stretch your chin toward each shoulder in turn and hold for a few seconds. You may need the help of a physical therapist or another practitioner with experience in body mechanics.
- Relieve stress. If you believe that emotional problems are contributing to your TMD, try to pinpoint the source of stress or unhappiness and do what you can to alleviate it. Some type of psychological counseling may be worthwhile.
- Apply cold packs, which can reduce inflammation, muscle spasm and pain. Place the cold packs in the affected area for about 10 to 15 minutes. Be sure to cover them with a cloth so that the pack is not directly on the skin, unless specifically designed for such use. (Direct contact could injury skin.)
No established measures can prevent TMD, but minimizing or avoiding the factors noted under What Causes It? may reduce the risk of getting the condition.
Beyond Home Remedies: When To Call Your Doctor
Contact your physician or dentist if TMD symptoms interfere with everyday activities. Not all jaw and facial pain is caused by TMD, so other conditions must be ruled out.
What Your Doctor Will Do
Since there are no precise causes and because TMD symptoms are not clear, diagnosing this disorder is often difficult. No standard test is widely accepted for identifying TMD. Your doctor may refer you to a dentist, who will perform a complete oral examination that includes feeling the jaw joints and listening for clicking, popping, and grating sounds.
If the TMD is related to your bite, your dentist may be able to correct your bite simply by grinding down a few tooth surfaces. Before submitting to this or any other procedure, remember that in most cases the discomfort of TMD eventually goes away. Also, be sure to get a reliable second opinion before agreeing to this irreversible treatment. Bite plates or splints, fitted over the biting surface of your teeth, can also help stabilize the bite and eliminate nocturnal tooth grinding.
Another option is to see a physical therapist trained in muscle relaxation techniques for the jaw and neck, which can be very helpful. Ask your doctor for a referral.
Surgical techniques exist for extreme cases, but consider surgery only as a last resort. At least one surgical technique that was touted as “state of the art” some years ago actually caused bone damage. As with any surgery, get a second opinion.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media