The Temporomandibular Joint is the triangle-shaped area below the ear that connects your lower mandible jaw to your temporal bone or skull. The entire ball-and-socket system is made up of muscles, blood vessels, cartilage, nerves and bone and allows your mouth to open, close, and move from side to side in an easy sliding motion.
If you experience jaw pain when opening mouth, you might be suffering from TMJ. Temporomandibular Joint disorders are commonly called TMJ or TMD and affect millions of people each year. TMJ pain is more common in women than men and often occurs in adults aged 20 to 40. Though the exact cause can sometimes be hard to pinpoint, there are several common causes for TMJ pain and many ways to treat it.
What does jaw joint pain feel like?
You can feel pain in one or both of the joints, and the pain can be temporary or last for several years. Once treated, it can also reappear. The pain can show up as tenderness in the jaw area, or as an aching or tired feeling in your face. You might have pain when trying to chew.
Other symptoms include toothaches, headaches, dizziness and migraine pain. Some patients may suffer from earaches or ringing in the ears. Severe cases may cause swelling in the face or actual locked jaws. The most common symptoms include a popping sound or grinding sensation when opening the mouth or chewing.
Common Causes of TMJ
TMJ pain falls into two categories of causes: behavioural and medical. Some causes can be reversed by simply changing a behavioural pattern, such as not biting your nails. Other causes may need diagnosis and treatment by a medical professional. Check out the following risk factors to see if they could be causing your joint pain.
Jaw Injury. A blow to the jaw, injury to the head or neck, and whiplash can cause displacement of the cartilage disc and cause popping when the mouth is opened or closed.
Bruxism. Also known as teeth grinding, it causes constant wear and tear on the joint that can erode the disk and cause the jaw to move out of alignment.
Teeth Clenching. Many patients clench their teeth together due to stress without even realising they’re doing it. This can add pressure to the joint and cause TMJ pain. When your bite doesn’t fit together properly, this may also add pressure to the joint. Chewing gum and biting your nails can also cause your jaw joint to move out of line and cause the pain.
Incorrect Posture. Pulling your head and neck forward while on the computer can cause your joint to move out of alignment. Sleeping on your side can push your jaw out of its proper spot and cradling a mobile phone in your shoulder can also put undue pressure on one side of the jaw.
Orthodontic Treatments. Braces may well give you that beautiful smile in time but all that pulling and shifting can be hard on your jaw joints.
Medical Causes of TMJ
Arthritis. Various types of arthritis can cause jaw pain. Osteoarthritis can cause stiffness and pain in the joints. Rheumatoid Arthritis, especially in the young, is one of the TMJ causes. Degenerative diseases and aging also erode the bone and cause pain.
Immunologic and Inflammatory Diseases. Certain auto-immune diseases, such as lupus, can cause bone and joint pain in the jaw. Connective tissue disorders and problems with the bones at birth can cause TMJ pain as well. Joint disorders and certain cancers can also cause TMJ symptoms.
Oestrogen. Women are more prone to this type of pain than men. Although doctors are still trying to figure out why, new studies are pointing to oestrogen as the culprit.
If the pain from one of the TMJ causes we just mentioned persists, contact your medical professional to seek treatment. A doctor, dentist, TMJ specialist or surgeon will figure out the possible causes and treatments depending on how severe your pain is. You’ll first be given a physical exam to check for signs and symptoms.
Your doctor will listen and feel your jaw, have you open and close your mouth and see how wide you are able to open your mouth. If your doctor is having a hard time determining the cause of your TMJ pain or thinks it may be related to arthritis, they may require the following tests to get to the root of the problem:
Dental X-Rays. Though not the best method of finding the cause of the pain, your dentist may use this to rule out any other kind of dental pain.
Computer Tomography (CT) Scan. These scans give doctors a better view of the bones.
Magnetic Resonance Imaging (MRI). These help pinpoint problems with the joint’s disk.
If all physical tests come back normal, your doctor will look at other reasons for the pain such as infections, nerve issues or headaches. Your doctor may give you blood tests to check for lupus, arthritis or gout.
TMJ Treatment and Prevention
Once your doctor discovers the cause of the pain, several treatments are available to help ease your pain and correct the problem.
Certain pain relievers and anti-inflammatories can greatly reduce the pain and swelling in your jaw joint. Doctors commonly prescribe NSAIDs such as Ibuprofen and Motrin IB. New studies have shown a tricyclic antidepressant called amitriptyline can help relieve symptoms. You may also find some relief from muscle relaxers that help your jaw release as it heals.
Your dentist may prescribe a mouth guard or oral splint to give your teeth a break from clenching and grinding. These devices create space between the upper and lower mandibles, giving your jaw joint a much-needed rest.
Physical therapy and massage are both great ways to release tension and strengthen the jaw muscles. If your jaw is swollen, you may use cold compresses to help ease the inflammation. If not, you’ll be given a warm compress to hold on your jaw to release tension.
Actual therapy may be prescribed if you’re clenching or grinding behaviour is the result of an outside stressor that needs to be handled in counselling. At-home therapies include eating soft foods until the jaw heals and refraining from activities that stretch the jaw, such as singing or yawning.
Surgery for your TMJ pain is a big decision and often the last line of defense in treating the problem. Make sure you get a second opinion before choosing to go that route. Your surgery will most likely be performed by an Oral and Maxillofacial Surgeon.
Scarring and possible complications may occur and should be carefully considered before you proceed. If you require a procedure to treat your pain, the following options are available.
Injections. Botulinum toxin type A (Botox) and Corticosteroid injections help relieve pain in the jaw muscles.
Arthrocentesis. Uses a small needle to channel fluid through the joint to remove debris and inflammation byproducts.
TMJ Arthroscopy. A small tube is inserted into the joint space and a camera is used to view the area.
Modified Condylotomy. If you experience lock jaw, you may have this surgery on the mandible which helps ease your jaw pain.
Open-joint Surgery. The most invasive option, this is carried out under general anesthesia, and is used to replace or repair the joint.
TMJ can effect up to 33% of people in their lifetime, which means there’s a good chance you’ll experience it at some point in your life. Make sure you act fast and seek out the proper treatment. TMJ jaw pain is easily treated and the prognosis for continuing a normal life is good.
Mehta, Noshir R. DMD, MDS, MS: ‘Arthritis of the Temporomandibular Joint (TMJ).’
Wright, Edward F. DDS , MS, and North, Sarah L. PT MPT, The Journal of Manual and Manipulative Therapy, ‘Management and Treatment of Temporomandibular Disorders: A Clinical Perspective,’ 2009; 17(4): 247–254.
American Academy of Otolaryngology-Head and Neck Surgery: ‘TMJ.’
National Institute of Dental and Craniofacial Research: ‘TMJ Disorders.’
University of Maryland Medical Center: ‘TMJ Disorders.’
The TMJ Association.