The Temporomandibular Joint

The temporomandibular joints lie on either side of the head directly in front of the ears. Here the back of the lower jaw (mandible) meets the temporal bone. These joints normally allow the mouth to smoothly open, close and move from side to side for biting, chewing and talking.


Temporomandibular Disorders

Temporomandibular disorders, also known as TMD or TMJ disorders consist of any abnormality, pain or dysfunction of the temporomandibular joint. Symptoms of the condition might develop in one or both joints. The abnormality also often impinges on delicate nerve tissue in the joints and causes pain. Individuals may experience TMD temporarily or problems might become permanent and require medical intervention. Most patients develop the condition between the ages of 20 and 40. Statistics indicate that females experience TMD more frequently than males.


TMD Symptoms

TMD symptoms often begin as clicking, crunching, grating or popping noises heard when opening or closing the mouth. Chewing problems occur because the lower and upper teeth do not come together properly. Patients may experience facial pain or tenderness in one or both jaws around the joint area. Individuals might also develop earaches, headaches, neck aches or upper shoulder pain. The face on the affected side may swell. Some people endure dizziness, hearing difficulties or ringing in the ears. As the condition worsens, the jaws may lock preventing the mouth from opening or closing completely.


Causes of TMJ Disorders

Malocclusion of the teeth („bad bite“) can be a cause for the development of TMJ disorders.
Also chronic teeth clenching or grinding causes articular disc damage, which prevents fluid movements of the joint. Some people clench or grind their teeth while asleep and may awaken with ear or jaw pain. Other people subconsciously perform the action while under stress. Visible signs of this behavior include abnormal wearing on teeth surfaces. Habitually biting fingernails, chewing gum or chewing food on one side of the jaw may also lead to TMD.
Damage to any component of the joint because of trauma may also create TMJ disorders.


Treatment for Temporomandibular Jaw Disorders

If there is malocclusion of the teeth, the dentist will work to align the teeth and correct the bite.
Preventing teeth clenching and grinding relieves tension in the soft tissue of the joint. If the behavior occurs at night, patients may require custom-made soft dental appliances, which keep teeth separated. When the action occurs secondary to stress, patients may benefit from stress management counseling. Dentists might also suggest resting the jaws by not chewing crunchy or hard foods. Patients should also avoid opening the mouth fully. In the presence of an inflammatory process, pain or muscle spasms, dentists suggest over-the-counter or prescription medications. Physical therapy often helps patients. As a last resort, patients may require TMJ arthroscopic procedures that correct structural abnormalities.