If you suffer from jaw pain and a clicking sound when chewing or yawning, you may have TMJ. If you do, seek treatment from a TMJ specialist or an otolaryngologist to improve your quality of life. Treatments include oral splints that prevent teeth clenching and grinding, physical therapy to stretch and strengthen muscles, ice packs to reduce swelling, and pain relievers and muscle relaxants. Surgery might be advised in more severe situations.
What Is TMJ Disorder?
Your lower jaw and your skull on either side of your head, in front of your ears, are connected by the temporomandibular joint (TMJ). A TMJ disorder is a health condition that impacts the joints, muscles, or ligaments associated with it. Symptoms include pain and discomfort when chewing or speaking, a clicking noise in the joint, a locked jaw, headaches, neck pain, or ringing in the ears. TMD can have multiple causes, including a misaligned bite (malocclusion), teeth grinding, stress, arthritis, or trauma to the face or jaw. TMD can also be exacerbated by foods that require a lot of chewing or are large and crunchy, such as meats, raw vegetables, thick fruits, or salads. Avoiding these types of foods may help ease symptoms.
The best TMJ specialist can diagnose the disorder and recommend the proper treatment. These specialists can include myofunctional therapists, who focus on the mouth, tongue, and facial muscles; dentists, who treat problems with the teeth and jaw; otolaryngologists, who treat conditions of the nose, throat, and ears; or oral and maxillofacial surgeons, who specialize in the bones, joints, and muscle of the face and jaw. A TMJ specialist’s goals are to reduce your pain and improve your quality of life. They do so by helping to restore a healthy, functioning jaw and treating the underlying causes of your symptoms.
Diagnosing TMJ Disorder
When you chew or talk, the temporomandibular joint (TMJ) opens and closes to move your jaw from side to side, up and down. If this is happening too often and results in pain or a clicking sound, you may have a TMJ disorder. Certain medications, stress, clenching or grinding teeth, and genetics increase your risk. If your TMJ symptoms are severe, your doctor can diagnose the problem by asking about your symptoms and doing a physical exam. They might take x-rays of your jaw and gently explore the area around the TMJ for tenderness. Additionally, your physician may suggest a mix of therapies, such as Botox injections for painful trigger points, physical therapy to strengthen and stretch the jaw muscles, analgesics or short-term muscle relaxants, and oral splints to hold your jaw in place.
In general, doctors prefer to start with conservative, reversible treatments that don’t change the structure of the face or jaw. Usually saved for more severe cases or when other treatments fail to alleviate symptoms, TMJ arthroscopy and open-joint surgery involve the surgeon making a small incision to access the jaw joint and remove or adjust tissue. TMJ symptoms can interfere with daily life and cause problems like difficulty opening or closing the mouth, pain in the neck, shoulders, or head, ringing in the ears, or unsteady gait.
Symptoms of TMJ Disorder
The temporomandibular joints are highly complex and work with other facial muscles to allow chewing, swallowing, and talking. They also balance the muscular workload on each side of your head so that it isn’t too stressful in one area or another. Your symptoms may include jaw pain and discomfort, clicking or popping in your ear, head, or neck, or trouble opening and closing your mouth. Other signs include chewing food that is too hard or small, a locked-up or stiff feeling in your jaw or neck, facial tenderness, difficulty sleeping with a completely open mouth, snoring or chronic headaches, and a locked, stiff, or uneven bite.
Symptoms of TMJ are often related to stress, so it is essential to find ways to reduce your level of tension. Your dentist or physician may recommend relaxation techniques to ease your jaw muscle spasms and relieve pain. These might include biofeedback (electronic devices that monitor the tightness of your jaw muscles and help you learn to control them), deep breathing exercises, or self-care, such as using a heating pad, moist heat, or ice packs. Your doctor might also prescribe a pain reliever, such as ibuprofen. They might also prescribe stronger medications to suppress the more severe pain and inflammation in your TMJ. Injections of a corticosteroid or a nerve block might help. Muscle relaxants sometimes reduce TMJ-related muscle spasms and help you sleep better.
Treatments for TMJ Disorder
The temporomandibular joint (TMJ) combines hinge action with sliding movements. The rounded upper ends of the jaw bones (the condyles) glide within the joint socket at the base of the skull, and a small shock-absorbing disk keeps the motion smooth. This complex combination of movement — along with three-dimensional motion and a joint surface covered by cartilage — makes the TMJ unique among weight-bearing joints in the body. In most cases, TMJ pain improves with simple treatment measures, such as avoiding foods that require chewing forcefully or eating in large pieces, using a soft diet, sleeping on the side rather than the back, and applying heat and cold to the area. Medications may be prescribed to ease inflammation, reduce muscle spasms, and relax the jaw muscles.
Counseling and behavioral therapy are often part of a TMJ treatment plan. Stress management techniques and counseling can help you to identify and avoid behaviors that aggravate your symptoms, such as teeth clenching or grinding at night, leaning on your chin while sitting or working, chewing gum excessively, and using your teeth to tear or pull items. In rare instances, corticosteroid injections into the joint can help relieve pain, and a minimally invasive procedure called arthrocentesis (ahr-throe-SEEN-tee-sis) can drain fluid from the joint to remove debris, decrease swelling, and reduce stiffness. For some people with TMJ pain, injections of botulinum toxin type A (Botox) into the sore jaw muscles used for chewing may also be helpful.
