For some, it’s just a collection of letters. For others, TMJ can mean pain and difficulty every day. Temporomandibular jaw pain, commonly referred to as TMJ, is a chronic pain condition that affects approximately ten million people in the U.S.
What is TMJ?
TMJ is a joint disorder that involves the temporomandibular joint. This sliding joint connects the lower jaw with your skull at a point right in front of each ear. The temporomandibular joint allows us to eat, talk, yawn, and otherwise open our mouths.
A diagnosis of TMJ (also known technically as TMD) is made with a combination of tools. Your doctor or dentist will physically examine your jaw for signs of decreased mobility, swelling, and tenderness. They may put you through range of motion exercises and listen to any sounds your jaw makes when you open and close your mouth.
In some cases, dental X-rays are ordered to assess the health of your teeth and to see if there are any underlying issues. An MRI can examine the tissues in the joint to see if there are any issues with the disc of the joint. Finally, your dentist may refer you to a TMJ specialist or oral surgeon for a more complete diagnosis.
What causes TMJ?
TMJ has many different causes. The joint can be damaged by:
- Injury or trauma
- Deterioration due to arthritis
- Erosion in the joint or the disc that cushions it
There are certain risk factors that can increase your risk of developing TMJ and TMJ pain, including the following.
Bruxism
Grinding your teeth and clenching your jaw fall into the category of bruxism, a disorder that puts incredible stress on the jaw and the temporomandibular joint over time.
People with bruxism are not guaranteed to develop TMJ, but it can contribute to their diagnosis.
Arthritis and other inflammatory conditions
Those who suffer from arthritis may also develop TMJ.
Osteoarthritis is a wear-and-tear form of arthritis that occurs over time. A lifetime of eating and talking can take its toll on the temporomandibular joint, grinding away the connective tissue until it becomes inflamed.
Rheumatoid arthritis (RA) is an autoimmune disorder that can cause TMJ at any age.
There is also some evidence that TMJ is related to other inflammatory conditions, like fibromyalgia.
Previous injury or trauma
A blow to the jaw or trauma to the face can knock the temporomandibular joint out of alignment. Once this happens and the sliding nature of the joint is impacted, TMJ can develop.
There are a number of factors that contribute to the development of TMJ. Not every case has an easily pinpointed cause.
How long does TMJ last?
TMJ pain and other symptoms can last anywhere from days to weeks in the acute phase. Once treatments are in place, symptoms of a flare up may diminish or disappear altogether.
If the underlying cause of the TMJ is not addressed or treated, TMJ can become chronic. Patients may experience periods of flare up and remission for years.
What are major TMJ symptoms?
Major TMJ symptoms may come and go during the day. They can include any or all of the following:
- TMJ pain in the joint itself
- Warmth and swelling in the face
- Headache (even migraine)
- Tenderness in the jaw
- Difficulty eating, chewing, or opening the mouth
- Locked jaw (inability to open the mouth or move the jaw at all)
- Clicking or ticking sound in the joint when chewing
- Decreased mobility in the jaw
- Grating noise (or feeling) in the joint
- Toothaches
- Ear pain
- Tinnitus (ringing in the ears)
- Hearing problem
Some patients experience these symptoms most intensely in the morning, especially if their TMJ has been caused by bruxism at night. Others might find that after a day of talking and eating hard foods their jaw is aching.
If left untreated, TMJ symptoms can get progressively worse.
Who treats TMJ?
TMJ treatment (and who provides it) really depends on the severity of the condition. For mild TMJ without pain or swelling, it is often okay to manage it at-home. Clicking and popping may not necessarily mean TMJ, so a “wait-and-see” approach might work.
If symptoms progress, you should always talk to your primary care doctor or dentist. They’ll be able to suggest a number of treatment options.
At-home care
For TMJ pain and swelling, most primary care physicians, dentists, and TMJ specialists recommend treatment with over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen during flare-ups.
Swelling can be treated with ice, off and on for ten minutes at a time, until it begins to subside. Some patients prefer warm compresses instead of ice.
For painful flare-ups, sticking to a diet of soft foods can help. Foods that offer healing nutrition with very little chewing include:
- Scrambled eggs
- Well-cooked vegetables
- Yogurt
- Mashed potatoes
- Beans
Cut food into small bites, and chew slowly. Conversely, avoid hard foods or foods that require lots of chewing. Skip the pretzels, gum, crunchy salads, and steak while you heal.
Stress relief
If your TMJ pain is caused by stress-related bruxism, take some time to learn meditative practices. Yoga, t’ai chi, and meditation are powerful stress relievers than can help with the underlying cause of your TMJ.
Removing or minimizing the causes of stress can help, too.
Your Phoenix area TMJ dentist may also suggest some adjustments to physical habits we take for granted. Resting your chin in your hand or keeping your teeth firmly together all day applies continuous pressure on the temporomandibular joint. Eliminating these two behaviors can help provide some relief.
Treatments for severe TMJ pain
Severe TMJ pain may not be relieved by simple icing and eating of soft foods.
For more moderate cases, your dentist may prescribe a TMJ mouth guard to wear at night. They may also look at imbalances in your bite caused by older dental work (e.g. crowns) and make changes if necessary.
Other treatments like trigger-point injections, transcutaneous electrical nerve stimulation (TENS), and low-level laser therapy can be used to fight pain and inflammation.
In rare cases, TMJ surgery may be necessary to offer relief. Because this treatment is irreversible, it’s important to get multiple opinions and try more moderate treatments before taking this step.
AZ Dentist is your Phoenix area TMJ specialist. If you are feeling the pain of TMJ, come see us today. We can help you find treatments that work.