tmj face painEveryone has two temporomandibular joints (TMJ), one on each side of the face just in front of your ears.  This is the joint that connects the mandible or jaw bone to the rest of the skull and allows you to chew, yawn, move your jaw in all directions, and talk.

If you have problems with this joint, it is known as temporomandibular joint disease or TMD.

Causes of TMJ Disease

People can get TMJ disease from an injury or just from overuse of the jaw.  You can be in a car accident and have direct trauma to the jawbone or to the joint itself, leading to arthritic changes in the joint and subsequent chronic pain. A whiplash injury can lead to TMJ disease as well.

Other common causes of TMJ disease include the following:

  • Arthritic changes in the TMJ
  • Constant clenching or grinding of your teeth, which causes wear and tear on the joint
  • A slipped disc within the joint, which is normally a ball and socket type joint
  • Increased stress, which tightens the face and jaw muscles, leading to pain in the joint

Symptoms of TMJ Disease

Temporomandibular joint disease results in significant discomfort and pain in the area of the joint.  Some people have transient pain, while others have pain that lasts for years.  It is more common in women who are between 20 and 40 years of age.  It can affect just one joint or both joints.

Symptoms you might experience include:

  • Pain when trying to widely open your mouth
  • Tenderness in the area of the joint, which can radiate to the shoulders, neck or ears.
  • Pain when chewing, talking or opening your mouth.
  • The feeling of a popping, grating or clicking sound in the jaw area when you use your mouth
  • A locked jaw, which can lock in the open or closed position and which is very painful.
  • The sense that your teeth are out of alignment
  • Facial pain
  • Swelling over the temporomandibular joint area

The pain of TMJ disease can mimic other diseases, such as pain in the neck, earache, toothache, headache, shoulder pain or tinnitus (ringing in the ears).

Diagnosis of TMJ Disease

Often the diagnosis is made by the dentist or oral surgeon because you feel as though the problem is with a sore tooth or with misalignment of your teeth.  The dentist or oral surgeon will examine your mouth and evaluate the movement of your jaw bone.

If the problem is due to problems with the temporomandibular joint, the doctor will be able to feel a popping sensation when you open and close your mouth.  A stethoscope placed over the joint will be able to pick up the clicking or popping sound.  Because the joint can cause spasm of your facial muscles, you may actually have teeth that are out of alignment.

An X-ray can be taken that includes the temporomandibular joint.  This can pick up on any arthritic changes you may have with the joint.  An MRI of the TMJ area will be able to assess the disc located within the joint space.   CT scans can also show up bony abnormalities of the joint.

Treatment of TMJ Disease

You can take nonsteroidal anti-inflammatory medications for the management of the TMJ pain.  These include naproxen sodium or ibuprofen, which also work on the inflammation around the joint (always consult a doctor before taking any medication). Ice or moist heating pads can ease the pain of TMJ disease.  This can be done prior to doing exercises that stretch the jaw and loosen the muscles.

Using a TENS unit can also help relax your jaw.

You may have to eat soft foods that don’t irritate the joints.  Try not to chew on hard foods like raw vegetables or nuts, or eat foods that are too chewy.  Try not to yawn or chew gum or do anything that makes you jaw open widely.  Learn how to relax your jaw.  Massage therapy or other physical therapy techniques can lessen the pain of TMJ disease.

In rare cases, you may have to wear a mouth splint that keeps the pressure off the joint.  If the problem is severe, the oral surgeon may recommend surgery to repair or replace the joint.