Temporomandibular joint disorder, which is also known as TMJ, is a painful condition that affects the joint connecting the jawbone to the skull. TMJ may also involve the surrounding muscles and soft tissues.
Temporomandibular joint disorders are poorly understood. They are thought to involve a disturbance of the joint that connects the back of the jaw to the skull. This joint is located just in front of the ear and can be felt when the jaw opens and closes.
The exact causes of temporomandibular joint disorders are still a subject of debate. Ninety percent of the people with TMJ are women in their childbearing years. Many times, TMJ is linked to inappropriate activities, such as:
Other causes of TMJ are as follows:
Temporomandibular joint disorders may cause a wide variety of complaints, such as:
Certain other symptoms are often seen in people who have temporomandibular joint disorders. These symptoms may be part of the TMJ. Sometimes they may be caused by another condition that is also occurring at the same time. These symptoms include:
The results of a medical history and physical exam often cause a healthcare provider to suspect a temporomandibular disorder. Blood tests and X-rays are often used to make sure more serious diseases are not causing the symptoms. No single test can confirm the diagnosis. Dental X-rays can sometimes help make the diagnosis.
Prevention of temporomandibular joint disorders is not always possible. However, these measures may be helpful in avoiding or minimizing TMJ:
Prolonged temporomandibular joint disorders may result in deformity of the joint. Poor alignment of the jaw or teeth can also result. The main long-term effect is frustration from the symptoms. For many people with TMJ, there are no long-term effects.
Temporomandibular joint disorders are not contagious. They pose no risk to others.
Initial treatment of temporomandibular joint disorders involves identifying actions that cause symptoms to get worse, such as clenching or grinding the teeth. Many people may not realize they are doing these things.
Some other measures used to treat TMJ are as follows:
If these treatments fail, referral to a dentist who treats TMJ may be needed. Special bite appliances may be used. In severe cases of TMJ that do not respond to other treatments, surgery to realign the jaw is sometimes helpful. Joint replacement or a joint implant may be considered.
Pain medicines may cause stomach upset and allergic reactions. Medicines to relax the muscles may cause drowsiness or allergic reactions. Other side effects depend on the drug used. Surgery may cause bleeding, infection, or allergic reaction to anesthesia. Surgery does not always cure TMJ.
If symptoms go away, no further treatment is generally needed for the temporomandibular joint disorders. The person should take care to avoid factors that may cause another episode of TMJ, such as teeth grinding.
Symptoms and a physical exam are used to monitor temporomandibular joint disorders. Sometimes, X-rays may be used to monitor the condition. Any new or worsening symptoms should be reported to the healthcare provider.
Author:Adam Brochert, MD
Editor:Ballenberg, Sally, BS
Reviewer:Eileen McLaughlin, RN, BSN
Otolaryngology Head and Neck Surgery, 1998, Cummings et al.
Emergency Medicine, 1998, Rosen et al.