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What's TMJ and how can I get some relief?

1) Dear Alice,

What is TMJ? What kind of doctor handles this problem?

2) Dear Alice,

I have a rather odd problem. For the past several years, I have noticed that when I open my mouth wide to yawn or take a bite out of a sandwich, the right condyle of my jawbone slips laterally from the temporomandibular joint, making it difficult, and at times, painful, to close my mouth. I basically have to slip the condyle back into the socket; otherwise, it slips in by itself, which is what causes the pain.

Other than being inconvenient, this has not adversely affected me in any way that I can tell, except that I am now careful not to open my mouth completely when I yawn. I am reluctant to see a doctor about this because I cannot reproduce the situation at will, and don't know if the problem can be diagnosed or detected unless the doctor actually sees the condyle slip out.

Also, any time I have gone to Health Services, it seems that whatever the problem, they just send me home with a jar full of ibuprofen. What do you think is wrong? Is this problem serious? Does it deserve immediate attention? What type of doctor would I need to see and could I get a referral from Health Services?

Signed,
Jaws

Dear Reader 1 and Jaws, 

Temporomandibular joints (TMJs) are the point where the lower jaw meets the temporal bone of the skull. Temporomandibular disorders (TMDs) affect over 10 million adults in the United States. They encompass over 30 conditions that affect these joints and the muscles in the face that are used for chewing. These conditions can be categorized into three main types: joint and disc disorders, chewing muscle disorders, and headaches associated with TMD. These challenges are often addressed and diagnosed by a dentist or a physician who specializes in TMJ disorders and TMD treatments. While it's common to experience TMJ clicking and popping without pain, TMD symptoms can include: 

  • Pain in the chewing muscles or jaw joint (this is the most commonly reported symptom). 
  • Pain that spreads to the face or neck. 
  • Jaw stiffness or jaw locking. 
  • Painful clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth. 
  • Ringing in the ears, hearing loss, or dizziness. 
  • Changes in the alignment of the upper and lower teeth. 

List adapted from The National Institute of Dental and Craniofacial Research 

While the exact causes of TMD are unclear, it’s often a result of physical ailments such as a jaw injury, arthritis, or disk erosion. TMD has also been linked to behaviors such as teeth grinding and jaw clenching that stem from emotional stress. These behaviors can introduce an increased amount of wear and tear on the teeth, creating an unevenness in the jaw joints. 

TMDs can be short-term issues that resolve on their own or chronic conditions that coexist with other medical issues. You may want to visit a health care provider if you’re experiencing persistent symptoms. There’s no standard test to diagnose TMDs. However, health care providers can diagnose TMDs using information like your symptoms and medical history, and from doing a physical examination of your head, neck, and jaw. They may also recommend imaging tests, such as x-rays or magnetic resonance imaging (MRI), to get a clearer view of your jaw structure. You may also get referred to specialists who treat TMDs like dentists, oral surgeons, orthodontists, otolaryngologists, or prosthodontists

It seems like the issue for you, Jaws, is that you’re dissatisfied with the advice you've received from health care providers. It's important to acknowledge this dissatisfaction, because despite a health care provider’s medical expertise, you’re the one who may have the best understanding of your body, symptoms, and health goals. Feeling unheard could increase your risk of misdiagnosis or going without a proper diagnosis and treatment. Know that it’s within your right to continue getting another opinion until you find a physician that’s right for you. 

Some additional at-home or behavior-based remedies that you might explore to relieve jaw tightness and tension in the meantime can include: 

  • Consuming soft foods to reduce overexerting joints and muscles. 
  • Applying heat or cold to the face while doing exercises to gently stretch and strengthen jaw muscles. 
  • Taking over-the-counter medications like nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. These can help to reduce some of the swelling you may be experiencing in the area. 
  • Practicing stress reduction and relaxation techniques. This can help curb unconscious awake habits like jaw clenching, gum and ice chewing, or chewing on inedible objects like nails, silverware, or writing utensils—all of which may lead to TMD symptoms. 

List adapted from The National Institute of Dental and Craniofacial Research 

If these interventions don’t do the trick, a health care provider may recommend treatments involving prescription pain relievers, muscle relaxers, or referrals to physical therapy or mental health to release muscle tension and focus on stress reducing techniques. For rare and severe last-resort cases, there are more invasive treatment options that may be available to you. That said, similar to other procedures, these treatment options can involve risks, so working closely with a medical professional that you trust to discuss what options will work best for your lifestyle may be helpful. 

Pain from TMJ disorders can really gnaw at you, but here's hoping it all locks into place! 

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Last updated Dec 15, 2023
Originally published Mar 15, 1996