Temporomandibular Joint Dysfunction (TMJ)

Temporomandibular joint dysfunction is a disorder affecting the jaw joint, causing pain, clicking or locking of the jaw, and difficulty chewing.
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The basics

Temporomandibular Joint Dysfunction (TMJ) is a medical condition that affects the temporomandibular joint, which is the joint that connects your jawbone to your skull. It is a common condition that can cause pain and discomfort in the jaw, face, and neck. TMJ can also lead to difficulty opening and closing the mouth, clicking or popping sounds when the jaw moves, and even headaches.

TMJ can affect anyone, but it is more common in women than men. It typically occurs in people between the ages of 20 and 40. The causes of TMJ are not fully understood, but it is thought to be a combination of factors such as injury to the jaw, arthritis, stress, and teeth grinding. The prognosis for TMJ varies depending on the severity of the condition and the individual. For most people, TMJ is a temporary and manageable condition that can be treated with self-care at home or by a healthcare professional. However, in severe cases, TMJ may need surgical intervention or long-term management by a specialist.

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Symptoms

The presentation of Temporomandibular Joint Dysfunction (TMJ) can vary from person to person, but it commonly presents with the following symptoms:

  • Pain or tenderness in the jaw, face, or neck
  • Difficulty opening and closing the mouth
  • Clicking or popping sounds when the jaw moves
  • Locking of the jaw
  • Aching pain in or around the ear
  • Headaches
  • Toothaches
  • Dizziness or vertigo
  • Changes in the way the upper and lower teeth fit together
  • Ear congestion or ringing in the ears

The symptoms of TMJ can range from mild discomfort to severe pain and can affect one's quality of life and ability to eat, speak, and engage in daily activities.

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Therapies & treatments

Orofacial Therapy

Orofacial therapy is a type of physical therapy that specializes in treating jaw and facial pain. This therapy can involve exercises, stretches, and massage techniques to improve range of motion and alleviate pain in the jaw muscles and joints.

Medications

Pain specialists work with people with TMJ to formulate a medication strategy specifically tailored to the source of the TMJ.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Medications such as ibuprofen, naproxen, and aspirin can help reduce pain and inflammation in the TMJ.

Muscle relaxants

These medications, such as cyclobenzaprine or diazepam, help relieve muscle spasms in the jaw and face.

Tricyclic antidepressants

Medications such as amitriptyline and nortriptyline can help relieve pain and improve sleep in people with TMJ.

Anticonvulsants

Medications such as gabapentin and pregabalin may be used to treat pain and muscle spasms associated with TMJ.

Topical medications

Creams or gels containing lidocaine or other pain-relieving medications can be applied directly to the skin over the affected joint to help relieve pain.

Corticosteroids

These medications may be injected directly into the TMJ to reduce inflammation and relieve pain.

Bite Guards

A bite guard, also known as an occlusal splint, is a device that is worn over the teeth to help alleviate symptoms of TMJ. The bite guard helps to reduce clenching and grinding of the teeth, which can exacerbate TMJ symptoms.

Botox

Botox injections can be used to alleviate the muscle spasms and pain associated with TMJ. Botox works by blocking the nerve signals that cause muscle contractions.

Arthrocentesis

Arthrocentesis is a minimally invasive procedure that involves the insertion of a needle into the TMJ joint. Fluid is then injected into the joint to help flush out debris and reduce inflammation.

Trigger Point Injections

Trigger point injections involve the injection of a local anesthetic and/or steroid medication into specific trigger points in the jaw muscles. This can help to alleviate pain and reduce muscle spasms.

Pulsed Radiofrequency Procedure

Pulsed radiofrequency is a minimally invasive procedure that uses electrical stimulation to interrupt pain signals along the nerves in the face and jaw, providing pain relief for TMJ.

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Self-care strategies

Avoid clenching or grinding your teeth

This can be done by becoming aware of any clenching or grinding, and using relaxation techniques to reduce tension in the jaw muscles.

Apply heat or ice to the jaw

Alternating between heat and ice can help reduce inflammation and alleviate pain. A warm compress can help relax muscles, while a cold compress can help reduce swelling.

Practice relaxation techniques

Stress and anxiety can worsen TMJ symptoms, so relaxation techniques such as deep breathing, meditation, or yoga can help manage symptoms.

Massage the jaw muscles

Gentle massage of the jaw muscles can help reduce tension and improve blood flow to the area.

Avoid chewy or hard foods

Foods that require a lot of chewing or are hard to bite can exacerbate TMJ symptoms. Soft, easy-to-chew foods may be easier on the jaw.

Practice good posture

Poor posture can contribute to TMJ symptoms, so it is important to maintain good posture throughout the day.

Use over-the-counter pain relievers

Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate pain and reduce inflammation.

Try mouth guards or splints

Mouth guards or splints can help reduce clenching and grinding, and can be custom-made by a dentist for a better fit.

Stretch the jaw muscles

Simple jaw stretches, such as opening and closing the mouth or moving the jaw side to side, can help reduce tension in the muscles.

Get plenty of rest

Adequate rest is important for overall health and can help manage stress, which can exacerbate TMJ symptoms. Aim for 7-9 hours of sleep per night.

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