If you experience ongoing pain in the area near your ear, your jaw, or the muscles on the side of your face, possibly accompanied by a clicking or popping sound or restricted jaw movement, you may be suffering from TMD.
Suppose you experience ongoing pain in the area near your ear, jaw, or the muscles on the side of your face, possibly accompanied by a clicking or popping sound or restricted jaw movement. In that case, you may be suffering from TMD — an abbreviation for Temporomandibular disorders. Sometimes people incorrectly use the term TMJ to refer to these problems when TMJ is the abbreviation for the temporomandibular joint — or jaw joint — itself. So while you definitely have a TMJ (two of them), you may or may not have TMD.
TMD describes a group of conditions characterized by pain and dysfunction of the TMJ and/or the muscles surrounding it. It’s not always easy to figure out exactly what’s causing these symptoms, but the good news is that most TMD cases resolve themselves with the help of conservative remedies you can try at home. It’s important to exhaust all such reversible remedies before moving on to anything irreversible, such as bridgework or surgery.
The two TMJs that connect your lower jaw, the mandible, to the skull’s temporal bone on either side are very complex joints that allow movement in three dimensions. Large pairs of muscles in the cheeks and temples move the lower jaw. The lower jaw and temporal bone fit together as a ball and socket, with a cushioning disk in between. Any of these parts — the disk, the muscles, or the joint itself — can become the source of a TMD problem. If you are in pain or have difficulty opening or closing your jaw, a thorough examination can help pinpoint the problem area; then, an appropriate remedy can be recommended.
As with any other joint, the TMJ can be subject to orthopedic problems, including inflammation, sore muscles, strained tendons and ligaments, and disk problems. TMD is also influenced by genes, gender (women appear more prone to it), and age. Physical and psychological stress can also be a factor. In some cases, jaw pain may be related to a more widespread, pain-inducing medical condition such as fibromyalgia (“fibro” – connective tissues; “myo” – muscle; “algia” – pain).
Clicking Sounds: Some people with TMD hear a clicking, popping, or grating sound coming from the TMJ when opening or closing the mouth. This is usually caused by a shifting of the disk inside the joint. Someone standing next to you may even hear it. Clicking alone is not a significant symptom because studies show that one-third of all people have jaw joints that click. However, if the clicking is accompanied by pain or limited jaw function, the jaw getting “stuck” in an open or closed position, for example, would indicate TMD.
If you feel soreness and stiffness upon waking up in the morning, it’s often related to habits such as clenching and/or grinding the teeth at night. This can be felt in the cheeks (masseter muscles) and temples (temporalis muscles), where the two big pairs of jaw-closing muscles are located. If you have this type of nocturnal habit, a custom-made nightguard should be very helpful in decreasing the force applied to your teeth, which will, in turn, allow your muscles to relax and relieve pressure on your jaw joints. Other self-care remedies are discussed below (please see Relieving the Pain).
Pain that’s actually coming from one or both jaw joints technically would be described as arthritis (“arth” – joint; “itis” – inflammation) of the TMJ. Radiographs (x-ray pictures) show that some people have arthritic-looking TMJs but no symptoms of pain or dysfunction; others have significant symptoms of pain and dysfunction, but their joints look normal on radiographs. There is no cure for arthritis anywhere in the body, but medication can sometimes help relieve arthritic symptoms.
Once you have been examined, a strategy for treating your condition and managing your pain can be developed. Sometimes a temporary change to a softer diet can reduce muscle and joint stress. Ice and/or moist heat can help relieve soreness and inflammation. Muscles in spasms can also be helped with gentle stretching exercises. Non-steroidal anti-inflammatory medications and muscle relaxants can also provide relief.
Severe TMD cases may require more complex forms of treatment, including orthodontics, dental restorations like bridgework, or minor procedures inside the joint, such as cortisone injections or lavage (flushing) the joint. It’s rare for major surgery ever to be necessary in a case of TMD. Again, it’s essential to try the wide range of conservative, reversible treatments available and give them enough time to work as they almost always prove effective. The first step is an examination at the dental office.