An Overview of Temporomandibular Joint Disorder

In This Article

The temporomandibular joint (TMJ) is located in front of each of your ears, joining your lower jaw to your skull. You can easily locate it by opening and closing your mouth and feeling for the joint with your fingers.

A TMJ disorder may occur when there is a problem with the actual TMJ or with the muscles surrounding it. Besides a dull pain at the site of the joint near the ear, a TMJ disorder may trigger headache, ear pain, neck stiffness, and popping or clicking of the jaw.

The diagnosis of TMJ disorder involves a medical history and physical examination. In certain cases, imaging tests may be ordered. Conservative therapies, such as avoiding triggering behaviors and taking an over-the-counter pain reliever, are used to treat TMJ disorder.

Symptoms

The symptoms of TMJ disorder often include:

Facial/TMJ Pain

The pain of TMJ disorder is often described as a dull ache that spreads from the TMJ to the temple, lower jaw, and back of the neck. The pain is worsened by chewing or moving the jaw. Tenderness around the TMJ, headache, and neck stiffness are also common.

Ear Pain

Sharp ear pain that worsens with jaw movement or pain around the ear may occur, along with ear stuffiness and tinnitus (ringing in the ear).

Jaw Dysfunction

Popping or clicking of the jaw, automatic jaw clenching or teeth grinding, and less commonly, jaw locking may occur. These symptoms are most common in the morning.

Other potential symptoms of TMJ include:

  • Lower jaw muscle spasms
  • Eye pain
  • Arm and back pain
  • Dizziness
  • Poor sleep

Causes and Risk Factors

It was originally thought that TMJ disorders were due to misalignment of the upper and lower teeth. While this structural factor still plays a role, experts believe that other factors (e.g., emotional and environmental) are involved.

Bottom Line

It's the combination of multiple factors that trigger the manifestation of TMJ disorder.

Some of these factors include:

  • Trauma to the jaw or joint (e.g., from a whiplash injury, teeth grinding/clenching, or excessive gum chewing)
  • Psychological factors like anxiety, stress, or depression
  • Poor head and neck posture
  • Increased pain awareness and/or sensitivity

Certain people are more prone to developing a TMJ disorder. For instance, TMJ disorders are more common in women and in Caucasians than in African-Americans.

There are also disorders or conditions that have been associated with TMJ, including:

Diagnosis

The diagnosis of TMJ disorder is based on a medical history and physical examination, often by a primary care physician or an otolaryngologist (ENT).

Medical History and Physical Examination

During your medical history, your doctor will ask you specifics about your pain, such as the severity, location, and quality of your pain, as well as what makes your pain worse or better. Your doctor will also ask about associated symptoms (e.g., headache) and potential triggers (e.g., trauma or a history of teeth grinding).

The purpose of these questions is to not only make the diagnosis of TMJ disorder but to rule out mimicking conditions, such as:

During the physical examination, your doctor will look inside your mouth for dental malocclusion, and signs of wear on your teeth from grinding and clenching. He may also measure how far you are able to open your mouth, assess your jaw range of motion, and press on your TMJ/jaw/shoulder/neck muscles for tenderness.

Imaging

Imaging tests, such as an X-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI), can be helpful in the diagnosis of TMJ disorder, especially if the medical history and physical examination findings are vague or uncertain. Imaging tests can also help sort out conditions that may be causing or exacerbating TMJ pain, such as arthritis.

Treatment

The treatment of TMJ begins with the following simple, conservative therapies:

Self-Care Measures

Jaw rest, sticking to soft foods, and applying a warm compress to the tender joint can help soothe the pain and inflammation associated with TMJ disorder. Engaging in stretching jaw exercises and stress-alleviating relaxation techniques may also be helpful.

Medication

Over-the-counter pain relievers, such as the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen, can ease the discomfort associated with TMJ disorder.

For people with TMJ-related muscle spasms of the lower jaw, a muscle relaxant may be prescribed. For chronic TMJ pain, a tricyclic antidepressant, such as Elavil (amitriptyline) or Pamelor (nortriptyline) may be prescribed.

Behavioral Changes

Stopping triggering and/or irritating behaviors is another key component. This means that people with a TMJ disorder should avoid chewing ice or gum, grinding teeth, and clenching their jaw. Sometimes a bite plate or occlusal splint can help with this.

Occlusal therapy aims to protect your bite and prevent severe clenching and grinding that can damage the teeth. To determine if this is an option, you should consult your dentist.

Surgery

Rarely, in severe cases, like if trauma has occurred to the TMJ area, or if a patient continues to have severe TMJ pain and dysfunction despite conservative therapies, surgery may be necessary.

A Word From Verywell

If you are experiencing possible symptoms of TMJ disorder, be sure to see your doctor for a proper evaluation, especially since there are a number of conditions that can mimic TMJ pain.

Then, if you (or a loved one) are diagnosed with TMJ disorder, try to remain patient and resilient. The good news is that with simple self-care measures and small lifestyle changes, the vast majority of people get better over time.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.