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JAW JOINT (TMJ) DISORDERS

The jaw joint is also known as the 'temporomandibular joint', known for short as the 'TMJ'. It can be felt by placing your fingers just in front of your ears, and opening and closing your mouth. The joint allows the jaw to open, close and move to the side and forward. It plays an important role in jaw functions such as talking, chewing and yawning. It is one of the most complex and frequently used joints in the body.

 

A TMJ disorder may affect one or both joints, often causing pain and limiting jaw function. Symptoms usually arise in early adulthood, but children and the elderly can also be affected. TMJ disorders are common, with about seven in ten people being affected at some time in their lives. Although about one person in four is aware of the symptoms or reports them to a dentist or medical practitioner, only five people in every hundred seek treatment. Most symptoms of TMJ disorders or pain are mild and do not need treatment. As with pain in other joints of the body, symptoms often go away with time.

Causes and Symptoms of TMJ Disorders

Disorders of the TMJ can be caused in a variety of ways, including:

In some people, the cause of their TMJ disorder is difficult to diagnose and may include several of the above factors. In different people, TMJ disorders can cause different symptoms which may vary from mild discomfort to severe pain. For example, pain may be sharp, searing and intermittent, or dull and constant.

Symptoms may include:

Diagnosis of TMJ Disorders

An accurate diagnosis is very important to ensure that the right treatment is undertaken. Before starting treatment your dentist will make a diagnosis based on a clinical examination and your medical and dental history. During the examination the dentist will note the exact location of pain, stiffness or soreness, the range of jaw movement and any noises in the jaw joint. The dentist may examine your bite, tooth wear and movement of teeth. To assist with diagnosis your dentist may recommend:

Treatment of TMJ Disorders

TMJ disorders are best treated 'conservatively', that is cautiously, using treatment methods that do not have any permanent effect on the teeth and jaw joint. As TMJ disorders are often temporary, simple treatment methods are used whenever possible to help reduce symptoms and restore jaw function. Relief from symptoms may take time, particularly if the TMJ disorder has developed over a long period. Your dentist will involve you in preparing a treatment plan and may call upon other healthcare professionals, if necessary. A well-designed treatment plan may address both physical and emotional factors. Effective treatment should:

In some people, the treatment plan may take several months to be effective. For the best results, follow your treatment plan carefully. It may include some or all of the following treatments:

Occlusal splint

Occlusal Appliance Therapy

Occlusal splints (also known as bite plates) may be used to take pressure off the jaw joints and teeth. These are usually worn at night and should not have any permanent effect on the position of teeth. Custom made by your dentist, occlusal splints must be adjusted regularly and monitored for some months to help relieve pain.

Modified Diet

To minimise chewing and rest the jaw, eat only soft foods. When a small amount of chewing is necessary, try to chew on both sides of the mouth. Do not favour one side.

Avoid Extreme Jaw Movements

To rest the jaw, do not yawn, chew or talk too much.

Physiotherapy

Exercises, massage, gentle movement and muscle stretching can be effective in reducing pain and stiffness and increasing strength and mobility.

Warm or Cold Packs

Muscle relaxation can be achieved by applying warm or cold packs to tender areas.

Relaxation and Stress Management

Learn how to relax and lessen stress. This can reduce tension in the jaw joint. Your dentist may recommend a stress management program.

Behaviour Modification Therapy

Individual or group counselling, or support sessions, can be effective in identifying sources of stress and learning how to modify behaviour.

Medication

In some cases, your dentist may recommend short-term medication to help relieve symptoms and assist other treatment methods. Your dentist may prescribe a painkiller, anti-inflammatory, anti-anxiety agent, antidepressant, sedative or muscle relaxant. Take medication only as directed. Your dentist will be happy to answer any questions you may have regarding medication. Read the Consumer Medicine Information which most prescription medicines have in the box.

Specialist Management

If pain and dysfunction are severe and chronic and initial conservative treatment has not been effective in relieving symptoms and restoring jaw function, the dentist may refer the patient to a specialist or an oro-facial pain clinic.

Surgery

Very rarely, surgery may be required. On average, only about three in every 2,000 people will require surgery. Your dentist will refer you to an oral and maxillofacial surgeon if surgery may be needed.