Finding Restorative Treatment for TMJ Disorders

Jonathan Vellinga, MD

What are TMJ disorders?

TMJ disorders are named for the temporomandibular joint, which is the intersection where your jawbone (mandible) and your skull (the temporal bone, specifically) meet near your ear (1). A soft disc made of cartilage and highly innervated tissues act as a barrier between the bones, and multiple small, short muscles on top of this joint allow for movement (2). With all of these small moving parts working together, the jaw is able to open and close, move forward and backward, and side to side (2). The mixture of mobility, so many different moving parts, and the innervated tissue running through the TMJ creates the potential for many avenues of injury and pain. Pain often comes from dysfunction in the muscles that control jaw movement, dislocated jaws or discs, and inflammation (1).

Finding Restorative Treatment for TMJ Disorders

The most common symptoms of TMJ disorders are (1):

  • Pain in the jaw joint or muscles on the side of the face

  • Pain in the face, jaw, or neck

  • Jaw locking and/or reduced mobility

  • Popping, grating, or clicking when opening or closing the mouth

  • A difference in the way your teeth fit together that causes discomfort or pain

What can cause TMJ disorders?

Causes of TMJ disorders (TMD) and pain vary, and in fact, do not always have a singular root cause. Trauma to the jaw, arthritis, night clenching or teeth grinding, and disc erosion or displacement are the most commonly attributed causes (3). However, for many people, symptoms can appear with any obvious origin (1).

Another possible link to the development of temporomandibular joint disorders is female hormones, though the exact role they play is not known (4). Women are 1.5 - 2x more likely than men to develop TMJ problems, and women of reproductive age (20 - 40) bear the highest risk (4).

Diagnosis of TMD

Because the root cause is often unknown or multi-factorial, there is generally an element of difficulty in identifying temporomandibular joint disorders. Due to this lack of clarity, there is not currently a widely-used test to diagnose TMD. Usually, it is recommended that your doctor assess your symptoms, become familiar with your medical history, and examine your head, jaw, neck, and face to determine the severity of the symptoms listed above (1).

Conventional Treatment Options

Doctors often recommend the most conservative, easily reversible treatment plan possible. Surgery on the temporomandibular joint is generally aggressive, invasive, and unsuccessful and can even cause irreversible harm and new dysfunction (1). Even for those with persistent TMJ disorders, simple treatment is generally recommended to minimize the pain. Conventional treatment recommends (1):

  • Using anti-inflammatory compounds combined with a stabilizing splint or bite guard for a short period of time

  • Practicing jaw exercises and stretches to increase jaw mobility

  • Changing to a diet of softer foods

  • Icing the jaw area

  • Avoiding extreme jaw movements like singing or yelling, chewing gum, and wide yawning