Temporomandibular joint (TMJ) disorder is a condition that affects your temporomandibular joint (the hinge connecting your lower jaw to the skull and upper jaw). Various factors, such as bruxism, stress, malocclusion, jaw injuries, and arthritis, can contribute to the condition. However, the exact cause varies with patients. Some symptoms you can experience include pain or tenderness in the jaw, limited range of motion, challenges chewing, vertigo, toothaches, and tinnitus. You should consult a skilled dentist who can diagnose the condition and develop a treatment plan that relieves your symptoms. Seeking treatment early could restore your oral health, general health, and well-being.

Defining Temporomandibular Joint Disorders

Also known as temporomandibular joint dysfunction, temporomandibular joint (TMJ) disorders refer to a category of diseases involving the orofacial system, divided into those impacting the masticatory muscles and the temporomandibular joint. They affect the jaw joints, nearby ligaments, and muscles. The dysfunctions can cause numerous issues, including headaches, challenges closing and opening the mouth, and jaw pain.

Humans have two temporomandibular joints on both sides of the head in front of the ears. They connect the lower jaw (mandible) to the skull. The TMJ functions differently from other joints since it is a hinge joint. The joint rotates like many joints, but it also translates. Translation involves the joint sliding forward, allowing you to eat and speak, and the jaw to close and open.

According to the National Institute of Dental and Craniofacial Research, approximately 11 to 12 million people in the U.S. experience pain in the TMJ region. TMDs are more prevalent in females than in males.

You might have heard people calling these conditions TMJ. TMD refers to temporomandibular joint dysfunction, while TMJ describes the jaw joint.

Types of TMDs include the following:

  • Myofascial pain—It is the most typical type of TMD. It causes pain in the connective tissues covering your muscles (fascia) and muscles regulating shoulder, neck, and jaw function, or discomfort.

  • Internal derangement of your joint — It refers to an injury to your condyle (the rounded end of your jawbone articulating with your temporal skull bone) or a displaced disk (cushion of cartilage between the skull and your jawbone’s head) or dislocated jaw.

  • Degenerative joint disease, including rheumatoid arthritis or osteoarthritis, in your jaw joint.

Please note that you can suffer from at least one of the above conditions simultaneously.

Causes of TMD

One cause does not cause TMDs. Instead, different factors cause them.

Here are its causes:

  • Bruxism (teeth clenching or grinding)

  • Jaw injuries, including a dislocated or broken jaw

  • Arthritis in the jaw joint

  • Stress

  • Malocclusion (when teeth fail to fit together as they ought to)

While you cannot regulate factors that cause TMD, there are specific habits that can worsen the condition. They include the following:

  • Using your teeth as tools

  • Poor posture that exerts excess force on the shoulder, facial, and muscles

  • Chewing on items like pens and pencils

  • Excessive gum chewing or chewing on ice

  • Taking huge bites of food can overwork the jaw muscles

  • Grinding or clenching teeth during the day

  • Sleeping on your stomach

Complications of Temporomandibular Joint Disorder

The condition can cause many complications, including restricted chewing function, bruxism-associated wear and tear, and chronic pain.

Since some factors may overlap, it can be hard to determine the exact root cause. It sometimes makes finding the most effective treatment option for you more time-consuming.

Symptoms of TMD

The signs of TMD you experience vary depending on the cause and severity of the disease. Pain in your jaw and nearby muscles is the typical symptom.

Other symptoms are as follows:

  • Pain in your neck or face

  • Stiffness in the muscles of your jaw

  • Restricted movement of your jaw

  • A popping or clicking sound from your TMJ site

  • Locking of your jaw

  • Dental challenges like the wear and tear of your teeth

  • Tinnitus

  • Headaches

  • Malocclusion (shift in your jaw, changing how your lower and upper teeth align)

  • Vertigo

Diagnosing TMJ Dysfunction

Dentists do not follow a standard test to diagnose TMJ dysfunction. The exact cause of the condition is unclear, making it challenging to identify the ailments.

Your physician will focus on your signs and symptoms and thoroughly review your medical history. They will inquire about the pain, including when it happens, the location, what worsens it or makes it better, and whether it progresses to other body parts or remains in one location. Additionally, they will inquire whether you experience other painful conditions like back pain or headaches.

Your dentist will inspect your jaw, head, face, and neck for jaw clicking, popping, challenges with movement, or tenderness.

Your healthcare provider can also use any of the following diagnostic imaging tests to obtain images of the jaw joints and nearby structures:

  • X-rays

  • Magnetic resonance imaging

  • Computer tomography (CT) scans

  • TMJ arthroscopy

Note that facial, mouth, or jaw pain is not necessarily associated with TMDs. The dentist can dismiss other diseases before making a TMJ dysfunction diagnosis.

Treating TMDs

Before your dentist treats TMJ dysfunctions, you should understand the following:

  • Sounds that do not cause pain in your temporomandibular joint occur frequently, do not require treatment, and are normal.

  • TMD symptoms disappear in most patients without treatment.

  • Since there is limited research on most TMD treatments, it is wise to avoid treatments involving surgery or those that can permanently alter your bite, teeth, or jaw joints.

The treatment options can be surgical or nonsurgical.

Since most muscle and joint challenges do not worsen and are temporary, simple treatment might be all you need. When you initially experience discomfort, your dentist can recommend:

  • Applying cold or heat to your face alongside doing exercises that strengthen and gently stretch your jaw muscles

  • Stopping habits like nail biting, gum chewing, and jaw clenching

  • Taking prescription and over-the-counter medication

  • Eating soft foods

If these recommendations fail to work, your dentist can recommend one of the treatment options below:

Physical Therapy

Physical therapy aims to improve and restore your jaw's physical function and movement. There are various kinds of physical therapy techniques. One form of therapy therapists use is manual therapy, which involves using their hands to stretch muscles and soft tissues around the joint. It relieves pain and improves function.

Intraoral Appliances

An intraoral appliance is a device that fits over your teeth. It does not alter your bite or teeth.

It is also referred to as a nightguard, splint, occlusal splint, bruxism splint, interocclusal splint, or stabilization splint.

You should stop using your intraoral appliance and seek medical attention if it leads to pain.

Complementary Treatment Options

A complementary treatment option is a technique that medical practitioners use alongside conventional medicine. Transcutaneous electrical nerve stimulation (TENS) and acupuncture are some of the complementary treatments dentists have used to treat TMJ disorders.

Acupuncture involves the practitioner stimulating particular points on a patient’s body by inserting needles via the skin. On the other hand, TENS is a battery-powered tool that utilizes electrodes placed on your skin. The equipment generates electrical impulses that can alter how you perceive pain.

TMJ Surgery

A dentist can recommend performing a surgical procedure if:

  • The patient feels intense, consistent tenderness or pain whenever they close or open their mouth

  • The patient has challenges drinking or eating due to jaw immobility or pain

  • The patient cannot close or open their mouth all the way

  • The immobility or pain worsens progressively, even with other nonsurgical treatment options

  • The patient has a structural disease in their jaw joint, verified with an imaging test

It is wise for a dentist trained in temporomandibular disorders to evaluate your medical history and thoroughly examine your clinical presentation, radiological findings, and symptomatic history to determine whether you qualify for surgery. Surgical procedure should be your last resort after nonsurgical alternatives fail.

Depending on your condition’s severity or your symptoms, your dentist can perform any of the following surgical procedures:

  • Arthrocentesis — It is a minimally invasive procedure involving injecting a fluid into the joint. The fluid cleans chemical byproducts of inflammation and can lower pressure that makes the joint painful or stiff. It helps the jaw regain its range of motion.

  • Arthroscopy — Oral surgeons perform the procedure by opening a tiny hole in your skin above your TMJ. Next, they will insert a cannula (narrow tube) via the hole and into your joint. Then, they insert an arthroscope (a device with a camera and light to visualize the joint) into the cannula. After setting up everything, the surgeon will operate on your joint with surgical tools inserted via the cannula.

  • Open-joint surgery — The surgical procedure entails opening an incision inches long over your TMJ so your dentist can operate on your joint. Typically, dentists reserve open-joint surgery for severe TMDs that involve excessive bone or tissue growth that hinders the TMJ from moving, inability to reach the joint using arthroscopy, and fusion of the joint cartilage, bone, or tissue.

The Consequences of Untreated TMJ Disorders

Ignoring TMJ signs can seem easy at first. However, the discomfort and pain can become severe as time goes by.

What to expect after ignoring the condition can include the following:

  • Increased pain — Mild discomfort could become persistent, throbbing pain in the jaw, face, or neck.

  • Speaking issues — You might experience more speech difficulties when the jaw becomes stiff.

  • Chewing issues — You could find it problematic to chew some foods, making eating painful and devastating.

  • Severe headaches — Persistent pressure in your jaw can result in tension headaches or migraines, making focusing hard.

If the TMJ is left untreated, it can cause long-term complications, including jaw misalignment. As the joint condition deteriorates, it becomes challenging to shut your mouth correctly. The misalignment could affect your gums and teeth, causing additional oral issues. Sometimes, it can make your facial muscles uneven, impacting your appearance.

Botox Treatment for TMDs

Botox is a neurotoxin protein that helps treat TMJ disorder symptoms like headaches due to bruxism, lockjaw, and jaw tension.

The treatment is a nonsurgical, outpatient procedure performed in a dentist’s office. Typically, the treatment session takes about thirty minutes, and you can expect more than three injection sessions over many months.

Depending on your signs, your dentist will inject Botox into the temple, jaw muscles, forehead, and other regions. The dentist will determine the number of injections you require. Botox injections can cause you pain identical to a prick or bug bite. Dentists suggest easing the pain using a numbing cream or a cold pack.

It can take days to see improvements and relief. You can also return to your daily activities after leaving your dentist’s office.

You should avoid massaging or rubbing your injection areas for hours following treatment. It prevents toxins from advancing to other muscles.

The price of Botox treatment varies depending on the treatment needs, the severity of your signs, your dentist’s geographical location, and the number of injections.

Botox is used off-label for TMDs; however, its efficacy and safety are still under investigation, and the United States Food and Drug Administration has not yet approved it for this use

According to a study conducted in 2012 involving 26 subjects, Botox could increase mouth movements and reduce pain. Participants in another study conducted in 2003 reported improvement of signs and symptoms after conservative treatment options failed. Despite the encouraging research results, scientists recommend more research to increase understanding of Botox treatment efficacy.

Typical side effects of this treatment include the following:

  • Headaches

  • Nausea

  • Flu-like illness

  • Temporary eyelid droop

  • Respiratory infections

  • The fixed smile that can last for up to eight weeks

Find a Qualified Dentist Near Me

TMDs can be a severe oral health issue since challenges like jaw misalignment and teeth grinding accompany them. Therefore, it is wise to treat it promptly before the condition becomes irreversible and long-term. At Northridge Advanced Dentistry, we are committed to assisting you in finding relief for your pain and discomfort. Our dentists can take a thorough approach to the condition so that you can avoid visiting many medical practitioners as you seek relief. We can also partner with you and maintain an open line of communication to develop an effective treatment plan for you. Please contact us at 818-701-3010 to schedule your initial dental appointment.