Overview
 More
than fifteen percent of American adults suffer from
chronic facial pain. Some common symptoms include
pain in or around the ear, tenderness of the jaw,
clicking or popping noises when opening the mouth,
or even headaches and neck aches.
Two joints and
several jaw muscles make it possible to open and
close the mouth. They work together when you chew,
speak, and swallow. These structures include muscles
and ligaments, as well as the jaw bone, the mandible
(lower jaw) with two joints, the TMJ’s.
The TM joint is one of the
most complex joints in the body. Located on each
side of the head, these joints work together and can
make many different movements, including a
combination of rotating and translocational
(gliding) action, used when chewing and speaking.
Several muscles help open and
close the mouth. They control the lower jaw
(mandible) as it moves forward, backward, and
side-to-side. Both TM joints are involved in these
movements. Each TM joint has a disc between the ball
and socket (see diagram). The disc cushions the load
while enabling the jaw to open widely and perform
rotating and translocational movements. Any problem
that prevents this complex system of muscles,
ligaments, discs and bones from working together
properly may result in a painful TMJ disorder.
Diagnosis & Treatment
A dentist can help identify
the source of the pain with a thorough exam and
appropriate x-rays. Often, it's a sinus, toothache
or an early stage of periodontal disease. But for
some pain, the cause is not so easily diagnosed. The
pain could be related to the facial muscles, the jaw
or temporomandibular joint, located in the front of
the ear. Treatments for this pain may include stress
reducing exercises, muscle relaxants, or wearing a
mouth protector to prevent teeth grinding. They've
been successful for many and your dentist can
recommend which is best for you.
Several conditions may be
related to TMD, but they can be quite varied, and
they are often difficult to pinpoint. TM disorders
can result when the jaw muscles or jaw joints are
affected.
The joint, ligaments, and
muscles used for chewing and grinding food may all
be involved. In some cases, it is not possible to
clearly determine the causes. In some complex cases,
where more than one doctor is involved, it may be
difficult to get a consensus on treatment.
Some TM problems result from
arthritis, dislocation, and injury. All of these
conditions can cause pain and dysfunction. Muscles
that move the joints are also subject to injury and
disease. Injuries to the jaw, head or neck, and
diseases such as arthritis, might result in some TM
problems. Other factors that relate to the way the
teeth fit together—the bite—may cause some types of
TMD. Stress is thought to be a factor. TMD affects
women of childbearing age more than men, or older
men and women.
There are several ways the TMJ
disorders may be treated. Your dentist will
recommend what type of treatment is needed for your
particular problem or recommend that you be referred
to a specialist. Treatment may involve a series of
steps. The step-by-step plan is in your best
interest because only minor, relatively non-invasive
treatment may be needed.
Diagnosis is an important step
before treatment. Part of your clinical examination
includes checking the joints and muscles for
tenderness, clicking, popping or difficulty moving.
Your complete medical history may be reviewed, so it
is important to keep your dental office record
up-to-date. Your dentist may take x-rays and may
make a “cast” of your teeth to see how your bite
fits together. Your dentist may also request
specialized x-rays for the TM joints. Depending on
your case, the dentist may refer you to a physician
or another dentist.
 Additional
Resources
ADA Dental
Minute
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