Temporomandibular disorders (TMD) are disorders that develop from problems with the fit between the upper and lower teeth, the jaw joint, and the muscles in the face that control chewing and moving the jaw.
What is the temporomandibular joint?
The temporomandibular joint (TMJ) is the jaw joint. It is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull, which is immediately in front of the ear on each side of your head. The joints move smoothly up and down and side to side, which allows you to talk, chew, and yawn. Muscles attached to and surrounding the jaw joint control its position and how it moves.
What causes TMD
TMD can be caused by injury to the jaw, TMJ, or muscles of the head and neck, such as from a heavy blow. Other causes include:
- Grinding or clenching the teeth (puts a lot of pressure on the TMJ)
- Dislocation of the soft cushion or disc between the ball and socket
- Presence of osteoarthritis or rheumatoid arthritis in the TMJ
- Stress, which can cause a person to tighten muscles in the face and jaw or to clench the teeth
What are the symptoms of TMD?
People with TMD can feel severe pain and discomfort that can be temporary or last for many years. TMD is most common in those 20 to 40 years of age and is more common in women than in men.
Symptoms of TMD include:
- Pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
- Limited ability to open the mouth very wide
- Jaws that get "stuck" or "lock" in the open- or closed-mouth position
- Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth. Pain may also be present.
- A tired feeling in the face
- Difficulty chewing or a sudden uncomfortable bite – as if the upper and lower teeth are not fitting together properly
- Swelling on the side of the face
Other common symptoms include toothaches, headaches, neck aches, dizziness, and earaches and hearing problems such as tinnitus.
How is TMD diagnosed?
Because other conditions cause similar symptoms -- including a toothache, sinus problems, arthritis, or gum disease -- a thorough history and clinical exam is taken. Temporomandibular joints are examined for pain or tenderness; clicking, popping, or grating sounds during jaw movement; limited motion or locking of the jaw while opening or closing the mouth; and bite and facial muscle function.
Panoramic X-rays might be taken. These full face X-rays show the entire jaws, TMJ, and teeth to make sure other problems aren't causing the symptoms. Sometimes other imaging tests are needed. Magnetic resonance imaging (MRI) views the soft tissue, such as the TMJ disc, to see if it is in the proper position as the jaw moves. A computed tomography (CT) scan helps view the bony detail of the joint.
You may be seen by a maxillofacial surgeon for further care and treatment. This doctor specializes in surgical procedures in and about the entire face, mouth, and jaw area.
- TMJ (Temporomandibular Joint and Muscle Disorders). National Institute of Dental and Craniofacial Research. National Institutes of Health. www.nidcr.nih.gov Accessed 6/1/2016.
- TMJ Disorders. National Institute of Dental and Craniofacial Research. National Institutes of Health. www.nidcr.nih.gov Accessed 6/1/2016.
- Goddard G. Chapter 26. Temporomandibular Disorders. In: Lalwani AK. eds. CURRENT Diagnosis & Treatment in Otolaryngology—Head & Neck Surgery, 3e. New York, NY: McGraw-Hill; 2012.
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