Temporomandibular joint dysfunction

Temporomandibular joint dysfunction is a collection of painful symptoms affecting the jaw joints. These two joints are formed by the temporal bone of the skull, the jawbone, and the jaw muscles. Think of the temporomandibular joint as a hinge that connects your jaw to your skull. This joint lets you chew and talk.

Temporomandibular joint dysfunction has several possible causes:

• injury to or dislocation of the joint
• problems with the jaw muscles, particularly stress on jaw muscles from gum chewing or tooth grinding
• joint disorders such as arthritis
• tumors of the bone or soft tissue
• nerve problems in which pain messages continue to be transmitted to the brain after the source of pain is removed
• psychological factors that exacerbate chronic pain

Symptoms

Symptoms of temporomandibular joint dysfunction include difficulty chewing or opening your jaw, clicking or popping noises while chewing, locked jaw, jaw pain, throbbing temples, ringing ears, and aching shoulders. It can happen to anyone, but is most common among women in their teens, 20s, and 30s.

Diagnosis

Your doctor or dentist will ask you about your symptoms and your medical history. He or she will also examine your face and jaw, paying particular attention to your jaw's range of motion and looking for painful spots or or listening for clicks or grating sounds when you open and close your jaws.  X-rays can help take a closer look at your jaws, temporomandibular joints, and teeth. Tests like magnetic resonance imaging (MRI) or a CT scan may sometimes be needed.

Treatment options

Pain in the temporomandibular joint rarely signals a serious disease. Sometimes it goes away on its own. Treatment aims to address the underlying cause.

Halt tooth grinding. Stress can contribute to tooth grinding. Finding ways to ease stress, such as exercise or meditation, can help. Dental appliances such as bite guards to prevent tooth grinding may also work

Give your jaw a break. Try to avoid foods that are difficult to chew or necessitate opening your mouth extremely wide. Switch to a diet of soft foods for several weeks and see if you feel an improvement.

Ease the pain. Painkillers such as aspirin can help relieve pain. Warm, moist compresses applied to the painful area may help reduce muscle spasms. Muscle relaxants and low doses of antidepressant drugs are effective treatments for some people.

Biofeedback and psychotherapy. These therapies help some people with temporomandibular joint dysfunction.

Surgery. When temporomandibular joint dysfunction is caused by degenerative joint disease, surgery may be needed to change the structure of your jaw.

Treatments for temporomandibular joint dysfunction that have not been carefully studied and have not been proven helpful include wearing braces or retainers to realign the teeth; grinding down teeth and fitting them with crowns; or extracting teeth.