What is Temporomandibular Joint (TMJ)?
You may not have heard of it, but you use it hundreds of times every day. The temporomandibular Joint (TMJ) the joint where the mandible (the lower jaw) joins the temporal bone of the skull, immediately in front of the ear on each side of your head. A small disc of cartilage separates the bones, much like in the knee joint, so that the mandible may slide easily; each time you chew you move it. But you also move it every time you talk and each time you swallow (every three minutes or so). It is, therefore, one of the most frequently used of all joints of the body.
You can locate this joint by putting your finger on the triangular structure in front of your ear. Then move your finger just slightly forward and press firmly while you open your jaw all the way and shut it. The motion you feel is the TMJ. You can also feel the joint motion in your ear canal.
How does TMJ work?
When you bite down hard, you put force on the object between your teeth and on the joint. Actually, more force is applied (per square foot) to the joint surface than to whatever is between your teeth. To accommodate such forces and to prevent too much wear and tear, the cartilage between the mandible and skull normally provides a smooth surface, over which the joint can freely slide with minimal friction.
What are the symptoms of TMJ dysfunction?
- Ear pain
- Sore jaw muscles
- Temple/cheek pain
- Jaw popping/clicking
- Locking of the jaw
- Difficulty in opening the mouth fully
- Frequent head/neck aches
How does TMJ dysfunction feel?
The pain may be sharp and searing, occurring each time you swallow, yawn, talk, or chew, or it may be dull and constant. It hurts over the joint, immediately in front of the ear, but pain can also radiate elsewhere. It often causes spasms in the adjacent muscles that are attached to the bones of the skull, face, and jaws. Then, pain can be felt at the side of the head (the temple), the cheek, the lower jaw, and the teeth.
A very common focus of pain is in the ear. Many patients come to the ear specialist quite convinced their pain is from an ear infection. When the earache is not associated with a hearing loss and the eardrum looks normal, the doctor will consider the possibility that the pain comes from a TMJ dysfunction. There are a few other symptoms besides pain that TMJ dysfunction can cause. It can make popping, clicking or grinding sounds when the jaws are opened widely. Some people get ringing in their ears from TMJ trouble.
Is TMJ a problem for you?
- Are you aware of grinding or clenching your teeth?
- Do you wake up with sore stiff muscles around your jaw?
- Do you have frequent headaches and neck pains?
- Does the pain get worse when you clench your teeth?
- Does your jaw click, pop or lock when you open your mouth?
- Is it difficult or painful to open your mouth, eat or yawn?
- Have you injured your neck, head or jaw?
- Do your teeth meet differently from time to time or do they no longer touch when you bite?
The more you have answered yes, the more likely it is that you have a TMJ disorder.
What can be done for TMJ?
Because TMJ symptoms often develop in the head and neck, ENT specialists are appropriately qualified to diagnose TMJ problems. Proper diagnosis of TMJ begins with a detailed history and physical, including careful assessment of the teeth occlusion and function of the jaw joints and muscles. If the doctor diagnoses your case early, it will probably respond to these simple, self-remedies:
- Rest the muscles and joints by eating soft foods.
- Do not chew gum.
- Avoid clenching or tensing.
- Relax muscles with moist heat (1/2 hour at least twice daily).
- Exercise your jaw by opening and closing your mouth keeping the teeth aligned.
- Relaxation techniques and stress reduction, non-steroidal anti-inflammatory drugs, muscle relaxants or other medications may be indicated in a dose your doctor recommends.