TMD: Temporomandibular Disorder

T he temporomandibular joints connect both sides of the lower jaw (mandible) to the temporal bone of the skull. Ligaments, tendons, and muscles attached to and surrounding the joints control the up-and-down and side-to-side movement of the jaw. Temporomandibular (jaw) disorders, formerly called temporomandibular joint (TMJ) syndrome, include problems with the jaw joints and the muscles that control chewing and talking.

TMD symptoms include pain or tenderness in the jaw muscles; pain that radiates to the face, neck, or shoulders; clicking, popping, or grating noises in a jaw joint when opening or closing the mouth; locking or limited movement of the jaw. There is typically no single cause of temporomandibular disorders. A severe injury to the jaw or dislocation of the jaw joint can cause TMD. Some experts believe that anxiety and stress can lead to bruxism (the clenching and grinding of teeth at night), which can cause muscle spasms and pain. Malocclusion (an improper bite) and arthritis in a jaw joint may contribute to TMD.

TMD symptoms should be evaluated by a dentist or physician. In most cases the problems causing TMD pain are temporary and simple treatment is all that is needed to relieve discomfort. Simple remedies a dentist may suggest include eating soft, nonchewy foods; avoiding extreme jaw movements, such as wide yawning and gum chewing; applying hot or cold compresses to the chewing muscles along the sides of the face; and taking aspirin or other anti-inflammatory medication.

The dentist may prescribe a mouth guard that is worn over the teeth while sleeping. The guard can reduce bruxism and ease muscle tension and joint stress. Other conservative treatments include biofeedback and relaxation therapies, muscle-relaxant medications, and physical therapy. Surgery and other permanent changes to the mouth or jaw are usually not necessary and may make TMD discomfort worse.