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Jaw joint dysfunction

Jaw joint dysfunction is a group of conditions that can cause joint pain. They can stop your jaw joint and the muscles that control the movement of your jaw from working correctly.

Jaw joint dysfunction problems are also known as temporomandibular disorders (TMJ). Sometimes you may also hear the condition referred to as temporomandibular dysfunction or temporomandibular joint dysfunction. It’s common – around one out of six people in the UK are affected by it.

The medical name for your jaw joint is the temporomandibular joint. It’s located in front of your ear on both sides of your head. The joint allows your jaw bone (mandible) to move from side to side, backwards and forwards, and allows you to open and close your mouth.

Your jaw joint is one of the most complicated joints in your body. It has several muscles and ligaments which allow different movements.

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An image showing the jaw joint

Details

  • Symptoms Symptoms of jaw joint dysfunction

    Your symptoms may include:

    • pain, most likely around your jaw joint, but may also be around your cheek, ear and neck
    • restricted movement and locking of your jaw
    • joint noise, such as popping, grating and clicking sounds, when you move your jaw
    • a headache
    • difficulty chewing
    • a change in the way your upper and lower teeth fit together

    Your symptoms may be worse when you’re chewing or if you’re feeling stressed.
    You may be able to manage these symptoms at home, without seeing your dentist. But if they get worse or don’t improve within a few days, see your dentist for advice.

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  • Diagnosis Diagnosis of jaw joint dysfunction

    Your dentist will ask about your symptoms and examine you. He or she may also ask you about your medical history.

    Because your jaw joint is complicated and there are many possible causes of jaw problems, it can be difficult to work out what is causing your symptoms. There’s no one test that can be used to diagnose jaw joint dysfunction.

    Your dentist may also examine your head, neck, face and jaw to see if there is any tenderness. You may be asked to move your jaw in all directions to make sure you can move it freely and find out if it’s painful or makes clicking noises when you move it.

  • Treatment Treatment of jaw joint dysfunction

    Jaw joint dysfunction can often be treated successfully and doesn’t lead to other problems. Your treatment will depend on the type of jaw joint dysfunction you have.

    Self-help

    Your dentist may advise you to do one or more of the following.

    • Eat soft foods so you don’t have to chew food for too long.
    • Stop wide yawning, singing, chewing gum and biting your nails.
    • Stop any habits, such as clenching your jaw or grinding your teeth.
    • Massage your affected muscles and apply a heat pad, such as a hot water bottle (filled with warm but not boiling water) wrapped in a cloth or towel.
    • Identify sources of stress and use relaxation techniques, such as massage.

    Medicines

    You may find over-the-counter painkillers, such as paracetamol or ibuprofen, can help to ease your pain. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    There are some other medicines your dentist might suggest if you’re in a lot of pain. See our FAQs for more information about medicines.

    Non-surgical treatment

    If your dentist thinks you’re clenching your jaw or grinding your teeth when you’re asleep, he or she may recommend wearing a bite guard. This is a cover made from plastic that fits over your upper or lower teeth and stops them coming into contact with each other. Evidence for how effective a bite guard is varies, but some people may find it helpful.

    These self-help measures will probably ease your discomfort and relieve your symptoms. Most jaw joint problems are only temporary and don’t get worse. However, if your symptoms last for longer than four to six weeks, your dentist may refer you to a specialist. This could be an oral surgeon or a specialist jaw joint dysfunction dentist.

    There are other treatments that may be helpful, such as physiotherapy. See our FAQs for more information.

    Surgery

    Surgery for jaw joint dysfunction is very rare and may be offered if other non-surgical treatments have been tried but haven’t worked. Surgery may involve opening your jaw joint and operating on the bones, cartilages and ligaments. It’s important to discuss the risks and benefits of surgery with your oral surgeon.

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  • Causes Causes of jaw joint dysfunction

    There are three main causes of jaw joint dysfunction.

    • Myofascial pain is the most common jaw joint dysfunction. It involves pain or discomfort in your muscles or the tissue (myofascia) that surrounds the muscles in your jaw joint.
    • Disc displacement happens when the articular disc (a thin disc within the joint) is in the wrong position, you have dislocated your jaw, or your jaw joint has been injured.
    • Osteoarthritis is a disorder of synovial joints. Rarely, it can affect your jaw joint, but is more common in the knees, hips and small joints of your hand.

    It’s possible that you may have more than one of these at the same time.

    Injuries can also trigger jaw joint dysfunction, such as a knock to your jaw, or overstretching when yawning, or during dental treatment.

    Clenching your jaw or grinding your teeth (bruxism) may cause jaw joint dysfunction. However, many people with jaw joint dysfunction don’t grind their teeth and many people that do grind their teeth, don’t have jaw joint dysfunction. The crucial thing is the symptoms, not the grinding of teeth.

    Joint noises, such as clicking, cracking or popping can happen if the articular disc has moved out of its normal position. The disc sometimes slips forward and as it returns to its normal position between the bones of your jaw joint, a noise is made.

  • FAQs FAQs

    Are there any medicines that I can take to help with my jaw joint problems?

    Answer

    Yes, medicines can be helpful for some people.

    Explanation

    Painkillers that you can buy over-the-counter, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help to relieve your pain. Always read the patient information leaflet that comes with your medicine, and if you have any questions, ask your pharmacist for advice.

    If you're in a lot of pain, your dentist may prescribe a muscle-relaxing medicine to help reduce the tightness and pain in your jaw. Medicines to help treat depression, known as antidepressants, may also be tried to help relieve pain. Your doctor will prescribe you a lower dose than what is usually given to treat depression. Antidepressants work by relaxing the muscles of your jaw joint.

    If your symptoms are severe, your dentist may prescribe a drug called diazepam, which relaxes your muscles and can also reduce anxiety. Your dentist will usually only prescribe this if you're in a lot of pain and you can only take it for a short amount of time.

    Can physiotherapy help to reduce the pain of jaw joint dysfunction?

    Answer

    There’s some evidence that suggests physiotherapy may help to improve the symptoms of jaw joint dysfunction for some people.

    Explanation

    Several types of physiotherapy may be helpful. A review of research found limited evidence that active exercises, manual therapies (such as massage and manipulation), some types of electrotherapy, postural correction and relaxation techniques may be beneficial. And that a combination of some of these treatments may be effective too. However, the authors say that more research may show more robust results.

    In particular, transcutaneous electric nerve stimulation (TENS) may be used to treat jaw joint dysfunction. This is a type of electrotherapy which involves using a device that stimulates the nerves with mild electrical pulses to relieve pain.

    You may have what are called spray and stretch exercises. This is where your dentist or physiotherapist sprays a cooling substance over your cheeks and temples, which allows him or her to stretch your jaw muscles.

    Acupuncture may also be useful in relieving jaw joint pain, though the research is limited. Experts say that more research needs to be done before clear recommendations about acupuncture can be made for jaw joint pain.

    You can find out more about the different types of physiotherapy in our factsheet. Talk to your dentist about whether physiotherapy treatments might be a suitable option for you.

    If I have jaw joint dysfunction, can it cause arthritis in my jaw?

    Answer

    Some forms of jaw joint dysfunction may lead to you getting arthritis in your jaw joints (temporomandibular joints).

    Explanation

    Arthritis is a condition that causes inflammation (swelling) of your joints. There are several different types of arthritis. The most common types are osteoarthritis and rheumatoid arthritis. Both osteoarthritis and rheumatoid arthritis can affect your jaw joint, as well as infectious and traumatic arthritis.

    If you have myofascial pain for a long period of time, it may cause secondary degenerative arthritis but this is uncommon. Secondary degenerative arthritis means your arthritis is a result of another condition. If you have arthritis in your jaw joint, you may have pain on one side of your jaw and have difficulty opening your mouth. Your symptoms may repeatedly get worse and then better.

    Your dentist may refer you for an X-ray to diagnose if you have arthritis in your jaw. Treatment is generally the same as jaw joint dysfunction treatment and may include one or more of the following.

    • Eating soft foods so you don’t have to chew food for too long.
    • Stopping wide yawning, singing, chewing gum and biting your nails.
    • Stopping any habits, such as clenching your jaw or grinding your teeth.
    • Massaging your affected muscles and applying a heat pad, such as a hot water bottle (filled with warm but not boiling water) wrapped in a cloth or towel.
    • Taking over-the-counter painkillers, such as paracetamol or ibuprofen.
    • Using a bite guard.

    Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

  • Resources Resources

    Further information

    Sources

    • TMJ disorders. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published October 2010
    • Simon C, Everitt H, van Dorp F. Oxford handbook of general practice. 3rd ed. Oxford: Oxford University Press, 2010: 520-5, 931
    • TMJ disorders. National Institute of Dental and Craniofacial Research. www.nidcr.nih.gov, published August 2013
    • Jaw joint problems. British Association of Oral and Maxillofacial Surgeons. www.baoms.org.uk, accessed 21 January 2014
    • Overview of temporomandibular disorders. The Merck Manuals. www.merckmanuals.com, published September 2013
    • Myofascial pain syndrome. The Merck Manuals. www.merckmanuals.com, published September 2013
    • Mitchell L, Mitchell DA. Oxford handbook of clinical dentistry. 5th edition. Oxford: Oxford University Press, 2013: 9, 393,446–9, 468–9
    • Arthritis of the temporomandibular joint. The Merck Manuals. www.merckmanuals.com, published September 2013
    • Analgesics. British National Formulary (online). www.medicinescomplete.com, London: BMJ group and Pharmaceutical Press, accessed 21 January 2014 (online version)
    • Skeletal muscle relaxants. British National Formulary (online). www.medicinescomplete.com, London: BMJ group and Pharmaceutical Press, accessed 21 January 2014 (online version)
    • Chronic facial pain. British National Formulary (online). www.medicinescomplete.com, London: BMJ group and Pharmaceutical Press, accessed 21 January 2014 (online version)
    • Medicott MS and Harris SR. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training and biofeedback in the management of temporomandibular disorder. Phys Ther 2006; 86:955–973. ptjournal.apta.org
    • Cho SH and Whang WW. Acupuncture for temporomandibular disorders: a systematic review. J Orofac Pain 2010; 24: 152–162 www.quintpub.com
    • Al-Ani MZ, Davies S, Gray R, et al. Stabilisation splint therapy for temporomandibular pain dysfunction syndrome. Cochrane Database of systematic Reviews 2004. Issue 1. doi: 10.1002/14651858.CD002778.pub2
    • Rehabilitative measures for treatment of pain and inflammation. The Merck Manuals. www.merckmanuals.com, published August 2013
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  • Author information Author information

    Reviewed by Natalie Heaton, Bupa Health Information Team, May 2014.

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