TMJ dysfunction

Temporomandibular joint (TMJ) dysfunction is when you feel pain in your jaw joint and the muscles that surround it. There are lots of possible causes, like an injury, grinding your teeth, or arthritis. TMJ dysfunction usually gets better on its own with some self-help measures, but sometimes needs treatment.

What causes TMJ dysfunction?

It’s not always possible to know the exact reason for temporomandibular joint (TMJ) dysfunction. But there are lots of things that could be the cause. You might have more than one cause at the same time too. These could include:

• an injury to your jaw
• grinding or clenching your teeth (bruxism)
• arthritis in the joint
• having a long-term health condition, like fibromyalgia or irritable bowel syndrome (IBS)
• the small disc inside your jaw joint moving out of place (disc displacement or dislocation)
• misaligned teeth
• too much stress, which can make you clench your jaw or grind your teeth
• poor posture, which can put a strain on your neck and facial muscles

Symptoms of TMJ dysfunction

If you have temporomandibular joint (TMJ) dysfunction, you might notice:

• pain around your jaw, face, ear, neck, or shoulders
• difficulty opening your mouth wide
• trouble moving your jaw
• your jaw gets stuck when you try to move it (known as lock jaw)
• clicking or popping sounds, or a grating sensation, when you move your jaw
• a change in the way your teeth fit together, known as your ‘bite’
• headaches, especially around your temples
• earache or tinnitus (ringing in your ears)
• dizziness
• trouble sleeping

If you have pain, you might find it gets worse when you’re chewing, talking, or feeling stressed.

Self-help for TMJ dysfunction

The symptoms of temporomandibular joint (TMJ) dysfunction often get better within a few months without treatment. Until then, there are lots of things you can do at home to help relieve your symptoms.

• Take over-the-counter painkillers like paracetamol or ibuprofen. This can be in the form of a tablet or anti-inflammatory gel that you rub over your jaw.
• Place an ice or heat pack, wrapped in a tea towel, over your jaw.
• Eat soft foods like pasta, smoothies, and soups.
• Take small bites of food and chew slowly, which is easier for your jaw muscles.
• Avoid chewing gum or biting your nails.
• Try to rest your jaw muscles by not talking too much.
• Try not to yawn widely.
• Massage the muscles around your face and jaw for one minute, four times a day.
• If you clench or grind your teeth, try to consciously release the tension.
• Practise relaxation techniques like deep breathing, or talk to your GP for support with stress.

Diagnosis of TMJ dysfunction

If the pain or discomfort in your jaw doesn’t get better after a few months of treating it yourself at home, or your symptoms are very bad, make an appointment to see a dentist. They can investigate what’s causing your symptoms and recommend treatment if you need it.

Your dentist will ask you some questions about your lifestyle, medical history, your symptoms, if anything triggers them, or makes them worse. They’ll also ask whether or not you grind your teeth or bite your nails.

Then, your dentist will examine your head, neck, face, and jaw to see if you have any tenderness, and may ask you to move your jaw in all directions. This can help them to see how well you can move your jaw, and whether it’s painful or makes clicking noises when you move it. They’ll also ask to look inside your mouth to check if you have any problems with your teeth or gums.

If your dentist isn’t sure what’s causing your symptoms, or they think it’s down to an underlying health condition like arthritis, they might refer you to a specialist for some more tests, which could include:

• a CT scan
• an X-ray
• an MRI scan

How to treat TMJ dysfunction

If self-help measures aren’t working, and you do need treatment, the type you’ll need will depend on how bad your symptoms are and what’s causing them. Temporomandibular joint dysfunction treatments might include the following.

Mouth guards

If your dentist suspects the pain in your jaw is a result of clenching your jaw or grinding your teeth when you sleep, they may suggest you wear a mouth guard  at night. This is a plastic cover that fits over your upper or lower teeth and stops them coming into contact with each other. It’s best to get this made by your dentist, so it fits perfectly over your teeth.

Physiotherapy

Sometimes, a physiotherapist might be able to help ease the pain in your jaw. They can teach you exercises to stretch the muscles in your jaw, and show you how to correct your posture to relieve tension in your neck. They might also massage the area for you, to ease the pain and get some movement back into your jaw joint.

Cognitive behavioural therapy (CBT)

If stress, anxiety or chronic pain is making you clench your jaw or grind your teeth, your doctor might suggest CBT. This is a type of talking therapy that helps you to change negative thought patterns and behaviours that might be contributing to your symptoms. It teaches you new skills designed to help you manage stress and cope with pain.

Medicines

If over-the-counter painkillers like paracetamol and ibuprofen aren’t working, your doctor or dentist might prescribe some stronger painkillers. These could include a short course of muscle relaxers to ease the tension in your jaw. Or a small dose of antidepressants, which can change the way your body responds to pain.

Painkilling injections

Sometimes, your doctor might suggest having an injection into your jaw to help ease your pain. This could be a corticosteroid injection, which is a strong type of anti-inflammatory medicine. Or they might suggest a botulinum A toxin (Botox) injection, which weakens the muscles around your jaw to relax them.

Oral surgery

If other treatments for TMJ dysfunction haven’t worked, or your condition is causing you severe problems, your doctor might refer you to a specialist to discuss oral surgery. But this only happens in a small number of cases. Depending on what’s causing your symptoms, your surgeon might suggest surgery to remove fluid from your jaw joint, repair, or reposition it. Or they might recommend replacing your jaw joint completely with an artificial one.