TMJ Disorder

What is TMJ Disorder?

The TMJ or the temporomandibular joint connects the jawbone to the skull. There is one on either side of the jaw.The TMJ allows for the smooth movement of the jaw in the vertical or up and down direction and also the horizontal or side-to-side direction, allowing for actions like talking, chewing and yawning. TMJ usually has sliding motions that are mingled with a hinge action. The bones that combine in this joint are laced with cartilage and are separated by a small disk that can absorb shock.


TMJ Disorders consists of the different problems that arise at the TMJ, which can in turn affect the jaws and the muscles controlling them. Some of the causes are:

  • Eroding of the disk and its misaligning from its proper position.
  • Damage of the cartilage due to arthritis
  • Damage of the bone by trauma, even an injury from neck strain or stress.
  • Excessive teeth clenching or grinding can exert huge pressure on TMJ.
  • Genetics has also been a cause in some cases. Some patients seem to inherit the vulnerability to TMJ disorders.


A TMJ disorder patient might suffer from the following symptoms:

  • The jaw might experience pain and tenderness.
  • There might be pain in either one or both of the joints.
  • The area around the ear might also experience an aching pain.
  • Chewing food would be painful.
  • Patient’s face might have pain.
  • Patient might have difficulty in opening or closing the mouth due to locking of the jaw.
  • Some patients have heard a clicking sound or felt a grating sensation while opening the mouth.
  • A mild swelling on the face.

Some patients have also reported headaches, dizziness, pain in the teeth, tinnitus and upper shoulder pain. 


The doctor will do a physical evaluation of the patient, based on the symptoms. Some physical examinations performed by the doctor are:

Listening for any clicking or grating sounds while opening and closing the mouth. 

  • Monitor the jaw’s range of motion.
  • Inspect the face joints for any tenderness or pain.
  • Examine the patient’s bite for any problems with the facial muscles.

The following tests are also performed to confirm diagnosis:

  • X-rays to get a clear image of the jawbones and teeth to eliminate the possibility of fractures.
  • Magnetic Resonance Imaging (MRI) will display the TMJ disk during the movement of the jaw; in turn help in checking for any misalignment issues.
  • Computer Tomography (CT) scan is performed to get the detail of the bones in the joint.


There are three types of treatments that are available for TMJ disorders:


The dentist or the doctor might recommend any of the following medications to relive the pain in the joints.

  • Pain relievers and Anti-inflammatories
  • Tricyclic Antidepressants
  • Muscle Relaxants


Some dentists or doctors might recommend the following therapies:

  • Insertion of oral splints or mouth guards over the teeth has proved beneficial in relieving pain.
  • Physical Therapies that include ultrasounds, relaxation techniques, usage of heat or ice packs.
  • Home Treatment therapies that include eating of soft foods, avoiding acute jaw movements and also avoiding resting of the chin on the hand.
  • Dental Therapies that include replacement of missing teeth, using of crowns, bridges and braces for correcting bite issues and balancing teeth biting surfaces.


Doctors might recommend surgeries if other treatments are not effective or depending on the issue. The types of surgeries performed for a TMJ disorder are:

Arthrocentesis: This is a minor surgery performed when the patient’s jaws are locked. In this procedure, the dentist will administer general anesthesia and use needles to wash out the joint and also use specialized instruments to perform the following:

  • Remove damaged tissue
  • Disentangle the disk that is stuck in the joint
  • Unlock the joint

Arthroscopy: This is performed using a tiny camera attached to a thin tube that is inserted through a tiny incision near the ear. This camera is used to view the injured area and help confirm the diagnosis. Tiny surgical instruments are then inserted through this incision and guided to the injured area using the camera. Then the damaged tissue is removed or the disk or joint is then realigned.

Authored By Dr Sanjay N - Orthodontics & Dentofacial Orthopaedics, Bangalore

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