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Relief for jaw pain: TMJ symptoms and treatment

By Jenilee Matz, M.P.H., Staff Writer, myOptumHealth

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Thirty-five million Americans are bothered by the discomfort of temporomandibular joint and muscle disorders(TMJDs),also called "TMJ." This group of poorly understood conditions causes pain and limited movement of the jaw. The good news is that self-care can often bring relief.

What is the temporomandibular joint?

The temporomandibular joint connects the lower jaw bone to the skull. There is one TMJ in front of each ear. They allow your jaw to move in all directions so you can chew, swallow, talk and make facial expressions.

Who gets TMJ?

Anyone can get TMJ but it is more common in women than in men. The reason for this is unknown.

Symptoms

The most common symptom of TMJ is a dull, achy pain in the jaw, ear or face. Some people have no pain, but still have trouble with jaw movement.

Other TMJ symptoms may include:

• Headache
• Discomfort when biting down or chewing
• Locking of jaw or a stiff jaw
• Painful clicking or popping sound in the jaw
• A change in the way upper and lower teeth fit together or a bite that feels "off"

Clicking or popping of the jaw without pain or decreased movement is common and is not a sign of TMJ.

Possible causes

The cause of TMJ is unknown. Some possible risk factors may include:

• Injury to the jaw area
• Disease, such as osteoarthritis
• Genetics
• Hormone changes
• Clenching your jaw

Research is mixed whether teeth grinding (bruxism) or stress may contribute to TMJ. While these used to be common suspects, experts now find that people with TMJ may be less likely to grind their teeth because it causes pain. And, it's not clear whether stress is the cause or result of chronic pain. The National Institute of Dental and Craniofacial Research (NIDCR) does ongoing research on the cause of and treatment for TMJ.

Diagnosing TMJ

There is no test to diagnose TMJ. If you have symptoms, your doctor will examine you and may perform tests to rule out other conditions, such as ear and sinus infections. If those possibilities are eliminated, your doctor may diagnose you with TMJ. Your dentist may also help make the diagnosis.

Treatment options

Fortunately, TMJ pain is usually short-lived and gets better with home treatment. Sometimes medications or other treatments are needed to relieve symptoms.

Home treatments

The goal of home treatments is to ease pain. Try these treatments first if you have been diagnosed with TMJ:

• Rest the jaw. Eat soft foods. Avoid extreme jaw movements, like yawning or loud singing. Don't chew gum.
• Apply ice or a warm compress to the jaw area for 15 minutes, three times a day.
• Practice relaxation techniques to reduce stress.

Noninvasive treatments

Call your doctor if home treatments don't ease discomfort, or if pain is severe or persists. Your doctor will likely suggest some other treatment options with the goal of relieving pain. These may include:

• Over-the-counter pain or anti-inflammatory medications
• Prescription muscle spasm medicine
• Jaw stretching and relaxation exercises
• Stabilization splint or bite guard

Invasive treatments

If you still have severe pain, you may be referred to a doctor who specializes in musculoskeletal disorders (muscle, bones and joints) and treating pain conditions.

NIDCR advises against treatments that permanently change your jaw or bite, including any surgical treatments for TMJ. There is no evidence that these treatments work. And no studies have looked at the long-term safety and effectiveness of these procedures. They may even make the problem worse. Avoid the following treatments:

• Orthotics (repositioning splints) that change your bite
• Grinding down teeth to adjust the bite (occlusal adjustment)
• Crown and bridge work to balance the bite
• Orthodontic procedures

Surgery and replacement of jaw joints with implants should also be avoided if at all possible.

View the original Relief for jaw pain: TMJ symptoms and treatment article on myOptumHealth.com 

SOURCES:

• The National Institute of Dental and Craniofacial Research. Less is often best in treating TMJ disorders. Accessed: 10/07/2009

• National Institute of Dental and Craniofacial Research. TMJ disorders. Accessed: 10/07/2009

• Bontempo LJ. Maxillofacial disorders. In: Adams JG, Barton ED, Collings J, DeBlieux PMC, Gisondi MA, Nadel ES, eds. Emergency Medicine. 1st edition. Philadelphia, PA: Saunders Elsevier; 2008. Accessed: 10/07/2009