Temporomandibular Joint Disorder

Last updated: March 12th, 2018

Disorder/ Dysfunction of The Temporomandibular Joint

skullTemporomandibular joint disorder, or dysfunction, is a term used to describe pain and discomfort in the muscles that move the jaw. Temporomandibular joint disorder is known as TMJ, TMD or TMJD.

Temporomandibular joint disorder is characterized by pain and restriction in movement of the jaw or mandible. TMJ is not life-threatening but it can lower quality of life because the symptoms can become chronic and difficult to manage.

TMJ is a not attributed to a single condition or cause, it is a complex symptom. There is not universal agreement on the factors which cause TMJ.

TMJ could be caused by teeth grinding as a result of a sleep breathing disorder like sleep apnea. When someone struggles to breath at night, they may grind their teeth. People with sleep apnea sometimes report headache that is causes by teeth grinding related to TMJ.

Parts Of The Temporomandibular Joint

If you place your fingers just in front of your ears and open your mouth, the motion you feel is your TMJ. This is a small, ball-and-socket joint with three parts:

  1. The ball, called the "condyle"
  2. The socket, called the "glenoid fossa"
  3. The small disc that sits between the ball and socket

skeleton of jaw bones

Causes of Temporomandibular Joint Disorder

There are many potential causes of TMJ. Some of most common causes include:

  • Injury to the teeth or jaw
  • Misalignment of the teeth or jaw
  • Teeth grinding
  • Poor posture
  • Stress
  • Arthritis
  • Gum chewing

What Are Signs and Symptoms of Temporomandibular Joint Disorder?

  • Pain in the jaw joint
  • Jaw clicking and popping
  • Ear pain/ ear ache
  • Popping sounds in the ear
  • Headaches
  • Stiff or sore jaw muscles
  • Pain in the temple
  • Locking of the jaw

Temporomandibular Joint Disorder Stats

  • 20% to 30% of the adult population experience TMJ in their lifetime according to Cochrane Oral Health Group
  • In the 6 months before TMJ is experienced, 50-70% of people report experiencing stressful life events related to work, money, health or relationships, according to Oral and Maxillofacial Medicine: The Basis of Diagnosis and Treatment
    • The report also indicates m​​​​​​uscular hyperactivity has been shown in people while taking examinations or while watching horror movies
  • 75% of people with TMJ could be diagnosed with fibromyalgia (widespread muscle pain and tenderness)
    • 18% of people with fibromyalgia report having TMJ
  • Only 20% of people with TMJ need surgery according to the American Society of Maxillofacial Surgeons
  • TMJ mostly effects people in the 20-40 age group, the average is 33.9 years of age as cited here
  • About 75% of the general population may have at least one sign or TMJ such as clicking in the jaw
  • Females are more likely to have TMJ at about a 2 to 1 ratio according to the Essential dental handbook : clinical and practice management advice from the experts
  • Approximately 75% of people with TMJ have sleep breathing disorder

Treatment For Temporomandibular Joint Disorder

According to TMJ.org, TMJ can be difficult to manage because there is not a single cause and it may involve multiple health care professionals in both dentistry and neurology to treat the disorder. The general approach is to not permanently alter the jaw or treeth. Medication may be prescribed for pain.

  • Relaxation techniques
    • Treating TMJ could involve treatment of pain, mood disorder, anxiety or fatigue. Relaxation techniques may help reduce TMJ.
  • Teeth grinding mouthpieces
    • Mouthpieces, also called bite plates, grind guards or intra-oral appliances, are often used by dentists to treat TMJ. They can be designed to fit on the upper or lower teeth. The mouthpieces are usually worn during sleep and can confirm if someone grinds their teeth by looking at wear on the device.
  • Medication
    • The main way TMJ is treated is through pain killers.
    • It is possible to get medical marijuana perscribed in locations where it is legal for treatment of severe TMJ pain.
  • Surgery
    • This is reserved for the most severe cases
    • Botox injections
  • Jaw exercises
    • It is thought that exercises may relieve pain. See more detail on TMJ exercises.
  • Ice packs
  • Eating soft foods and avoiding gum chewing

Temporomandibular Joint Disorder and Snoring Treatment

It is generally not recommended to use a snoring mouthpiece, such as a mandibular advancement device, when someone has TMJ. Using such a device can cause pain and discomfort because mouthpieces designed for snoring often move the jaw. Mouthpieces often lock the jaw in a certain position and this can cause discomfort.

A way to treat snoring for someone with TMJ is often to use a tongue stabilizing device instead of a mandibular advancement device. One such example of a tongue device is the Good Morning Snore Solution. Tongue displacement does not usually cause jaw pain because it does not alter the position of the jaw.

Temporomandibular Joint Disorder and Sleep Apnea

Dental and sleep researchers have found a that a disorder of the TMJ can contribute to sleep problems like sleep apnea. Obstructive sleep apnea (OSA) is related to chronic pain disorders which can include TMJ disorders.

A common symptom of OSA is headaches and these headaches may be caused by jaw disorder. According to the Journal of Dental Research, participants in a study who had OSA symptoms had a 73% higher rate of TMJ symptoms.

Temporomandibular Joint Disorder Recap

Temporomandibular joint disorder is experienced by over a quarter of the adult population with many causes from stress to injury. Snoring is experienced by almost half of the adult population and there is overlap with those who have TMJ and those who snore.

If you have TMJ and snore, you could try a mandibular advancement device. It may prove to be uncomfortable, this is why many snoring mouthpiece companies do not advise use of their product when someone has TMJ.

If you experience discomfort using a mouthpiece for snoring which rests on your teeth, you should strongly consider discontinuing using it and instead try a tongue stabilizing device. A tongue device will not alter the position of the jaw and is more likely to be comfortable over time.

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