WHAT IS THE TEMOROMANDIBULAR JOINT (TMJ)

The temporomandibular joint (TMJ) is a small joint located in front of the ear where the skull and lower jaw meet, which allows the lower jaw (mandible) to move and function.

TMJ disorders have a variety of symptoms. Patients may complain of earaches, headaches and limited ability to open the mouth. They may also complain of clicking or grating sounds in the joint and feel pain when opening and closing the mouth. What must be determined, of course, is the cause.

WHAT CAUSES TMJ DISORDERS?

Arthritis is one cause of TMJ symptoms. It can result from an injury or from grinding of the teeth at night. Another common cause involves displacement or dislocation of the disc that is located between the jawbone and the socket. A displaced disc may produce clicking or popping sounds, limit jaw movement, and cause pain during opening and closing of the mouth. There are also conditions such as trauma or rheumatoid arthritis that can cause the parts of the TMJ to fuse, preventing jaw movement altogether.

SOMETIMES THE JOINT ITSELF IS THE PROBLEM

Stress may trigger pain in the jaw muscles that is very similar to that caused by TMJ problems. Such patients frequently clench or grind their teeth at night causing painful spasms in the muscles and difficulty in jaw movement. Patients may also have a combination of muscle and joint problems. That is why diagnosing TMJ disorders can be complex and may require different diagnostic procedures.

Determining the cause of a TMJ problem is important, because it is the cause that guides the treatment.

THE ROLE OF THE ORAL AND MAXILLOFACIAL SURGEON

When symptoms of TMJ trouble appear, an Oral and Maxillofacial Surgeon should be consulted. A specialist in the areas of the mouth, teeth and jaws, the Oral and Maxillofacial Surgeon is in a good position to correctly diagnose the problem. Special imaging studies of the joints may be ordered and appropriate referral to other dental or medical specialists or a physical therapist may be made.

RANGE OF POSSIBLE TREATMENT

The Oral and Maxillofacial Surgeon’s treatment may range from conservative dental and medical care to complex surgery. Depending on the diagnosis, treatment may include short-term medications for pain and muscle relaxation, bite plate or splint therapy, and even stress management counseling.

Generally, if non-surgical treatment is unsuccessful or if there is clear joint damage, surgery may be indicated. Surgery can involve either arthroscopy (the method identical to the orthopedic procedures used to inspect and treat larger joints such as the knee) or repair of damaged tissue by a direct surgical approach.

Once TMJ disorders are correctly diagnosed, appropriate treatment can be provided.
Portions of the above information provided as a courtesy by:

American Association of Oral and Maxillofacial Surgeons
9700 W. Bryn Mawr Avenue
Rosemont, Illinois 60018-5701
847/678-6200 Fax: 847/678-6286
Website: www.aaoms.org