Have you been experiencing jaw-related pain or having problems closing or opening your mouth? These difficulties in your jawbone function may indicate that you have a temporomandibular joint disorder (TMD), also called temporomandibular joint (TMJ) syndrome. This condition might seem minor at first, but it is so critical that if you have it, your condition could worsen if you don’t seek a dental professional’s help as soon as possible.
At Washington Dental, we are proud to extend our expertise to patients seeking TMD/ TMJ treatment in Los Angeles, Carson, Torrance, and Lomita, California. All our personalized dental treatment plans encompass our all-inclusive approach, offering minimally invasive but effective methodology. We are here to offer you the necessary support to alleviate your temporomandibular joint condition and achieve long-lasting relief.
The temporomandibular joint (TMJ) is the joint connecting the jawbone to the skull. It enables you to move the jawbone sideways and down or up, making it possible to chew, yawn, and talk. If this joint suffers an injury or is damaged, it could cause a pain disorder known as temporomandibular disorder (TMD) or TMJ syndrome.
TMD/TMJ Syndrome Causes
It is not clear what causes TMJ/TMD. Dental professionals believe symptoms are a result of various problems with your jawbone muscles or the TMJ parts. Injury to the TMJ, jawbone, or neck and head muscles—from whiplash or heavy blow, for instance— can cause TMD/TMJ syndrome.
Another common TMD cause is the outcome of the relation of your bite or teeth. If your bite isn’t right, it may lead to problems with your temporomandibular joint and muscles. This is how it happens— when your lower and upper teeth meet in a manner providing stable bracing of the jawbone against your skull, the whole temporomandibular system remains stable. But if the lower and upper teeth come together in a way that doesn’t enable the lower jawbone to rest or brace into the TMJ joint in a proper position, it can result in numerous problems and symptoms. The most prevalent reason your teeth may fail to meet properly is if they are misaligned, or you have missing teeth or a bite that has changed or shifted due to tooth wear from uneven force/contacts or grinding.
TMJ disc displacement can cause an unstable bite, leading to your muscles working a lot harder than they’re designed to function. If your chewing muscles are overworked, they accumulate lactic acid then become painful and stiff. Your teeth meet every time you swallow, and an average adult swallows between 600 and 1000 times in a day. If you don’t have a proper bite, it develops a vicious cycle of worsening muscle spasms, and the constant contraction may lead to tissue damage, pain, tenderness. This leads to tenseness, stress, and making you feel miserable, which could, in turn, lead to TMD or TMJ syndrome.
Other causes are:
- Teeth clenching or grinding, which exposes the joint to so much pressure
- Gum chewing
- Stress, which could make you clench your teeth or tighten your jaw and facial muscles
- Arthritis to the TMJ
- Injury to your teeth
- Jaw misalignment
- Poor posture
- Movement of the disc or soft cushion between the TMJ socket and ball
The primary symptom of TMD/TMJ syndrome is discomfort and severe pain around the jawbone joint. The TMJ is found just before your ear. Therefore, TMD-related pain may affect the forehead, ear, eye, neck, and both or one side of the face. The discomfort and pain could be short- or long-lasting. More women experience it than men, and it is most prevalent among persons between twenty and forty years.
Common TMD/TMJ syndrome signs and symptoms include:
- Tenderness or pain in the jawbone, particularly at the joint area, face, shoulders, and neck, and around or in the ear whenever you open your mouth wide, speak, or chew.
- Crepitus (clicking, grating, or popping of the jawbone joint) whenever you chew or close/open your mouth. This might or might not be painful.
- Earache (ear pain) or cracking sounds in your ears.
- Toothache-like pain.
- Tinnitus (popping or ringing sounds in your ears).
- Blurred vision.
- Muscle spasms in your jawbone.
- Headaches that include migraines and neck aches.
- Sore, stiff, or tight neck or jaw muscles.
- Pain underneath the tongue.
- Mouth, facial, jaw, or cheek pain, and chin tingling or numbness.
- Difficulty chewing or an unexpected, uncomfortable bite— as though your lower and upper teeth aren’t fitting together correctly.
- A lump, swelling, or pain in the temple area.
- Vertigo or dizziness.
- Upper shoulder pain.
- Swelling on your face (on the sides).
- Dislocation or locking of the jawbone (usually after yawning widely), known as lockjaw.
- A tired feeling on your face.
- Difficulty opening your mouth wide.
- Hearing problems.
TMD signs and symptoms are this diverse because the large trigeminal nerve innervates the entire head and face. The trigeminal nerve is the fifth paired cranial nerve and the largest facial nerve. It is also motor and sensory. This nerve has three branches on the sides of your head— the maxillary, ophthalmic, and mandibular nerve.
- The maxillary nerve— This nerve covers the cheeks, lower nose, part of your temples, and upper jaw
- The mandibular nerve— Covers part of your temples, part of your ears, and the lower jawbone.
- The ophthalmic nerve— Covers the eyes, upper nose, the crown of your head, and the forehead.
Each of these branches has sub-branches that enable movement and convey sensory data to the brain. When the jawbone muscles are inflamed, swelling exerts pressure on either one or several parts of any of these nerves, resulting in pain in that area. Compression of one part of a nerve can impact other places served by that nerve— you might experience pain in several locations.
When to See a Dentist
Seek medical attention if you’re experiencing persistent tenderness or pain in your jawbone or if you cannot close or open your jaw completely. Your dentist or TMJ specialist can discuss possible causes and treatment for your problem.
Preparing for Your TMD Appointment
You will probably first discuss your TMD symptoms with your family dentist. If the recommended treatment options do not provide you with enough relief, the dentist may refer you to a TMD expert. You might want to make a list that will answer these questions:
- When did you start experiencing symptoms?
- Have you ever had the symptoms before?
- Has your stress level increased recently?
- Do you experience frequent neck aches, toothaches, or headaches?
- What supplements and medications do you use regularly?
What to Expect from Your Dentist
Your dentist might want to know the following:
- Whether the pain is constant or the symptoms appear and disappear
- Whether there is any activity that triggers the pain
- Whether your jaw pops or clicks whenever you try moving it, and if the clicking is painful
- Whether it is difficult to open your mouth normally
The dentist will ask more questions depending on your answers, needs, and symptoms. Anticipating and preparing questions helps you make the most out of your time.
TMD/TMJ Syndrome Diagnosis
Several other conditions have similar signs and symptoms to TMJ syndrome, for instance, trigeminal neuralgia. The trigeminal nerve innervates the TMJ, and when it’s irritating, it may lead to facial-related pain. Other conditions with similar signs and symptoms are sinus problems, tooth decay, gum disease, arthritis, salivary gland disease, giant cell arteritis, swollen lymph nodes, ill-fitting dentures, and sore throat.
For a dentist to diagnose TMD/TMJ syndrome, he/she takes your medical history and performs a physical examination to determine what is causing the symptoms. There’s no precise test used to diagnose TMJ syndrome. The dentist will check your jawbone joints for tenderness or pain, then listen for a grating, popping, or clicking sound when you try moving them. He/she will also ensure your jawbone functions as it should be and does not lock whenever you close or open your mouth. Additionally, the dentist will test the correctness of your bite then check if there are any problems with the facial muscles.
At times the dentist may order that you undergo face x-ray scans so he/she can view the temporomandibular joints, teeth, and jaws to rule out other medical issues. He/she may also need you to undergo additional tests like a CT scan or a full MRI scan. The CT scan will show the bony details of the TMJ, while the MRI scan will show whether the temporomandibular joint disc is correctly positioned as the jaw moves.
Your dentist might refer you to an oral and maxillofacial surgeon (also known as an oral surgeon) to confirm the diagnosis and more treatment and care. An oral surgeon’s specialty is surgery around and in the entire jaw area, mouth, and face. The dentist could also refer you to an otolaryngologist (also known as an ENT specialist or ear nose and throat specialist) or orthodontist to check if your muscles, teeth, joints, ears, throat, and nose are functioning correctly.
TMD/TMJ Syndrome Home Remedies
Most TMD symptoms disappear with the use of home remedies and relaxation and stress reduction techniques. Your dentist may recommend that you try these remedies:
- Taking over-the-counter medicine— NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen or naproxen and pain relievers such as acetaminophen and aspirin can relieve swelling and muscle pain.
- Feeding on soft foods— Include mashed potatoes, yogurt, soup, cottage cheese, fish, scrambled eggs, cooked vegetables and fruits, grains, and beans in your menu. Make sure to cut your foods into tiny pieces to enable you to chew less. Avoid hard and crunchy foods such as raw carrots and pretzels, chewy foods such as taffy and caramels, and large or thick bites that will mandate opening your mouth wide.
- Using cold/ice packs or moist heat— Apply a cold pack over the temple area and side of the face for about ten minutes. Perform a few jaw stretches (in case your physical therapist or dentist approves them). When you are through, hold a warm washcloth or towel over the side of the face for approximately five minutes. Do this a few times every day.
- Avoiding extreme jaw movement— Minimize chewing (especially ice or gum) and yawning and do not sing, yell, or do things that will mandate opening your mouth wide.
- Not resting your chin onto your hand— Do not hold your phone in-between your ear and shoulder. Practice appropriate posture to minimize facial and neck pain.
- Gently self-stretching or massaging the neck and jaw muscles. Your physical therapist or dentist may suggest appropriate stretches.
- Carrying out various relaxation techniques. They will help loosen the jaw. Inquire from your dentist whether you need a massage or physical therapy. Consider undergoing stress reduction therapy and biofeedback.
- Keeping your teeth somewhat apart as often as possible. This relieves pressure on the jawbone. Place your tongue in-between the teeth so you can control grinding or clenching during the daytime.
- Some soothing essential oils (for instance, chamomile, lavender, clary sage, and sweet marjoram) may temporarily relieve you from the discomfort and pain of TMJ syndrome/TMD.
Treatments for TMJ Syndrome/TMD
Where home remedies aren’t helpful, medical treatment might be necessary. There are several medical treatment options, most of which won’t cure TMD/TMJ syndrome but provides temporary and sometimes long-lasting relief from TMD-related symptoms. Common treatment options for TMD or TMJ syndrome include:
Option 1: Medications
Your dental specialist can prescribe you higher NSAIDs doses in case you require them for swelling and pain. He/she may also recommend a muscle relaxant that will help you relax your jaws if you clench or grind your teeth. Alternatively, he/she may prescribe anti-anxiety medications that will help you relieve stress that might cause TMD. In lower doses, anti-anxiety medicines and muscle relaxants can also assist in controlling or reducing pain. Antidepressants, anti-anxiety medications, muscle relaxants, and anti-inflammatory drugs are available only by prescription.
Option 2: Therapies
Non-drug therapies for TMDs include:
- A night guard or dental splint— These are plastic mouthpieces. They fit over the lower and upper teeth so that they do not touch. They work by lessening the effect of grinding and clenching. They also correct your bite by placing your teeth in a correct position. A night guard differs from a dental splint. You put on night guards when you want to sleep, while a splint is used at all times. Your dental specialist will let you know which of these two you need.
- Physiotherapy with jawbone exercises can improve flexibility and range of motion and strengthen muscles.
- Bio-behavioral management (cognitive-behavioral therapy [CBT] and biofeedback) may help reduce pain intensity.
- TENS (Transcutaneous electrical nerve stimulation)— This kind of therapy utilizes low-level electric currents to relieve pain by relaxing facial and jaw joint muscles. It may also be performed at home or the dental clinic.
Option 3: Other Treatments
In case the above treatment options do not help, your dental specialist may recommend one or several of these options:
- Your dentist might use Botox injection to relax jaw muscles. However, this treatment is currently not FDA-approved for TMJ syndrome.
- Ultrasound— deep heat applied to the joint may improve mobility or relieve soreness.
- Trigger point acupuncture may at times be helpful
- In states that legalize medical marijuana, your dentist might prescribe it as it helps relieve severe TMD pain
- Dental work— your dental professional may replace the missing teeth and then use braces, bridges, or crowns to balance your teeth biting surfaces or correct any bite problem.
- Trigger-point injection— anesthesia or pain medication is injected into the tender face muscles (known as trigger paint) to alleviate pain.
Option 4: Surgical Procedures
In most severe cases where other methods do not help, your dentist may recommend dental surgery or surgery of the jawbone. We have three primary surgical procedures for TMD/TMJ syndrome. The procedure you should undergo is based on the issue you have. They include:
- Arthroscopy – This surgical procedure is conducted using an arthroscope. The arthroscope has a light and a lens on it that enables your dentist to view inside the joint. The dentist will administer general anesthesia and then make an incision in front of your ear then insert the equipment. The equipment will be attached to a video monitor so the dentist can examine the joint and area surrounding it. He/she may realign the joint or disc or extract inflamed tissue. This kind of surgery is minimally invasive. It leaves a tiny scar, its recovery period is shorter, and it has fewer complications than a major procedure.
- Arthrocentesis— This procedure is done if you don’t have a major TMJ syndrome history, but your jawbones are locked. It is a minor process that the dentist can carry out in his/her office. He/she will administer general anesthesia, then insert needles into the joint and wash it out. He/she might use special equipment to dislodge a disc, extract damaged tissue stuck in the joint, or unstick the joint itself. It takes about one week to recover after undergoing this procedure.
Open-joint surgical procedure— Based on what is causing your TMD, arthroscopy or arthrocentesis might not be an option. Your dentist may recommend you undergo this kind of surgical procedure if:
- Your TMJ is full of bone chips or scarred.
- You have developed tumors around or in the joint
- The bony structure in the jaw joint is wearing off
You will receive general anesthesia. The dentist will then open up the whole area surrounding the TMJ so he/she can obtain better access and full view. You will need a more extended period to recover after this surgery, and there’s a higher chance of nerve injury and scarring.
If TMD is left untreated, the pain can worsen, resulting in excruciating levels requiring urgent medical intervention. Patients with untreated TMD may also experience debilitating jaw or neck pain, malnutrition, depression, or even develop eating disorders because of the pain.
Who Treats TMD?
A primary caregiver, such as an internist, child’s pediatrician, or family practitioner, can first diagnose your TMD. Your health care provider might refer you to an otolaryngologist, a prosthodontist (prosthetic dentist), or an oral and maxillofacial specialist for more treatment. You might also visit a pain management specialist in case your TMD-related pain is severe.
TMD/TMJ Syndrome Prognosis
Generally, the TMD prognosis is good. TMD causes are several; thus, the outlook is based on what caused yours. Most people manage the pain and discomfort with home remedies and self-care. Long-term TMD complications include chronic headaches or chronic facial pain. In severe cases associated with various inflammatory disorders or where the pain is chronic, long-term treatment might be necessary.
TMD/TMJ Syndrome Risk Factors
Various factors that can elevate the risk of having TMD include:
- Poor posture in the upper back muscles and neck may result in abnormalities of jawbone muscle function and strain
- Women aged between 18 and 44 years are at a higher risk of developing this disorder
- Stress can increase jaw clenching and muscle tension
- Patients with poorly positioned teeth or jaw trauma are at a higher risk
- Patients with any other chronic inflammatory arthritis, such as osteoarthritis and rheumatoid arthritis, are also at increased risk
- People with increased stress responses and a genetic predisposition to pain sensitivity may be more susceptible
- Jaw injury
- Certain diseases of the connective tissue, which cause problems that might affect the TMJ
- Chronic clenching or grinding of teeth
TMD symptoms tend to be episodic and related to lifestyle and stress. Preventing these symptoms can usually be achieved through using self-care at home, including:
- Maintaining appropriate posture
- Feeding on soft foods
- Avoiding chewing of gum
- Practicing relaxation and stress reduction techniques
- Using proper safety tools to prevent jaw dislocations and fractures while taking part in sports, working, or exercising
- Wearing dental splints as your jawbone care professional would recommend
Schedule a TMD/TMJ Syndrome Appointment Near Me
At Washington Dental, we are devoted to empowering our patients with info about their dental health and providing exceptional services. Should you have any questions regarding our TMD/TMJ syndrome treatment or wish to set an appointment, please contact us right away. Our expert dentists offer comprehensive treatments that promote overall wellness for patients seeking dental services in Los Angeles, Carson, Torrance, and Lomita, CA.