The temporomandibular joints (TMJ) play a critical role in functions such as opening and closing the jaw, speaking, chewing, and swallowing. But like other body parts, the TMJ can suffer from a medical condition that can inhibit it from working correctly.
What is the Temporomandibular Joint (TMJ)?
The temporomandibular joints connect the lower jaw to the skull. There are two TMJs, one located on each side of the lower jaw. Each temporomandibular joint consists of three (3) parts: Mandibular condyle Glenoid fossa Meniscus The mandibular condyle is found in the lower jaw, while the glenoid fossa is located at the skull base. The meniscus is a small piece of cartilage shaped like a disc. It acts as a cushion between the mandibular condyle and the glenoid fossa. The meniscus is the part of the TMJ that allows the jaw to widely open, move up and down, forward and back, and side to side. Together, all three (3) parts of the TMJ function like a sliding hinge.
Temporomandibular Disorders (TMD)
Temporomandibular disorders (TMD) are medical conditions that affect jaw muscles, temporomandibular joints, and any nerve-related to chronic facial pain. TMDs fall into three (3) main categories:
Myofascial pain: This pain in the fascia – the connective tissue is covering the muscles – and the forces that control jaw movement. Myofascial pain is the most common type of TMD.
Internal joint derangement: This is classified in one (1) of three (3) ways: A dislocated jaw; The displacement of the cartilage disc is found between the jaw and the skull; An injured condyle bone, also known as the rounded end of the jaw bone.
Degenerative joint disease: The jaw joint develops osteoarthritis or rheumatoid arthritis.
Therefore, patients can suffer from more than one TMD at the same time.
What Causes TMJ?
Numerous issues cause TMJ. One known cause is bruxism or grinding or clenching teeth habitually. That causes a strain on the jaw joints and muscles responsible for chewing, speaking, and swallowing.
Significant trauma to the jaw, head, or neck is another possible cause. At the same time, arthritis can damage the joint’s cartilage resulting in TMJ. Another reason is when the meniscus erodes or falls out of alignment with the jaw.
Temporomandibular Joint Dysfunction (TMD) Symptoms
The following list includes many of the most common temporomandibular joint dysfunction symptoms:
- Jaw pain or discomfort
- Earaches or ringing in the ears
- Jaw locking
- Difficulty chewing
- Grinding or clenching your teeth
- Pain in the following spots – face, behind the eyes, shoulders, neck, or back
- Tooth sensitivity is not related to a different mouth health issue
- Upper and lower teeth don’t fit together properly
- Clicking or popping sound by the jaw
- Numbness in the fingers
Consult a dentist if you have any of these TMJ symptoms, as some of them can indicate other medical issues. Seek medical consultation if you have chronic jaw pain or you are unable to close your jaw completely. You’ll need a proper diagnosis by a doctor, dentist, or TMJ specialist to be sure you’re suffering from a TMD.
How Do I Treat TMJ?
There are multiple TMJ treatment avenues to pursue. Some are non-surgical, while others involve a certain level of surgery. Jaw surgery should be a last resort, so patients should try the non-surgical methods first.
Non-surgical methods are considered to be conservative treatments. Conservative treatment isn’t invasive to the face, jaw, or joint, and they don’t involve surgery. They are also considered reversible as that treatment type doesn’t cause permanent change to the structure or alignment of the jaw or teeth.
Surgical methods are considered to be irreversible. Jaw joint surgery can potentially cause acute pain and permanent damage to the jaw.
Those with TMJ can incorporate physical therapy with exercises that strengthen jaw muscles. A therapist can include heat, ice, and ultrasound in the treatments.
Splints and mouth guards that fit over the teeth are another method that can alleviate jaw pain.
Counseling is a third option since behaviors like fingernail biting and teeth clenching can aggravate that pain.
Medications prescribed by a medical professional are another non-surgical avenue to pursue.
Some over-the-counter pain relievers don’t provide relief, so a doctor or dentist might need to prescribe a pain reliever for a specific timeframe. Prescription-strength ibuprofen is one example.
Pain relief can also come in the form of a tricyclic antidepressant. These are typically used to ward off depression. Low doses of the medicine have been used for pain relief and bruxism.
Muscle relaxants are another type of medication that provides TMJ pain relief. They are typical taken for anywhere from a few days to weeks.
There are also some self-care treatments that you can practice in the comfort of your home.
- Apply ice packs to the throbbing area;
- Minimize or avoid, if possible, jaw movements such as yawning, chewing gum, and loud singing;
- Practice relaxation and stress reduction techniques;
- Employ jaw stretching exercises.
Surgical TMJ Treatments
Surgical treatment options range from minimally invasive to actual surgery on the jaw.
Two of the less invasive treatments are arthrocentesis and injections. Arthrocentesis involves inserting tiny needles into the joint. The needles allow for fluid to be drained through the joint to remove debris and other byproducts. Injections involve corticosteroids and Botox. Injecting either fluid into jaw muscles can alleviate pain.
TMJ arthroscopy – arthroscopic surgery – is when small surgical instruments access the joint by placing a thin tube known as a cannula. This type of procedure has fewer risks and fewer chances of complications than more invasive surgeries.
A modified condylotomy is surgery on the mandible. This is one possible method of addressing pain or jaw locking without operating on the joint.
Open-joint surgery, also known as arthrotomy, is the most invasive procedure. It tends to be caused by a structural joint issue. An arthrotomy repairs or replaces the joint to solve the problem.
TMJ Pain Relief Exercises
Jaw exercises are one way people can relieve pain brought on by TMJ symptoms. Here are nine exercises you can perform to provide you some relief.
Extend your tongue so that it touches the roof of your mouth. Then, slowly open and shut your mouth while your tongue remains in that position.
Forward jaw movement:
Find an object that is about a quarter-inch thick and place it between your front teeth. Then extend your bottom jaw so that the bottom teeth are in front of your top teeth. Gradually increase the object thickness as the exercise becomes simpler.
Side-to-side jaw movement:
Take the same quarter-inch thick object and place it between your front teeth. Then slowly move your jaw from side to side. Gradually increase the object thickness as the exercise becomes simpler.
Mouth resisted opening:
Start by placing your thumb under your chin. Then, slowly open your mouth as your thumb gently resists your chin. Hold your mouth open for three to six seconds before slowly closing it.
Mouth resisted closing:
With your mouth open, place both thumbs under your chin and index fingers on the ridge between the bottom of your chin and your mouth. Then gently resist your chin as you close your mouth.
Relax the jaw:
Extend your tongue so it gently touches directly behind your upper teeth. This move makes the upper and lower teeth part, thus, allowing the jaw muscles to rest.
This exercise is also called a chin tuck and can be performed from a standing or seated position. First, tip your shoulders back and your chest up. Then move your chin straight back while maintaining that position. Do not bend your head up down during the movement. Hold the move for two to three seconds. Repeat the exercise ten (10) times.
Hold your jaw in a neutral position. Then use your thumb to apply gentle pressure directly below the chin, to the right of the chin, and the left of the chin. Repeat all three moves five times while holding each movement for two (2) seconds. Perform five (5) total sets throughout the day.
Mandibular stabilization - advanced:
Begin by placing your index finger knuckle between the top and bottom teeth to create a gap. Hold that gap. Then perform the same number and duration of moves as outlined above.
TMJ Treatment Cost
Jaw surgery might be the only treatment option for some patients. That will make many patients wonder how much is jaw surgery?
Also known as orthognathic surgery, jaw surgery is the straightening or realigning of the jaw. There are a few factors that determine jaw surgery price.
Will the surgery be in-patient or out-patient? In-patient surgery will require a hospital stay. That will add significantly to the cost.
The seriousness of the jaw misalignment is another factor. The greater the misalignment means the more challenging the procedure will be.
The details of the procedure also dictate how much the surgery will cost. Those details include any initial pre-op testing, the surgery location, the anesthesia, a possible hospital stay, and any post-op pain medications.
If you have insurance, talk to your carrier to see what is and isn’t covered. If you lack insurance, then the finances could be significant. For example, jaw surgery can cost anywhere from $5,000 to $80,000, depending on the procedure type.
Find The Best TMJ Treatment Near You
If you're asking yourself where can I find a dentist near me to help with my TMJ check out The Smile Generation tool to find a dentist near you for your TMJ treatment needs. You can read patient reviews, peruse staff bios, and schedule an appointment online with a click of your mouse.