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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Temporomandibular Joint Syndrome

What is it?

Temporomandibular joint syndrome is characterized by pain in the temporomandibular joints (TMJs), where both sides of the lower jaw (mandible) are attached to the skull. Normally, the muscles and ligaments in the TMJ stabilize, cushion, and guide the mandible's movements during eating, speaking, and other activities. TMJ syndrome occurs when these muscles and ligaments do not work together in a coordinated manner. For unknown reasons, 90 percent of TMJ sufferers are women, and most are young (20 to 40 years old).

What Causes It?

  • Clenching and grinding the teeth (bruxism) is a common cause of TMJ syndrome. Bruxism often occurs during sleep, although the sleeper may be unaware of it.
  • Emotional stress may lead to bruxism.
  • Improper alignment of the teeth (malocclusion) is a common cause of TMJ syndrome.
  • Bad posture (for example, thrusting the chin forward), a blow to the jaw, whiplash, or eating chewy foods can promote TMJ pain.
  • Arthritis is an uncommon cause of TMJ syndrome.

Prevention

  • Try not to grind the teeth or clench the jaw as a reaction to stress.
  • See your dentist regularly.
  • Practice correct posture to avoid muscle strain in the head and neck.

Diagnosis

  • Patient history and exam by a dentist or doctor.
  • X-rays, CT (computed tomography) scans, or MRI (magnetic resonance imaging) of the TMJ may be done (although they usually show no abnormality).

How to Treat It

  • Follow prevention tips above.
  • Take a nonprescription pain reliever.
  • A hot or cold pack may offer temporary pain relief.
  • At times when symptoms are particularly troublesome, eat soft foods and avoid chewing gum.
  • Tranquilizers or muscle relaxants may be prescribed, and to reduce severe inflammation, corticosteroids may be injected into the TMJ.
  • Your dentist may grind tooth surfaces to correct malocclusion, prescribe a removable plastic or rubber mold that fits over the teeth at night to prevent bruxism, or prepare a type of splint to be worn in the mouth during the day.
  • Biofeedback (a technique for gaining voluntary control over certain of the body's reactions to stress and other stimuli) may be recommended. Relaxation training or physical therapy to lessen muscle tension may also be advised.
  • In severe cases surgery may be recommended to repair damaged joint tissue and to correct bone defects. Surgery should only be considered as a last resort, however, because of the risk of severe complications. Always get a second opinion.

When to Call a Doctor

  • Call a doctor if symptoms of TMJ syndrome interfere with normal activities.