University at Buffalo

Behavioral Medicine Clinic

 
 

What is TMD/TMJ (Temporomandibular Disorders)?

TMD/TMJ

Temporomandibular (TM) joint and muscle disorders (commonly called “TMJ” disorders) are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement.

For most people, pain in the area of the jaw joint or muscles does not signal a serious problem. Generally, discomfort from these conditions is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Some people, however, develop significant, long-term symptoms.

What Causes TM Disorders?

Trauma to the jaw or temporomandibular joint plays a role in some TM disorders. But for most jaw joint and muscle problems, scientists don’t know the causes. For many people, symptoms seem to start without an obvious reason. Research disputes the popular belief that a bad bite or orthodontic braces can trigger TM disorders. Because the condition is more common in women than in men, scientists are exploring a possible link between female hormones and TM disorders.

There is no scientific proof that clicking sounds in the jaw joint lead to serious problems. In fact, jaw clicking is common in the general population. Jaw noises alone, without pain or limited jaw movement, do not indicate a TM disorder and do not require treatment.

What is the Role of Stress?

The roles of stress and tooth grinding as major causes of TM disorders are also unclear. Many people with these disorders do not grind their teeth, and many long–time tooth grinders do not have painful joint symptoms. Scientists note that people with sore, tender chewing muscles are less likely than others to grind their teeth because it causes pain. Researchers also found that stress seen in many persons with jaw joint and muscle disorders is more likely the result of dealing with the day–to–day burden of having chronic jaw pain or dysfunction rather than the cause of the condition.

Symptoms and Diagnosis

A variety of symptoms may be linked to TM disorders. Pain, particularly in the chewing muscles and/or jaw joint, is the most common symptom. Other likely symptoms include:

  • Radiating pain in the face, jaw, or neck
  • Jaw muscle stiffness
  • Limited movement or locking of the jaw
  • Painful clicking, popping, or grating in the jaw joint when opening or closing the mouth
  • A change in the way the upper and lower teeth fit together

Some people have other health problems that co-exist with TM disorders, such as chronic fatigue syndrome, headache, irritable bowel syndrome, sleep disturbances or fibromyalgia. It is not known whether these disorders share a common cause.

There is no widely accepted, standard test now available to correctly diagnose TM disorders. Since the exact causes and symptoms are not clear, identifying these disorders can be difficult and confusing. Currently, health care providers note the patient’s description of symptoms, take a detailed medical and dental history, and examine problem areas, including the head, neck, face, and jaw. Imaging studies may also be recommended.

Treatment

Because more studies are needed on the safety and effectiveness of most treatments for jaw joint and muscle disorders, experts strongly recommend using the most conservative, reversible treatments possible. Conservative treatments do not invade the tissues of the face, jaw, or joint, or involve surgery. Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth. Even when TM disorders have become persistent, most patients still do not need aggressive types of treatment.

Because the most common jaw joint and muscle problems are temporary and do not get worse, simple treatment is all that is usually needed to relieve discomfort. For many people with TM disorders, short–term use of over–the–counter pain medicines or non–steroidal anti–inflammatory drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw discomfort. When necessary, your dentist or doctor can prescribe stronger pain or anti–inflammatory medications, muscle relaxants, or anti-depressants to help ease symptoms.

Managing Your TMD Pain

A number of noninvasive therapies are widely used and appear to help many patients with TM disorders. Treatments include pain medications, stabilization splints, and simple lifestyle changes such as eating soft foods, avoiding extreme jaw movements, doing jaw exercises. For TM disorder patients for whom these treatments do not provide adequate relief, behavioral self–management training is a clinically proven treatment option. This type of treatment aims to teach skills and tools to manage facial pain and the day–to–day burden of TM disorders such as diminished quality of life, frustration, and worry. In a recent study published in the journal PAIN, researchers at the University at Washington found that patients who underwent behavioral treatment for TM disorders were significantly less disabled by facial pain than control subjects. Improvements were also seen in pain control, well–being, and jaw function.

If you or someone you know is suffering from pain that medications or other therapies are not effectively controlling, the Behavioral Medicine Clinic may be able to help. Contact us online or call us at 716-898-5671 to get the help you need.

Source:

Turner J. A., Mancl,L., Aaron, L. A. (2005). Brief cognitive–behavioral therapy for temporomandibular disorder pain: Effects on daily electronic outcome and process measures. Pain, 117, 377–387.

Did you know ... ?
People with TMD spend an average of $4 billion per year on TMD treatment.

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