Temporomandibular disorder (TMD) is a painful condition in the joint that opens and closes the mouth. These temporomandibular joints are the small joints in front of each ear. They attach the lower jaw (mandible) to the skull. The disorder may affect the jaw joint or the muscles surrounding it. The disorder can include:
The exact cause of TMD is often unclear. Possible causes include:
TMD is more common in women aged 30-50 years old. Other factors that increase your chance of TMD include:
TMD may cause:
You will be asked about your symptoms and medical history. A physical exam will be done. The physical exam may include:
Images may be needed of your jaw. This can be done with:
Usually, the least invasive measures will be tried first. Treatment may include:
The area will need time to heal:
The most commonly used medications include:
Some medication may be injected into the jaw such as:
To help reduce pain and allow muscles to relax:
Some may benefit from counseling to learn stress management and relaxation techniques, such as:
A splint or mouth guard can be made to relax the jaw muscles. This will prevent clenching and grinding of the teeth. The guard is usually worn at night. Correction of bite abnormalities by a dentist or orthodontist is sometimes needed.
Surgical correction is a last resort. Many of the available procedures have not been well-studied for their effectiveness.
There are no current guidelines to prevent TMD.
Mouth Healthy—American Dental Association
The TMJ Association
Canadian Dental Association
Canadian Society of Otolaryngology—Head & Neck Surgery
Borodic GE, Acquadro MA. The use of botulinum toxin for the treatment of chronic facial pain. J Pain. 2002;3(1):21-27.
Haley DP, Schiffman EL, et al. The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain. J Am Dent Assoc. 2001;132(4):476-481.
National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/oralhealth/topics/tmj. Updated July 10, 2014. Accessed June 20, 2015.
Temporomandibular joint (TMJ) dysfunction . EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 11, 2015. Accessed June 29, 2015.
DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Turner JA, Mancl L, Aaron LA. Short- and long-term efficacy of brief cognitive-behavioral therapy for patients with chronic temporomandibular disorder pain: a randomized, controlled trial Pain. 2006;121(3):171-172.
Last reviewed June 2015 by Teresa Briedwell, DPT, OCS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.