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Temporomandibular Joint Disorder

Problems in the joint between the jaw and skull, causing headaches or pain in the face

  • Much more common in females
  • Stress may be a risk factor
  • Age and genetics are not significant factors

The temporomandibular joint connects the mandible (lower jawbone) to the part of the skull known as the temporal bone. The joint allows the lower jaw to move in all directions so that the teeth can be used to bite off and chew food efficiently. In temporomandibular joint disorder, the joint and the muscles and ligaments that control the joint do not work together properly, causing pain. The condition is three times more common in women than in men.

Temporomandibular joint disorder is most commonly caused by spasm of the chewing muscles, often as a result of clenching the jaw or grinding the teeth. Clenching the jaw and grinding the teeth may be increased by stress. A poor bite (see Malocclusion) places stress on the muscles and may also result in temporomandibular joint disorder, as may an injury to the head, jaw, or neck that causes displacement of the joint. In rare cases, arthritis is a cause of the condition.

What are the symptoms?

If you have temporomandibular joint disorder, you may notice one or more of the following symptoms:

  • Headaches.

  • Tenderness in the jaw muscles.

  • Aching pain in the face.

  • Severe pain near the ears.

In some cases, pain is caused by chewing or by opening the mouth too widely when yawning. There may be difficulty in opening the mouth, locking of the jaw, and clicking noises from the joint as the mouth is opened or closed.

What might be done?

Your dentist may take a panoramic X-ray of your mouth and jaws. He or she may also arrange for you to have special X-rays or an MRI of the joint.

Treatment is aimed at eliminating muscle spasm and tension and relieving the pain. There are several self-help measures that you can take, including applying a warm, wet towel to the face, massaging the facial muscles, eating only soft foods, and using a device that fits over the teeth at night to prevent you from clenching or grinding your teeth. Taking a painkiller, such as paracetamol, may also help. If tension of the muscles used for chewing is severe, your doctor may prescribe a muscle relaxant drug. If stress is a major factor, you may find relaxation exercises helpful.

If your bite needs to be adjusted, your dentist may recommend wearing a fixed or removable orthodontic appliance for a specified period of time (see Orthodontic treatment).

What is the prognosis?

In about 3 in 4 people, the symptoms improve within 3 months of treatment. However, in some cases, if symptoms do not improve, surgery may be needed to repair the temporomandibular joint.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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