Temporomandibular Disorder

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:

  • Causes

    The exact cause of TMD is often unclear. Possible causes include:

    • Injury of the jaw or face
    • Excess tension in the jaw muscles
    • Faulty alignment between the upper and lower teeth
    • Disturbed movement of the jaw joint
    • Displacement or abnormal position of the jaw joint or cartilage disc inside the jaw joint
    • Arthritis or similar inflammatory process in the joint
    • Excess or limited motion of the joint

  • Definition

    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:

    • Damage to the joint surface or intra-articular disk
    • Displacement or complete dislocation of jaw bones
    The Temporomandibular Joint
    factsheet image
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  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. The physical exam may include:

    • Range of motion of the jaw tests
    • Listening for sounds of popping or clicking in the temporomandibular joints
    • Visual inspection of your teeth, temporomandibular joints, and muscles of your face and head
    • Palpation of the joints and the muscles of the face and head

    Tests may include:

    • X-rays
    • Arthrography—jaw movements videotaped with x-rays taken after dye is injected into the joint
    • MRI scan
    • CT scan

  • Prevention

    There are no current guidelines to prevent TMD.

  • Risk Factors

    TMD is more common in women aged 30-50 years old. Other factors that increase your chance of TMD include:

    • Clenching or grinding of teeth
    • Poorly fitting dentures or crowns
    • Fibromyalgia
    • Stress
    • Arthritis

  • Symptoms

    TMD may cause:

    • Pain in the temporomandibular joint, jaw, or face
    • Pain may be worse with chewing, yawning, or opening the mouth
    • Clicking, popping, or grating sounds with movement of the jaw
    • A sensation of the jaw catching or locking briefly, while attempting to open or close the mouth, or while chewing
    • Difficulty opening the mouth completely
    • A bite that feels off, uncomfortable, or as though it is frequently changing
    • Headache
    • Earache
    • Neck pain

  • Treatment

    Usually the least invasive measures will be tried first.

    Treatment
    may include: