Imagine enduring immense jaw pain — clicking, popping or problems fully opening and closing your mouth. After years, you finally receive a diagnosis and learn you are suffering from temporomandibular joint (TMJ) disorder. While medical professionals agree that pinpointing a diagnosis of TMJ disorder may be difficult, there are specific ways to determine if you have it and how to treat it.
The fundamentals of TMJ disorder
“TMJ disorder is a broad term which describes problems associated with the temporomandibular joint and the related muscles of mastication (chewing) around the joints that help you move your jaw,” explains Dr. Bryan Clevenger, a doctor of dental surgery with Associates for Oral Maxillofacial Surgery in Southern Oregon. It can be acute or chronic, he says, but often becomes a lifelong condition because we use the temporomandibular joint so often for eating or talking.
Pain caused by TMJ disorder can affect one or both sides of the jaw, and may also radiate toward the ear or temple, explains Robert Babek, a physical therapist with Therapeutic Associates Medford Physical Therapy. “The most common symptom of TMJ disorder is pain or tenderness around the jaw,” he says.
Many people also experience jaw popping or clicking, and limited jaw mobility, according to Clevenger. “Normally you can open your mouth about 4-5 centimeters, but with TMJ disorder, you’re unable to open it more than three centimeters,” he explains.
Clevenger and Babek agree that it’s often hard to know the cause of TMJ disorder. “Grinding your teeth, sitting with poor posture or other neck issues are all things which could cause TMJ disorder,” explains Babek. Sometimes the cause could be extremely simple, he says, such as chewing gum on only one side of your mouth.
Arthritis or a previous injury may also result in TMJ disorder, says Clevenger. “If you fall and land on your chin, that could shove the jawbone into a different position,” he adds. While the root cause of TMJ disorder varies, there are ways to reach a diagnosis.
Diagnosing and treating TMJ disorder
First, you will have a thorough evaluation from your dentist to rule out any problems with your teeth, explains Clevenger. He says people suffering from TMJ disorder will usually have specific pain. “If a patient tells me ‘I have pain right here’ and points to the temporomandibular joint, I know it’s TMJ disorder.” Conversely, he says a more diffused pain is generally a sign of another problem, such as migraines.
Babek begins with an examination of the jaw to see how it moves, your range of motion and if you are experiencing pain while moving your jaw. Just as there are several ways to diagnose TMJ disorder, there are also a variety of treatment options.
Clevenger says that in the past, surgery was a treatment option early on in the process, but that is not the case now. “Today, we don’t jump to surgery,” he explains. Initial management is the best treatment, he says, which typically starts with a soft food diet to rest the joints, and then using warm or cold packs to alleviate inflammation. “If that fails, we could prescribe medications with steroids, or eventually provide the patient with a mouthguard to protect the joints.”
Physical therapy is another treatment option, according to Babek. If the patient lacks range of motion, he says they will work on the soft tissue and stretching the muscles. “It’s not so much about the power, but the control of moving the mouth in the right way.”
Resolving the pain
TMJ disorder can cause discomfort and affect a person’s quality of life, according to Babek and Clevenger. But there is hope to help patients without resorting to surgery. “We try to understand the cause of the pain and suggest ways to modify their behavior. Sometimes it’s about breaking the habits that started the pain in the first place,” says Babek.