TMJ Problems and Treatments

Have you ever thought you had TMJ symptoms?

If you have ever heard your jaw make a click, a pop, or a crunch, then you have probably wondered, “is that normal?”

If you’ve had jaw pain, then you probably know you have a TMJ problem. You probably want to know why you had TMJ pain and how to prevent it in the future.

Continue reading to learn the most common TMJ symptoms and the best treatments to protect your TMJ.

TMJ problems and dental treatments

Most TMJ problems can be successfully treated by your local dentist.

3 Common TMJ Problems

TMJ problems are divided into three categories:

  1. Muscle problems
  2. Joint problems
  3. Nerve problems

TMJ jaw pain causes

TMJ problems are most often muscle problems. True joint problems and nerve problems are other causes of TMJ pain.


Let’s start with the #1 most common TMJ symptom – muscle pain.

1. TMJ Muscle Problems

More often than not, “TMJ” problems are actually muscle problems.

That’s right; the pain associated with TMJ disorders is most often muscle-related; not joint related.

Typically, the jaw muscles become sore because they are overworked.

You would know if you had this type of soreness because you would sense a dull, aching pain in the affected muscle, often combined with tenderness and stiffness. In fact, if you gently press (not too hard!) the right muscle you can identify the overworked area.

Muscles become overworked because of excessive function (parafunction) beyond that of normal speaking, chewing and swallowing.

Clenching and tooth grinding during the daytime and nighttime are the most common parafunctional habits that overwork the jaw muscles.

In fact, one of the most common symptoms of clenching and grinding is TMJ pain.

There’s a second kind of muscle problem, too. It is different from the first type of TMJ muscle pain because of the area it affects.

The second type of muscle problem is a more regional pain, called myofacial pain.

This is a spreading kind of pain. It can be felt on the side of your head, around your eyes, or even in your teeth. Myofacial pain is often mistaken for a toothache – which is why it is important for dentists to evaluate patients with jaw pain.

Treating TMJ Muscle Problems

TMJ treatment custom mouthguard

TMJ muscle pain is alleviated in 1-2 months with conservative dental treatments. Muscle relaxing exercises and a custom mouthguard are able to relieve pain due to TMJ muscle problems.


The immediate solution for muscle related pain is rest and relaxation.

The most effective way to relieve overworked muscles is to eliminate parafunctional habits.

This is easy with the right muscle relaxing exercises – just puff air between your lips to interrupt tooth contact.

TMJ exercises work well for relaxing the muscles during the waking hours.

The pain associated with TMJ muscle problems can be relieved even more quickly with prescription strength Ibuprofen, warm compresses and a soft diet. Some especially taxed muscles may benefit from prescription muscle relaxants.

The right exercises, Ibuprofen, warm compresses and a soft diet relieve TMJ symptoms in 50% of people in 2-4 weeks.

What if you grind your teeth at night?

If tooth grinding (bruxism) occurs while sleeping, additional treatment beyond conscious muscle relaxation may be required.

The best way to protect the teeth, muscles, and joints from the effects of nighttime tooth grinding is with a custom mouth guard. A full occlusal coverage custom mouthguard made of hard acrylic will protect teeth, jaws, and muscles from the harmful effects of grinding.

A custom mouthguard will solve an additional 25% of TMJ problems over an additional 2-4 weeks.

For those of you still reading, allow me to repeat the great news:

75% of TMJ problems can be solved in 1-2 months without invasive procedures!

What about the other 25%? Well, I’m glad you asked – read on to learn about the other 2 causes of TMJ pain.

2. TMJ Joint Problems

TMJ problems that are actually “joint” problems are called intracapsular disorders.

Joint problems occur when the protective disc no longer separates the jaw bone from the base of the skull.

Normally, the articular disc of the TMJ rests between the bones. This position is ideal for proper jaw function – speaking, chewing, and swallowing.

TMJ in normal function

The disc (green) is normally between the bones (blue) of the TMJ.

A problem occurs when the TMJ disc moves from its ideal location. The most common disc displacement is forward of its normal location.

TMJ disc displacement click

The disc (green) can get trapped ahead of where it should rest between the bones (blue).

When the disc is trapped, the TMJ is no longer protected. A trapped disc is a problem because the ligaments and tendons that are attached to the disc get stretched out. Once the ligaments and tendons get stretched, it becomes easier and easier for the disc to slip forward.

The good news is that the disc will often find its way back into the right position. You will know when this happens because you will hear a “click” when the TMJ disc snaps back between the bones.

Occasional clicking is considered normal.

TMJ click disc displacement

When the jaw is opened and the space between the bones (blue) gets wider, the disc (green) can return to its normal position between the bones. The disc will typically snap into place quickly – making a “click” sound.

There are several advanced techniques in dentistry, like occlusal adjustments, that can help the disc back to its ideal position. The treatment will decrease the frequency of clicking and popping.

Unfortunately, even these specialized techniques sometimes fail to recapture the disc.

When the disc is not in its ideal position for a long duration, joint problems can develop.

Over time, the bone-on-bone contact can change the shape of the jaw bone. The bone will start to show degenerative changes and the disc will begin to disintegrate.

TMJ disorder affects the jaws

TMJ degeneration occurs when there is bone-to-bone contact. The disc appears to be disintegrating.

In this advanced stage, TMJ specialists may perform arthrocentesis, arthroscopy, arthroplasy, and possibly a joint replacement.

3. Neuropathic Pain

The third cause of TMJ pain is quite rare. Less than 5% of all patients with TMJ problems suffer from neuropathic pain.

TMJ pain due to neuropathic pain arises from pain sensing nerves.

Yes – from the nerves themselves!

Generally, there is no obvious noxious stimulus that instigates the pain.

Since the pain is due to a problem with the nerves, medications can be prescribed to treat the problematic nerves. Anticonvulsants have been found to be effective for many patients with neuropathic pain.

Neuropathic TMJ pain is usually treated by a team of TMJ specialists.

Summary

Now you know the three most common causes of TMJ problems – muscles, joints and nerves.

If someone you know suffers from TMJ pain, there is a 75% chance that they can be successfully treated within 1-2 months by their local dentist.

About Dr. Bryon Viechnicki

Dr. Bryon Viechnicki is an orthodontist and university professor. He specializes in braces and Invisalign ... Continue reading

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