Your temporomandibular joint (TMJ) is a hinge that connects your jaw to the temporal bones of your skull, which are in front of each ear.  It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn.  Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD).

 

What causes TMD?

Dentists believe symptoms of TMD, or temporomandibular disorders arise from problems with the muscles of your jaw or with the parts of the joint itself.  Injury to your jaw, the joint, or the muscles of your head and neck -- like from a heavy blow or whiplash -- can lead to TMD.  Other causes include:

 

• Grinding or clenching your teeth, which puts a lot of pressure on the joint

• Movement of the soft cushion or disc between the ball and socket of the joint

• Arthritis in the joint

• Stress, which can cause you to tighten facial and jaw muscles or clench the teeth

 

What are the symptoms?

TMD often causes severe pain and discomfort. It can be temporary or last many years.  It might affect one or both sides of your face.  More women than men have it, and it’s most common among people between the ages of 20 and 40.

 

Common symptoms include:

 

• Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide

• Problems when you try to open your mouth wide

• Jaws that get "stuck" or "lock" in the open- or closed-mouth position

• Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew

• A tired feeling in your face

• Trouble chewing or a sudden uncomfortable bite -- as if the upper and lower teeth are not fitting together properly

• Swelling on the side of your face

 

You may also have toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and a ringing in the ear (tinnitus).

 

How is TMD diagnosed?

Many other conditions cause similar symptoms -- like tooth decay, sinus problems, arthritis, or gum disease.  To figure out what’s causing yours, Dr. Merrick will ask about your health history and conduct a physical exam. 

 

Dr. Merrick will check your jaw joints for pain or tenderness and listen for clicks, pops, or grating sounds when you move them. Dr. Merrick will also make sure your jaw works like it should and doesn’t lock when you open or close your mouth. Plus he’ll test your bite and check for problems with your facial muscles.

 

Dr. Merrick may take full face X-rays so he can view your jaws, temporomandibular joints, and teeth to rule out other problems. He may need to do other tests, like magnetic resonance imaging (MRI) or computer tomography (CT). The MRI can show if the TMJ disc is in the proper position as your jaw moves. A CT scan shows the bony detail of the joint. 

 

If Dr. Merrick detects there's a problem, he has the capacity to perform oral and maxillofacial surgery to further treat the TMD. 

 

Traditional Treatments

 

Medications: Dr. Merrick can prescribe higher doses of NSAIDs if you need them for pain and swelling. He might suggest a muscle relaxer to relax your jaw if you grind or clench your teeth. Or an anti-anxiety medication to relieve stress, which may bring on TMD. In low doses they can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.

 

Orthodontics/Dental Devices: These plastic mouthpieces fit over your upper and lower teeth so they don’t touch. They lessen the effects of clenching or grinding and correct your bite by putting your teeth in a more correct position. What’s the difference between them? You wear night guards while you sleep. You use a splint all the time. Dr. Merrick will tell you which type you need.

 

Dental work: Dr. Merrick can perform necessary dental work, including replacing missing teeth, using crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem.