Temporomandibular Joint Dysfunction (TMJ)

Temporomandibular Joint Dysfunction (TMJ)

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Temporomandibular Joint Dysfunction (TMJ) is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Costes Syndrome
  • Impostor Disease
  • Myofascial Pain-Dysfunction Syndrome
  • Pain-Dysfunction Syndrome
  • Temporomandibular Joint Syndrome
  • TMJ

Disorder Subdivisions

  • None

General Discussion

Temporomandibular joint (TMJ) dysfunction is a general term for a group of conditions that affect the temporomandibular joint. The TMJs are small joints that connect the lower jaw (mandible) to the temporal bone of the skull. TMJ dysfunction is characterized by pain of the jaw joint that is made worse during or after eating or yawning. It can cause limited jaw movement and clicks and pops during chewing. In severe cases, pain can radiate into the neck, shoulders and back.

Symptoms

TMJ dysfunction is characterized by pain affecting the jaws. The pain may also involve the eyes, ears, teeth, head, neck, shoulders and back. Sometimes there is ringing in the ears (tinnitus), dizziness and loss of equilibrium. Difficulties of movement in the jaw can result in swallowing and chewing problems. About 85 percent of affected individuals feel pain on only one side usually in the temple, cheek, and front of the ear. The pain may be constant or come and go.



In some cases, the jaw may lock in an open or closed position. Affected individuals may also experience swelling on one side of the face, painful clicking, popping or grating when opening or closing the mouth (e.g., when chewing), an inability to open the mouth fully or comfortably, repeated headaches, earaches (otalgia), and hearing problems. Some affected individuals may experience a sudden change in the way the upper and lower teeth meet (malocclusion).

Causes

There are many suspected causes of TMJ dysfunction. The only definite cause is trauma to the jaw as from a heavy blow to the mouth. For example, jawbone dislocation from a blow during a car accident or fall may cause TMJ dysfunction. The jaw joint can be dislocated without force from outside the body (e.g., from strained opening of the mouth).



TMJ dysfunction may also occur secondary to myofascial pain dysfunction (MPD) syndrome or due to internal damage to the temporomandibular joint (true articular disease). MPD syndrome affects the chewing muscles. Muscle spasms, often caused by grinding the teeth, create facial pain that may spread to nearby muscles.



True articular disease may result from degenerative joint disease (osteoarthritis), systemic arthritis conditions, fibrous ankylosis, infections, or dislocation or displacement of the jaw.



Degenerative joint disease may cause cartilage-like tissues wear away from the jaw joint. This alters movement and creates a crackling sound when the jaw moves. Inflammatory joint disorders occur when membranes on the sides of the disk become inflamed due to rheumatoid arthritis. Chronic restricted jaw movement such as fibrous ankylosis, occurs when fibrous tissue forms in the joint reducing jaw movement. Left untreated it can "freeze" the jaw. Joint growth disorders cause the jawbone to continue to enlarge after growth should have stopped. This causes the bite and joint movements to become abnormal.



Functional causes of TMJ dysfunction include breakdown of the support provided by the teeth or most commonly grinding of the teeth (bruxism).

Affected Populations

TMJ dysfunction is a common condition of adulthood that affects females three times more often than males. It is most common in women ages fifteen to forty-four. People between the ages of 30-50 are most often affected.

Standard Therapies

Diagnosis

A diagnosis of TMJ dysfunction may be made based upon a thorough clinical evaluation, a detailed patient history, identification of characteristic findings, and certain x-ray tests that show the condition and shape of the jaw.



Treatment

Treatment of TMJ dysfunction varies according to the individual person's needs. Many affected individuals will only require conservative treatment including the application of heat or cold (e.g., heating pads or icepacks), eating soft foods, and special exercises to stretch or relax facial muscles. Anti-inflammatory drugs may be prescribed in some cases.



In some cases, a bite plate may be used to treat TMJ dysfunction. A bite plate is a device that repositions or relaxes the jaw and muscles and reduces pressure on teeth and jaw joints. If TMJ results from grinding of the teeth, these plastic devices often alleviate the problem. Some people wear the bite plates at night when grinding of the teeth cannot be consciously avoided. Treatment of muscle spasms may include relaxant drugs such as diazepam and analgesics for pain. Physical therapy, splints, permanent jaw adjustments or corrective dental work are also sometimes necessary.

Investigational Therapies

Doctors at the National Institutes of Health (NIH) are conducting a clinical trial on Temporomandibular Joint Dysfunction. For more information, contact:



Donald DeNucci

NIDR

Building 10 Room 1N103

10 Center Dr

Bethesda, MD 20892

(301) 402-2480



Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com

References

JOURNAL ARTICLES

Farley D. TM disorders; aches and pains from flaws in the jaws. FDA Consumer. 1988;6-10.



Uyanik JM, Murphy E. Evaluation and management of TMDs, Part 1. History, Epidemiology, classification, anatomy, and patient evaluation. Dent Today. 2003;22:140-5.



Tuz HH, Onder EM, Kisnisci RS. Prevalence of otologic complaints in patients with temporomandibular disorder. Am J Orthod Dentofacial Orthop. 2003;123:620-3.



Siegmund T, Harzer W. Orthodontic diagnostics and treatment planning in adults with temporomandibular disorders a case report. J Orofac Orthop. 2002;63:435-45.



Vincent SD, et al. Incidence and characterizations of temporomandibular joint sounds in adults. J Am Dent Assoc. 1988;116:203-6.



Weinberg S, et al. Cervical extension-flexion injury (whiplash) and internal derangement of the temporomandibular joint. J Oral Maxillofac Surg. 1987;45:653-6.



Gay T, et al. The acoustical characteristics of the normal and abnormal temporomandibular joint. J Oral Maxillofac Surg. 1987;45:397-407.



FROM THE INTERNET

National Institute of Dental and Craniofacial Research. TMD: Temporomandibular Disorders. Available at: http://www.nidcr.nih.gov/HealthInformation/OralHealthInformationIndex/TMDTMJ/Tmd.htm Accessed On: March 27, 2005.



Chaudary A. Temporomandibular Joint Syndrome. eMedicine Journal. 2002;3:11pp. Available at: http://www.emedicine.com/neuro/topic366.htm Accessed On: March 27, 2005.

Resources

American Chronic Pain Association

P.O. Box 850

Rocklin, CA 95677

USA

Tel: (916)632-0922

Fax: (916)652-8190

Tel: (800)533-3231

Email: ACPA@theacpa.org

Internet: http://www.theacpa.org



TMJ Association, Ltd.

PO Box 26770

Milwaukee, WI 53226-0770

USA

Tel: (262)432-0350

Fax: (262)432-0375

Email: info@tmj.org

Internet: http://www.tmjassociation.org



NIH/National Institute of Dental and Craniofacial Research

Building 31, Room 2C39

31 Center Drive, MSC 2290

Bethesda, MD 20892

USA

Tel: (301)496-4261

Fax: (301)480-4098

Tel: (866)232-4528

Email: nidcrinfo@mail.nih.gov

Internet: http://www.nidcr.nih.gov/



American Pain Society

4700 West Lake Avenue

Glenview, IL 60025

Tel: (847)375-4715

Fax: (866)574-2654

Email: info@ampainsoc.org

Internet: http://www.ampainsoc.org



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.