Angie's LIST Guide to

We typically associate dentistry with oral treatments designed to improve your smile. However, a more serious reason for people to visit a dentist is a temporomandibular joint disorder (TMJ).


dentist checks the inside of patient's mouth
If TMJ is the result of an abnormal bite or other dental problems, braces or another dental procedure may correct the alignment and relieve the pain of TMJ. (Photo by Jay Madden)
Little girl holding missing tooth

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What is TMJ?

Temporomandibular joint disorder, also known as TMJ or TMD, results from problems with the jaw joint. When the joint is injured or damaged, it affects the surrounding facial muscles responsible for moving the jaw and controlling chewing motions. The temporomandibular joint is a hinge joint that connects the mandible (lower jaw) and the temporal bone of the skull. The temporal bone is on each side of your head and directly in front of your ear. The temporomandibular joint is flexible, allowing your jaw to make smooth movements when moving up and down, side to side, yawning, talking and chewing. It's one of the most often used joints in your body. The muscles around the jaw help control the movement and position of the jaw. A TMJ disorder can cause pain and tenderness in the joint.

TMJ disorders are the most common type of chronic facial pain not related to your teeth. An estimated 10 million Americans are affected with TMJ disorders. They typically occur in women between the ages of 20 and 40.

Symptoms and causes of TMJ

Since the temporomandibular joint and surrounding muscles work together, stiffness is one of the main complaints of people who suffer from TMJ.

Other symptoms include clicking or popping sounds that occur when opening and closing your mouth, and locked jaw, which causes the jaws to get stuck and locks the mouth in an open or closed position. Other symptoms can include pain and tenderness in the neck, shoulders, jaw and around the ear when talking or chewing.

The most common symptom of TMJ is a headache that occurs in about 80 percent of all people with the disorder. About 50 percent of the people with TMD also report severe ear pain but don't show any signs of an ear infection.

Some people complain of dizziness or becoming unbalanced, or they experience a feeling of fullness in the ears. Ringing of the ears, also known as tinnitus, is also a common symptom for people with TMD.

Although the exact cause of TMJ isn't completely clear, many dentists believe the root of the problem starts in the joint itself or the jaw muscles. For example, a heavy blow to the head or whiplash can lead to TMD. Osteoarthritis or rheumatoid arthritis also can cause TMJ, as the disease may damage the cartilage in the temporomandibular joint.

Teeth clenching and grinding can increase the wear and tear on the cartilage, resulting in the disorder. Other factors that may contribute to TMJ include habitually biting fingernails, misaligned teeth, trauma to the jaw and stress.

Treatment for TMJ

Treatments for TMJ vary from basic home-care practices to surgery. Most dentists recommend trying noninvasive methods first and suggest surgery as the last resort. Try basic treatments, such as applying an ice pack to the affected side of the face for about 10 minutes or applying heat to the affected side for about five minutes. Your dentist may give you instructions for simple stretching exercises. Eating soft foods will help relieve the pain, and taking over-the-counter medications may help relieve the pain and reduce the swelling. Physical therapy is also an option to help increase strength and the range of motion in the joint.

If TMJ results from abnormal bite or other dental problems, corrective dental procedures may be necessary to correctly align the teeth and relive the pain of TMJ. Surgery can correct problems with the joint and may involve joint restructuring, ligament tightening or joint replacement.

If you suspect you may have TMJ, visit your family dentist for an examination. Your dentist will perform tests such as X-rays to decide if the joint is damaged. He or she will also ask you a series of questions about how long you have experienced the pain, whether a trauma ocurred to the head and what other kind of symptoms you are experiencing. If the dentist suspects you have TMJ, he or she will refer you to someone who specializes in this type of disorder.

If you have dental insurance, verify with your company that your insurance covers the dentist and the treatments. If you don't have dental insurance, contact several dentists to find out if they treat TMJ, and get an estimated cost for treatment. Compare those cost with Healthcare Blue Book, a free online guide that lists fair prices for health care services. The fair price is what a health service provider typically allows from insurance companies as full payment, which is substantially less than the billed amount. Once you have the price information from two to three dentists, check their references on Angie's List or through the American Academy of Cosmetic Dentistry.


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