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Symptoms and Signs of Temporomandibular Joint (TMJ) Syndrome

Doctor's Notes on Temporomandibular Joint (TMJ) Syndrome (Temporomandibular Joint Disorder)

Temporomandibular joint syndrome (TMJ syndrome) refers to injury or damage to the joint that connects the jaw to the skull. There are a number of conditions that can cause TMJ syndrome or pain in the area of the joint. Injury to the teeth, misaligned teeth, tooth grinding, gum chewing, and stress are all common causes. Arthritis conditions are another cause of TMJ syndrome.

Pain in the jaw joint is the major symptom of TMJ syndrome. Other associated signs and symptoms can include clicking of popping noises when moving the jaw joint, ear pain, headaches, locking of the jaw joint, or stiff or sore jaw muscles. While TMJ syndrome can be painful, it is usually not a sign of serious illness and can be effectively treated with home remedies or dental splints.

Medical Author:
Medically Reviewed on 3/11/2019

Temporomandibular Joint (TMJ) Syndrome (Temporomandibular Joint Disorder) Symptoms

  • Acute TMJ symptoms and signs may last anywhere from a few days to a few weeks and then disappear after the injury or cause of discomfort has resolved.
  • For a chronic TMJ condition, the symptoms can be ongoing with episodes of sharp and/or dull pain that occur over an extended period of time (months to years).
  • Pain in the facial muscles and jaw joints may radiate to the neck or shoulders. Joints may be overstretched and muscle spasms can occur. The pain may occur with talking, chewing, or yawning. Pain usually appears in the joint itself, in front of the ear, or it may move elsewhere on the, face, scalp or jaw and lead to headaches, dizziness, and even symptoms of migraines.
  • TMJ syndrome may cause ear pain, ringing in the ears (tinnitus), and hearing loss. Sometimes people mistake TMJ pain for an ear problem, such as an ear infection, when the ear is not the problem at all.
  • When the joints move, they may produce sounds, such as clicking, grating, and/or popping. Others may also be able to hear the clicking and popping sounds. This means the disc may be in an abnormal position. Sometimes no treatment is needed if the sounds do not cause pain.
  • The face and mouth may swell on the affected side.
  • The jaw may lock in a wide open position (indicating that it is dislocated), or it may not open fully at all. Also, upon opening, the lower jaw may deviate to one side. Some people may experience favoring one painful side or the other by opening the jaw awkwardly. These changes could be sudden. The teeth may not fit properly together, and the bite may feel odd.
  • Muscle spasms associated with TMJ syndrome may cause difficulty swallowing.
  • TMJ syndrome can also cause headache and dizziness, potentially leading to nausea and/or vomiting.
  • Some individuals with TMJ syndrome may have a history of poor dentition or emotional distress.

Temporomandibular Joint (TMJ) Syndrome (Temporomandibular Joint Disorder) Causes

TMJ syndrome can be caused by trauma, disease, wear and tear due to aging, or oral habits.

  • Trauma: Trauma is divided into microtrauma and microtrauma. Microtrauma is internal, such as grinding the teeth (bruxism) and clenching (jaw tightening). This continual hammering on the temporomandibular joint can change the alignment of the teeth. Muscle involvement causes inflammation of the membranes surrounding the joint. Teeth grinding and clenching are habits that may be diagnosed in people who complain of pain in the temporomandibular joint or have facial pain that includes the muscles involved in chewing (myofascial pain). Microtrauma, such as a punch to the jaw or impact in an accident, can break the jawbone, cause dislocation of the TMJ, or damage the cartilage disc of the joint. Pain in the TMJ can be brought on by dental work whereby the joint is stretched open for extended periods of time. Massage and heat application after the dental procedure can be helpful.
    • Bruxism: Bruxism, or teeth grinding, is a habit that can result in muscle spasm and an inflammatory reaction that can cause the initial pain. Changes in the normal stimuli or height of the teeth, misalignment of teeth, and repetitive use of chewing muscles may cause temporomandibular joint changes. Generally, someone who has a habit of grinding his or her teeth will do so mostly during sleep. In some cases, the grinding may be so loud that it disturbs others.
    • Clenching: Someone who clenches continually or bites on things while awake. This might be chewing gum, a pen or pencil, or fingernails. The constant pounding on the joint causes the pain. Stress is often blamed for tension in the jaw, leading to a clenched jaw.
  • Osteoarthritis: Like other joints in the body, the jaw joint is prone to arthritic changes. These changes are sometimes caused by the breakdown of the joint (degeneration) or the usual wear and tear of normal aging. The degenerative joint disease causes a slowly progressive loss of cartilage and formation of new bone at the surface of the joint. Cartilage destruction is a result of several mechanical and biological factors rather than a single entity. Its prevalence increases with repetitive microtrauma or microtrauma, as well as with normal aging. Immunologic and inflammatory diseases contribute to the progression of the disease.
  • Rheumatoid arthritis: Rheumatoid arthritis causes inflammation in joints and can affect the TMJ. As it progresses, the disease can cause the destruction of cartilage, erode bone, and eventually cause joint deformity. Rheumatoid arthritis is an autoimmune disease. It causes disease in a variety of organs with features of persistent joint inflammation. It occasionally affects the TMJ, especially in young children.
  • Other causes of TMJ syndrome include infection of the joint, cancer, and bone deformity that occurs at birth.

Top Problems in Your Mouth Slideshow

Top Problems in Your Mouth Slideshow

Also called fever blisters, you don't get cold sores from fevers or colds but they can be triggered by them. The virus that causes cold sores is usually passed via a kiss, shared utensils, or other close contact. Over-the-counter creams and ointments may help discomfort and speed healing. Frequent sores may require a prescription. Cold sores are a top mouth problem. Other problems include canker sores, TMJ, bad breath, and mouth cancer.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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