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Temporomandibular Joint (TMJ)

is the temporomandibular joint?

  • The temporomandibular joint (TMJ) is in front of the ear where the skull and lower jaw (mandible) meet.
  • The TMJ is a modified hinge joint and is the most constantly used joint in the body. The round upper end of the lower jaw, or the moveable part of the joint, is called the condyle; the socket is called the articular fossa.
  • Between the condyle and the fossa is a disk of cartilage that acts as a cushion to absorb stress and allow the condyles to move easily when the mouth opens and closes.
  • If this joint does not move effectively, it is called Temporomandibular Joint dysfunction

What are TMJ disorders?

  • Temporomandibular Joint disorders are problems with the jaw joint and the muscles around it.
  • Temporomandibular Joint disorders can be caused by many problems, including arthritis.
  • Sometimes Temporomandibular Joint is due to a combination of stress, jaw clenching, teeth grinding, and other things that strain the jaw joint and the muscles around it.
  • Some people with Temporomandibular Joint also have anxiety, depression or increased awareness and experience of jaw pain (e.g. Fibromyalgia)

What are the symptoms and causes of Temporomandibular Joint dysfunction?

  • TMJ disorders are quite common and have a variety of symptoms.
  • Patients may complain of
  • earache
  • headache
  • difficulty opening the mouth.
  • clicking or grating sounds
  • feeling jaw pain when opening and closing their mouth

What can I do to help improve my Temporomandibular Joint dysfunction and ease its jaw pain?

  • Massage your muscles
  • Avoid foods that are hard to chew
  • Exercise to relax your jaw and face
  • Practice good posture
  • Use a hot or cold pack on the face
  • Wear a mouth-guard or splint, which helps if you clench your jaw or grind your teeth, particularly at night

What exercises can I do to improve my jaw function?

  • The purpose of these exercises is to prevent clicking of the jaw joints and to strengthen the muscles that pull the jaw backwards. This will relax the muscles that close the mouth, and will prevent those muscles that pull the jaw forwards from side to side from functioning. The jaw will act more like a hinge, reducing strain.
  • As an addition to the Temporomandibular Joint exercises, some health practitioners may prescribe anti-inflammatory medication to help your jaws relax
     Exercises
  • Set aside 2 x five minute periods each day at a time when you are relaxed – eg just before you get up or go to bed. Sit upright in a chair to perform all the following man oeuvres:
  • Close your mouth and make sure that your teeth are touching but do not ‘clench’ your teeth, resting the tip of your tongue on your palate, just behind the upper front teeth.
  • Run the tip of your tongue backwards towards your soft palate as far as it will go, keeping your teeth together.
  • Force your tongue back to maintain contact with the soft palate and slowly open your mouth until you feel your tongue being pulled away. Do not open your mouth any further. Stay in this position for five seconds, then close your mouth and relax.
  • Repeat this whole procedure slowly but firmly, for the next five minutes.
  • As you open your mouth you should feel tension in the back of your neck and under your chin.
  • The first few times you perform the exercise you should do it by checking in a mirror that the teeth move vertically downwards and do not deviate to either side.
  • If the exercises are performed correctly, there will be no clicks or noises from the joints. If there is, restart the exercise and continue practicing until it is click-free.
  • Do not do this exercise more than recommended for the first week –five minutes, twice a day for a week. Thereafter, do the exercises as often as you can. This will help strengthen the ligaments around your jaw and relax the muscles that close your mouth.
  • You may find that the TMJ dysfunction dysfunction pain is worse for a while at first; this is because you are unaccustomed to the movement –over time this will subside.
  • After doing 2-3 weeks of the exercises you will find that the muscles will be retrained and your jaw will open and close smoothly without any clicking

What other things do I need to remember?

  • Never bite your fingernails
  • Never bite your lower lip
  • Avoid biting on your front teeth
  • Keep your upper and lower jaw teeth apart when at rest

What other treatments are available?

  1. Medicines – to relieve jaw pain and relax the muscle
  • Non-steroidal anti-inflammatory drugs
  • Muscle relaxants
  • Certain medicines used for depression.
  1. Devices – called “bite plates” or “occlusal splints”
  • These fit in your mouth and keep you from grinding your teeth at night.
  • They are made from either hard or soft plastic and might be made specially to fit your mouth.
  • N.B. If you have sleep apnea, be sure to tell your doctor as the splint might make your sleep apnea worse.