TMJ Disorders and Bruxism

The temporomandibular joint (TMJ) is the joint that connects the lower jaw (mandible) to the side of your head in front of your ear. This joint moves up and down, in and out and side to side. Muscles surround this joint and coordinate all jaw movements including talking, chewing and yawning. This joint is special due to the need to have a high amount of flexibility in order to bite and chew effectively.  Within this joint is a soft disc that serves as a shock absorber just as the cartilage(meniscus) in your knee does.

Any problem with this joint that involves the muscles or the joint itself can cause a TMJ disorder. The joint itself may be damaged from trauma or arthritis. Most problems are minor and improve with time. One or both joints may be involved.

The most common symptoms include pain in the area of the joint extending down the jawbone, into the neck or up the face. There may be jaw stiffness or limited range of motion of the jaw. Some jaw “locking” may be felt. At times painful clicking, popping or grating may be evident.  Minor jaw sounds without pain or limited jaw movement is usually normal. Many people have sleep bruxism (clenching, bracing, gnashing or grinding movements of the teeth while asleep) without any TMJ complaints. Similar movements can also occur while awake and this is called awake bruxism.

If you have this type of problem simple strategies to allow your jaw time to heal include limiting forceful chewing by avoiding hard foods that require chewing and avoiding extreme mouth opening such as yawning and loud singing or yelling. The use of ice and jaw muscle relaxation strategies can also help.  Sometimes a stabilizing splint called a bite guard is prescribed. This should only be used under supervision of your doctor or dentist since it may alter your bite pattern and exacerbate TMJ problems.  The best treatments are time and patience.

It is well known many people who have recurrent headaches also have a TMJ Disorder.  In these situations each of the disorders need to be assessed individually in terms of causation and treatment.  A thorough evaluation will help determine if headache pain is due to the TMJ Disorder.