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Section Questions and Answers

The Temporomandibular Joint ( TMJ )

"Acute and chronic pain can affect the oral-facial region, particularly in and around the temporomandibular joint"
"Oral facial pain is associated with sleep deprivation, depression and multiple adverse social outcomes." - U.S. Surgeon General's Report

  1. What is a joint?
  2. What are the Temporomandibular Joints (TMJ)?
  3. What is meant by the term "TMJ"?
  4. How will I know if I have a jaw joint problem?
  5. I hear snapping, clicking and popping in my ear. Is this a jaw joint problem?
  6. What causes jaw joint problems?
  7. How are jaw joint problems diagnosed?
  8. How are these joint problems treated?
  9. Can dental procedures damage the jaw joints?
  10. Is surgery ever a treatment option?

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1. What is a joint?

  • A joint is the area where two bones meet to allow movement of one or both bones. Examples are the hip and knee joints.

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2. What are the Temporomandibular Joints (TMJ)?

  • The temporomandibular joints are the two jaw joints, one at each side of the face.
    • Movement of the lower jaw is made possible by this joint.
    • The lower jaw is called the mandible or mandibular bone.
    • The upper jaw is called the maxilla and is joined to the temporal bone.
    • The term "temporomandibular" refers to the connection between the temporal and mandibular bones.
    • Chewing and speech would not be possible without this joint.

Click to enlarge
Jaw joint (TMJ)
  • The TMJ is a variation of a hinge joint. It is technically called a sliding hinge joint. This allows the jaw to be flexible and move in a number of directions:
    • The lower jaw moves up and down when the mouth is opened and closed.
    • When we chew food and speak the jaw movements can be forward, backward, sideways or circular.
    • In young children the jaw only moves up and down like a regular hinge.
      The flexibility and other movements develop with the arrival of the permanent teeth.

Click to enlarge
Jaw open
Click to enlarge
Jaw closed

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3. What is meant by the term "TMJ"?

  • When people refer to "TMJ", they usually mean that they have a TM Joint disorder, or a jaw joint problem.

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4. How will I know if I have a jaw joint problem?

  • The most common signs are:
    • Pain in the joint area, at the front of the ear.
    • Pain on biting into apples, carrots and any firm food.
    • Difficulty with opening the mouth, due to limitation of jaw movement.
    • Clicking and grating sounds in the joints.
    • Headache.

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5. I hear snapping, clicking and popping in my ear. Is this a joint problem?

  • Yes, it could be a joint problem.
    • There is a disc which is attached to the head or end of the lower jawbone in the joint.
    • This disk moves with the bony part it is attached to.
    • When the normal function of the disk and joint is impaired, sounds or noises may be heard.
    • The disc can become damaged by injury or disease.

Click to enlarge
T.M. Joint

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6. What causes jaw joint problems?

  • Many factors, some of which are not clearly understood, are believed to be associated with jaw joint problems. Some of the causes are:
    • Emotional stress.
    • Bruxism which is an involuntary habit of clenching and grinding of the teeth.
    • Joint degeneration in diseases such as arthritis.
    • Whiplash injury caused by accidents.
    • The way teeth come together during chewing, or abnormal jaw structure, may be the cause.
    • The professional terms for these last two conditions are occlusion and maloclusion.

See Bruxism

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7. How are jaw joint problems diagnosed?

  • The dentist or specialist will try to find the reason for the joint disorder:
    • The examination will include the joints and the muscles of the face, neck and mouth.
    • Special x-rays, CT scans or MRI examinations of the jaw joints will be made.
    • Your general physical health will be investigated, as the joint problem may be part of a wider condition.

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8. How are these joint problems treated?

  • The treatment depends on the cause of the problem.
    Emotional stress, arthritis, or other disease may have to be considered as causing the symptoms.
    If no cause can be discovered, the symptoms are treated by:
    • Physiotherapy.
    • Pain relievers.
    • Anti-inflammatory medication.
    • Moist heat application.
    • If bruxism is the cause, a specially made acrylic bite plate is placed over the teeth.
    • Relaxation therapy can also be helpful in treating the bruxism.
    • Appliances can be made to lessen the load on the jaws, and to change their position.

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9. Can dental procedures damage the jaw joints?

  • Improved orthodontics and dental restoration techniques make this very unlikely.

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10. Is surgery ever a treatment option?

  • Surgery is a seldom used, but it can be a last resort.
    There are, however, some instances where surgery may be necessary.

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