About TMJ Disorders - Basic Overview
The Basics of The Jaw Joint
Temporomandibular Joint and Muscle Disorders
Temporomandibular Joint and Muscle Disorders (TMJDs), commonly called TMJ, are a collection of poorly understood conditions characterized by pain in the jaw and surrounding tissues and limitations in jaw movements. Injury and conditions that routinely affect other joints in the body, such as arthritis, also affect the temporomandibular joint. People diagnosed with TMJDs may be experiencing other symptoms and medical conditions as part of a broad multi-systems illnesses that go unrecognized.
Who is Affected by TMJDs?
Approximately 35 million people in the United States suffer from TMJ problems. While both men and women experience TMJ problems, the majority of those seeking treatment are women in their childbearing years.
Symptoms of TMJDs
Pain is the most common symptom of TMJD. TMJ pain is often described as a dull ache in the jaw joint and nearby areas, including the ear, which comes and goes. Some people, however, report no pain, but still have problems using their jaws.
Other symptoms can include:
- pain in the neck and shoulders
- migraine and/or chronic headache
- jaw muscle stiffness
- limited movement or locking of the jaw
- painful clicking, popping or grating in the jaw joint when opening or closing the mouth
- a change in the way the upper and lower teeth fit together or a bite that feels "off'
- ringing in the ears
- ear pain
- decreased hearing
- dizziness and vision problems
NOTE: Jaw noises unaccompanied by pain or decreased mobility do not mean you have a TMJ problem.
Keep in mind that occasional discomfort in the jaw joint or chewing muscles is common, and is not always a cause for concern. Certain TMJD sufferers get better without treatment. Often the problem goes away on its own in several weeks to months. However, if the pain is severe and lasts more than a few weeks, see your healthcare provider.
Diagnosis of your TMJD
Diagnosing TMJDs can be difficult and confusing. Presently, there is no widely accepted, standard test to correctly identify all TMJ conditions. In most cases a complete evaluation, including a detailed medical history, the patient’s description of symptoms, and physical examination of the head, neck, face and jaw provide information useful for making a diagnosis.
Most current tests are intended to rule out other possible medical conditions. A diagnosis of TMJDs may be made only after every other possibility has been considered and eliminated. (For example, facial pain can be a symptom of many conditions: sinus/ear infections, various types of headaches, facial neuralgias (nerve-related facial pain), tooth decay, and even tumors.)
Many TMJ patients see multiple healthcare providers in their search for answers.
This list includes: primary care physicians, dentists, sleep specialists, ear, nose and throat specialists, neurologists, endocrinologists, rheumatologists, pain specialists and chiropractors.
NOTE: Before undergoing costly diagnostic tests, get an independent opinion from another healthcare provider not associated with your current provider.
Can TMJDs be Prevented?
Patients who are told they should undergo treatment(s) to prevent the development of a TMJ problem should know that there is currently no evidence that such conditions can be prevented.
Causes
Not all causes are known. Potential causes or contributing factors are:
- injuries to the jaw area
- various forms of arthritis
- dental procedures
- genetic predisposition
- hormonal influence
- low-level infections
- auto-immune diseases
- stretching of the jaw as occurs with inserting a breathing tube before surgery
- clenching or grinding of the teeth.
Progression of TMJDs
Most people with TMJ problems have relatively mild or periodic symptoms. Some TMJ problems improve on their own, without treatment, within weeks or months with simple home therapy.
For others, symptoms worsen over time and develop into long-term, persistent and debilitating pain.
Treatment of Your TMJD
Because most common jaw joint and muscle problems are temporary, lasting only weeks or months, simple care is all that is usually needed to relieve the discomfort. Self-care practices, for example, eating soft foods, applying ice or moist heat, and avoiding extreme jaw movements (such as wide yawning, loud singing, and gum chewing) are useful in easing symptoms.
Unfortunately, current TMJ treatments are based largely on beliefs that are not grounded in thorough scientific research. As a result, some patients are made worse by these treatments.
Insurance Coverage
Many medical and dental insurance plans do not pay for treatment of jaw joint and muscle disorders, or only pay for some procedures. Until the causes of the various TMJ diseases and disorders have been discovered, and quality science demonstrates that treatments are effective without causing harm, insurance companies will not recognize treatments that have questionable outcomes. Contact your insurance company to see which treatments are covered.
Costs
There are no standardized costs for TMJ treatments.