TMJ Disorders

The temporo-mandibular joint (TMJ) is the joint located between the skull and the top of the jaw - it allows your mouth to open and close. The joint has an upper and lower compartment, and a cartilage disc which permits a wide range of movement.

Temporo-mandibular dysfunction (TMD) occurs when you experience pain, clicking or locking of one or both joints, or pain in the muscles that move the jaw. TMJ disorders can be particularly debilitating.

TMD can occur due to:

  • Anatomical derangement (abnormality) within the joint itself

  • Wear and tear of one or both joints

  • Over-closure of the jaws due to loss of teeth (especially posterior support)

  • Rheumatological conditions which cause joint inflammation or destruction

  • Previous trauma

  • Clenching and grinding (parafunction), which stresses the muscles or causes damage to joint structures

TMD is often multi-factorial, and life stressors can potentially play a significant role in exacerbation of symptoms.

How is TMJD managed?

In the first instance, your surgeon will undertake a full examination and history, to understand the nature of your problem and any contributing factors.

Further investigations such as blood tests and imaging (MRI etc) may be required.

The treatment of TMJD may involve the following strategies:

Tier 1/conservative strategies:

  • Regular pain relief

  • Dietary modification

  • Physiotherapy

  • Self-massage and heat or cold-pack application

  • Dental splint

  • Relaxation or cognitive behavioural therapy

Arthrocentesis (joint washout +/- injection):

Aimed at flushing out inflammatory mediators, increasing joint mobility, and placing medication which may relieve pain and inflammation, or enable the joint to function better

Botox injection:

Botox is a muscular paralytic agent, used to reduce the tension within muscles that act on the jaw and around the jaw joint

Jaw joint replacement:

This option is generally reserved for end-stage joint dysfunction only.

Your surgeon will discuss with you, the relevant treatment options applicable to your circumstances. In many cases it is reasonable to trial a tier 1 treatment regime initially, and most patients experience significant improvement with a number of simple strategies employed in combination.