Temporomandibular joint (TMJ) dysfunction

Information about Temporomandibular joint (TMJ) dysfunction and your treatment with Bristol Dental School.

The temporomandibular joint is the name for your jaw joint. Temporomandibular joint (TMJ) dysfunction relates to any abnormal jaw muscle/joint movement that leads to jaw fatigue or overloading. TMJ dysfunction can cause symptoms such as jaw pain, limited jaw movement and clicking of the jaw joints. 
 
TMJ dysfunction is a common problem. It is more common in individuals that “clench” of “grind” their teeth during the day or in their sleep, who suffer from stress, who may have experienced trauma to the jaw or experience generalised joint/muscle conditions affecting the rest of the body. However, TMD can also affect patients who have had no previous problems with their jaw. 
 

TMJ dysfunction is often self-limiting, which means it resolves on its own after time. A small number of patients may need treatment for TMJ dysfunction. 

Symptoms

If you have TMJ dysfunction you may notice one/all of the following: 

  • Clicking of the jaw joints 
  • Pain in the jaw joints or face muscles especially with movement/chewing. Pain can also spread to the ear, neck or head. 
  • Limited or painful jaw movements. 
  • An inability to open your mouth wide. 
  • Headaches. 

Clicking is typical of TMJ dysfunction and does not suggest that your TMJ dysfunction is serious or will get worse. 

Very rarely, you may need to have an X-ray to help diagnose the cause of TMJ dysfunction.  

Diagnosis

TMJ dysfunction is most commonly diagnosed through a discussion and examination with a dentist. You will be asked specific questions about your jaw symptoms.  

Clinical examination will involve feeling the jaw joints and facial muscles, as well as looking at how the jaw is functioning. Inside of your mouth and your teeth will also be checked.

Treatment

For most patients, the following treatment successfully improves their TMJ dysfunction:   

  • Identifying habits (e.g. clenching, grinding, chewing gum, biting nails) andeliminating them 
  • Using splints (custom made plasticmouth guards) to wear at certain times of the day or night. Splints reduce the ability of the jaw muscles to clench as strongly. These are only recommended in certain cases. 
  • Jaw exercises – you will be shown some physio exercises to repeat at home which can help reduce the symptoms of TMJ dysfunction. 
  • Avoiding foods that are hard to chew. 
  • Massaging muscles of the face. 

What happens following TMJ Dysfunction Treatment? 

Improvements in TMJ dysfunction may take time, often several months. However, symptoms can be ongoing and may return when you feel stressed or resume associated habits (for example clenching in your sleep). If symptoms return, patients are often advised to use the same treatment strategies that helped alleviate symptoms in previous episodes. 

In a small number of patients’initial treatment options might not work. If symptoms worsen or do not resolve in 6 months, further treatment may be required which may include: 

  • Painkillers to help manage severe pain. 
  • More complex splint therapy (using different designs of custom mouth guards). 
  • Botox injections in the jaw muscles - this is only suitable in a small number of cases. 

It is important to tell your dentist if TMJ dysfunction means: 

  • You cannot eat a regular diet 
  • You dislocate your jaw often 
  • Your ability to open your mouth/move your jaw has suddenly changed 
  • There have been changes in your bite / the way your teeth meet feels different

What happens after treatment is finished

To check that you and your dental professional are happy with the outcome of your treatment, you will be reviewed after your treatment is finished.  

When all of your dental treatment is complete, you will be discharged from the dental school. We advise that you find a dentist outside the dental school to continue to look after your teeth and restorations. 

Maintaining good oral hygiene at home

Maintaining good oral hygiene is crucial for healthy teeth and gums, and will help reduce the risk of decay and gum disease. Brush your teeth twice daily for 2 minutes with fluoride toothpaste and clean between your teeth with floss or interdental brushes. 

Smoking and alcohol increase the risk of oral disease. If you want to quit smoking or reduce your alcohol intake, please talk to the clinician you see for further advice. 

It is important to attend dental check-ups regularly, as this will help your dentist to identify any dental disease early.