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By Diane Griffith, HealthAtoZ writer
You get out of bed. You yawn. You hear a loud crack and you feel your jaw pop - and for the next few hours you can't open your mouth or chew without feeling pain.
Sound familiar? Ten million Americans are plagued by this condition - known as TMJ syndrome or just "TMJ."
The temporomandibular joint (TMJ) connects the lower jaw bone to the skull. You have one of these joints in front of each ear. They allow your jaw to move in all directions so you can chew, swallow, talk and make facial expressions.
Who gets TMJ?
Anyone can get TMJ, but 90 percent of those who seek treatment are women in their childbearing years.
Symptoms
The most common symptom is jaw, ear or face pain. Some people have no pain, but still have trouble with jaw movement.
Other TMJ symptoms:
- Facial swelling
- Headache
- Discomfort when biting down
- Locking of jaw
- Clicking or popping sound in the jaw
- Pain or ringing in ears
- Dizziness
- Pain in neck, shoulder and back
Possible causes
The cause of TMJ is unknown. There are many suspected causes, but no evidence to support them. These include:
- Trauma to head or neck, such as whiplash
- Disease, such as osteoarthritis or cancer
- Tongue thrusting
- Mouth breathing
- Wide yawning
- Nail, lip or cheek biting
- Cradling telephone on shoulder
- Carrying heavy shoulder bags
- Playing a woodwind instrument or violin
- Talking or singing excessively
- Hunching forward when reading or working
- Having had a breathing tube placed
- Wisdom teeth removal
- Lengthy dental procedures
- Malocclusion ("bad bite")
- Teeth grinding
- Stress
Diagnosing TMJ
There is no test to diagnose TMJ. Your physician will examine the area as you bite down. If this causes pain, you'll have tests performed to rule out other conditions, including ear and sinus infections. If those possibilities are eliminated, your doctor may diagnose TMJ. Your dentist might also be involved in making this diagnosis.
Treatment
Fortunately, TMJ pain is usually short-lived and disappears on its own. If you have pain, try the following home treatments:
- Eat soft foods
- Apply ice or heat
- Avoid extreme jaw movements, like yawning
- Don't chew gum
If these treatments don't work, call your doctor, who may recommend:
- Over-the-counter pain medication
- A biteplate or nightguard from your dentist if you grind your teeth
- Jaw stretching and relaxation exercises
- Prescription medication
Severe pain
If you still have severe pain after trying these measures, talk to your doctor.
Other treatment
There's no evidence that invasive treatments work. They may even make the problem worse. Such treatments include:
- Adjusting the bite by grinding down teeth
- Inserting splints that reposition the jaw, ligaments and muscles
- Crown and bridge work to balance the bite
- Orthodontic procedures
- Surgery
- Replacement of jaw joints
Insurance
It's wise to check for insurance coverage on any procedures suggested. In general, insurance companies don't cover treatments that involve questionable outcomes.
Making a treatment decision
There is no scientific explanation for TMJ at this time. Patients are often treated based on their doctors' beliefs about TMJ, then need to be re-seen for problems caused by inappropriate treatment.
Because of the lack of information regarding TMJ, much research is focused on finding helpful treatments for TMJ disorders. You may wonder what type of doctor to see about your TMJ. The TMJ Association recommends that you see your family physician to discuss this problem, and receive several independent opinions before you commit to a treatment plan.
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External Sources
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The National Institute of Dental and Craniofacial Research
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The TMJ Association
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This article was reviewed and updated June 2007.
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