Temporomandibular disorder (TMD) is a painful condition in the joint that opens and closes the mouth. These temporomandibular joints are the small joints in front of each ear. They attach the lower jaw (mandible) to the skull. The disorder may affect the jaw joint or the muscles surrounding it.
The Temporomandibular Joint
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The exact cause of TMD syndrome is often unclear. Possible causes include:
Factors that increase your chance of TMD include:
The doctor will ask about your symptoms and medical history. A physical exam will be done. The physical exam may include:
Other tests may include:
Treatment may include:
The most commonly used medicines include:
Some medication may be injected into the jaw such as:
To help reduce pain and allow muscles to relax:
Some may benefit from counseling to learn stress management and relaxation techniques, such as:
A splint or mouth guard can be made to relax your jaw muscles. This will prevent clenching and grinding of your teeth. The guard is usually worn at night. Correction of bite abnormalities by a dentist or orthodontist is sometimes needed.
Surgical correction is a last resort. Many of the available procedures have not been well-studied for their effectiveness.
There are no guidelines for preventing TMD. If you have TMD, the following may help prevent symptoms:
Canadian Dental Association
Canadian Society of Otolaryngology—Head & Neck Surgery
Borodic GE, Acquadro MA. The use of botulinum toxin for the treatment of chronic facial pain. J Pain. 2002;3(1):21-27.
DynaMed Editorial Team. Temporomandibular joint (TMJ) dysfunction . EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated March 8, 2011. Accessed March 10, 2011
Haley DP, Schiffman EL, Lindgren BR, Anderson Q, Andreasen K. The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain. J Am Dent Assoc. 2001;132(4):476-481.
National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov. Accessed July 7, 2009.
DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Turner JA, Mancl L, Aaron LA. Short- and long-term efficacy of brief cognitive-behavioral therapy for patients with chronic temporomandibular disorder pain: a randomized, controlled trial Pain. 2006;121(3):171-172.
Last reviewed September 2012 by Peter Lucas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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