Although temporomandibular joint disorders have been recognized for more than 75 years, only recently has an agreed-upon set of official criteria been created. The temporomandibular joints—one left, one right—link the temporal bone in the lower jaw to the upper jaw, or mandible. The joint is used in opening and closing the mouth. It’s unclear what causes the pain of TMD. It is associated with whiplash, as well as with grinding teeth, arthritis, and blows to the jaw. Any of these things can move the joint out of its proper alignment in the mouth.
The disorder is most common in women in their 20s and 30s. It can cause pain, not only in the jaw, but also around the ear and face. Other symptoms include painful chewing and swallowing, an uncomfortable or uneven bite, a locking of the joint, or an audible clicking when you try to use the joint by opening or closing your mouth. TMD patients are also particularly prone to headaches, perhaps as a result of the same stress or misalignment that are the cause of the jaw pain. The same misalignment can cause trouble opening the mouth, which has an impact on the ability to speak and eat. Some people even get tinnitus, a ringing in the ears.
With the publication of evidence-based diagnostic criteria, doctors and dentists have a tool to evaluate patients whose pain may be TMD. The previous view of TMD had been the subjective consensus of professionals rather than anything that had been subjected to rigorous, and scientifically valid, testing and analysis. Health care professionals will now be better able to determine if a patient’s reported pain in fact constitutes TMJ and, if so, which of several subtypes it is. This will help in developing a treatment protocol tailored to the patient’s needs.
Most TMJ treatment starts with painkillers or muscle relaxants to address the pain. Depending on the type and cause of the disorder, modified botulinum toxin, or Botox, may be used to help with the misalignment. Physical therapy can sometimes help properly align the jaw, and mental health approaches are used in some cases, such as cognitive-behavioral therapy and medications called tricyclic antidepressants, though TMD is not necessarily a mental or psychosomatic condition. Surgery is only used to correct severe cases.