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TMJ management

What is TMJ?

The TMJ is also called the temporomandibular joint. It connects the jawbone to the skull and is present on either side of the jaw. It allows the jaw to have a smooth movement in both vertical and horizontal directions, thus allowing for actions like talking, chewing and yawning.

The sliding motions of the TMJ are mingled with a hinge action. The joint has a combination of bones laced with cartilage, which are separated by a small disk to absorb the shock.

What is TMJ Disorder?

This consists of the different issues that come up at the TMJ that can, in turn, affect the jaws and muscles that control them. Some of the causes for these disorders are:

  • Erosion of the disk and misalignment from its correct position.
  • Cartilage Damage caused by arthritis.
  • Trauma induced bone damage, even from neck strain or stress.
  • Clenching or grinding of teeth excessively exerts pressure on TMJ
  • Inheriting TMJ disorder vulnerability from parents.


Some of the symptoms usually seen in TMJ disorder patients are:

  • Pain and tenderness of the jaw.
  • Pain in either one or both the joints.
  • Aching pain around the ear.
  • Food chewing becomes painful.
  • Patients might have pain in their faces
  • Locking of the jaw causes difficulty in opening or closing of the mouth.
  • Some patients hear a clicking sound or feel a grating sensation when they open their mouths.
  • The face might have a mild swelling.


The Dentist will perform a physical evaluation of the patient and some of the physical examinations performed are:

  • Any clicking or grating sounds while opening or closing the mouth.
  • Evaluate the range of motion of the jaw.
  • Feel the face joints for any pain or tenderness.
  • Patient’s bite is examined for any facial muscle problems.

Diagnosis of TMJ disorder is confirmed by performing the following tests:

  • X-rays: For a clear image of the jawbones and teeth, eliminating the possibility of fractures.
  • Magnetic Resonance Imaging (MRI): For displaying the TMJ disk during the jaw movement, also helping in checking for any misalignment issues.
  • Computer Tomography (CT) scan: For getting the bone details in the joint.

TMJ Management

TMJ disorders are usually managed using any of the three types of treatments:

  • Medications: The following medications are usually recommended by the dentist to relieve the jaw pain.
    • Pain relievers and Anti-inflammatories
    • Tricyclic Antidepressants
    • Muscle Relaxants
  • Therapies: Therapies usually recommended by dentists are:
    • Mouth guards or oral splints are inserted over the teeth to relieve the pain.
    • Some physical therapies like ultrasounds, relaxation techniques, heat or ice pack usage, have been used to relieve the pain.
    • Eating soft foods.
    • Avoiding jaw movements and resting chin on the hand
    • Replacing Missing Teeth.
    • Use of Crowns, Bridges and braces to correct bite issues and balancing teeth bite surfaces.
  • Surgeries: The dentists or dental surgeons usually recommend surgeries if other treatment options are not effective and the issues. The surgeries usually recommended for TMJ management are:
  • Arthrocentesis: This minor surgery is performed for locked jaws. In this procedure, general anaesthesia is administered on the patient and then the joints are washed using needles. They also use specialized instruments to perform the following:
    • Remove damaged tissue
    • Disk stuck in the joint is disentangled
    • Unlock the joint
  • Arthroscopy: A tiny camera attached to a thin tube is inserted through a tiny incision near the ear. The camera will help the dentist to view the injured area and help confirm the diagnosis. The surgeon will then insert tiny surgical instruments through this incision and then guide them to the injured area using the camera to remove the damaged tissue or realign the disk or joint.

Authored by DR.NIRANJAN P



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