Temporomandibular disorder (TMD) is a problem affecting the muscles used to chew and the joints between the lower jaw and the base of the skull. It is sometimes referred to as “myofascial pain disorder”. You may initially see your GP, however dentistry can be very effective at treating the disorder. It’s been estimated that up to 30% of adults will experience TMD at some point in their lives.

The condition itself isn’t usually serious. However, these symptoms can significantly lower your quality of life and confidence.

Typical treatment length

4 to 6 months

What are the symptoms?

Consultation

You may be very aware of the noise that your jaw is making or have become very self-conscious when eating or talking. TMD may be also disturbing your sleep, which can have a significant effect on you.

What to look for

• Your jaw clicks, pops or grates as you chew or move your mouth
• An achy muscle pain around the jaw
• Pain in front of the ear that may spread to the cheek, ear and temple
• Difficulty opening the mouth
• Frequent headaches or even migraines
• A “buzzing” or blocked sensation in the ear
• Discomfort and tension in your neck or back

Possible causes

• Grinding your teeth or clenching your jaw when asleep
• An uneven bite as teeth move or after a new filling, crown or denture
• Increased stress can cause an increased sensitivity to pain
• General wear and tear of the inside of the jaw joint
• A trauma or injury to the jaw joint by sport or surgery
• Rheumatoid arthritis, gout or fibromyalgia can cause pain
• There may be no obvious cause

Treatment

If you think you have TMD, see your GP or dentist first for diagnosis and to discuss treatment options.

Generally, non-surgical treatments such as lifestyle changes and self-help physiotherapy-type treatments are tried first. A small number of people with severe TMD may be referred to an oral and maxillofacial surgeon to discuss further treatment options, which may include:

• Resting the joint by eating soft food and avoiding chewing gum
• Hold a warm or cold flannel to the jaw for 10-20 minutes, several times a day
• Doing a few gentle jaw-stretching exercises
• Avoiding opening the joint too wide until the pain settles
• Avoiding clenching the teeth for long periods of time
• Massaging the muscles around the joint
• Relaxation techniques to relieve stress
• Not resting your chin on your hand
• Made to measure mouth guard (plastic device that fits over your teeth) to guard against grinding or clenching
• Prescribed painkillers such as paracetamol, ibuprofen or codeine can help relieve the pain
• Steroid injections which can help reduce arthritis related pain and swelling in the jaw joint and the surrounding muscles
• If the above measures don’t help and the source of your symptoms is the temporomandibular joint, rather than muscular, your dentist may suggest surgical treatment