The temporomandibular joint is located between the temporal bone and the mandible; it connects the jawbone to the skull. Located at the sides of the head near each ear, these joints play an essential role in eating, speaking, and making facial expressions. In fact, the temporomandibular joint (TMJ) is one of the most frequently used and complex joints in the entire body.
TMJ disorder causes pain and discomfort in the jaw and head area. It can develop when one or both of the temporomandibular joints stop functioning properly. More than 10 million Americans suffer from TMJ disorder. Learn more about TMJ treatments, symptoms, and causes.
The symptoms associated with TMJ disorders will vary from person to person, depending on the unique causes of their discomfort. TMJ symptoms can include the following:
- Jaw joint pain: For those suffering from TMJ disorders, jaw joint pain is one of the most common complaints. Many patients notice a clicking, popping, or grinding sound when they chew or yawn and describe the pain they are experiencing as either dull and constant or sharp and sporadic.
- Ear pain: Many TMD sufferers do not know that their TMJ is the source of the ear pain they are experiencing, and assume instead that it must be caused by an ear infection or another inner ear problem. Radiating pain from the affected joint, nerves, or other surrounding structures may seem like it is originating from the ears.
- Headaches: Moderate to severe headaches can be caused by TMJ disorders. Improper articulation of the jaw joint can strain muscles and ligaments that attach to the skull, and even pinch nerves, causing painful headaches. Those with headache pain may also be experiencing TMJ related symptoms such as neck pain.
- Tooth pain: TMJ is most often linked to tooth pain in those patients who routinely clench or grind their teeth. The extreme pressure absorbed by the teeth and jaw joints while clenching or grinding can cause serious pain in the cheeks and damage in both areas.
There are many causes of TMJ disorders and jaw joint pain, including:
- Cartilage wear and tear: The cartilage disks that pad the TMJ become worn or displaced, causing painful grinding of the jawbone.
- Dislocated TMJ: Dislocation of the joint is indicated by popping and cracking noises when the jaw is opened or closed, and may negatively affect movement of the jaw and strain the musculature of the jaw, face, and neck.
- Clenching and grinding: Habitual clenching and grinding of the teeth places extreme pressure and strain on the joints and is one of the most common causes of TMJ disorders. The added stress on the jaw joint can cause wear and tear of the cartilage disks, and may even cause the jaw joint to become dislocated.
- Misaligned bite: If the bite of the upper and lower teeth is not aligned properly, everyday jaw movement like chewing can take a toll on the TMJ and strain the surrounding musculature.
- Arthritis: Arthritis can cause uncomfortable inflammation of the TMJ and may also result in swelling in the adjoining tissues, ligaments and muscles. Those with arthritis may experience difficulty opening and closing their mouth, as well as other painful TMJ symptoms.
Because the causes and symptoms of TMJ disorder are so varied, the condition is typically classified into three main sub-categories:
- Myofacial pain
- Internal derangement of the joint
- Inflammatory joint disease
These classifications help doctors develop more effective treatment options for sufferers of TMJ disorder, based on each patient's unique symptoms and needs. For proper diagnosis and treatment of TMJ conditions, a patient may require evaluations from multiple medical specialists. In addition to general dentists, dentists trained in neuromuscular dentistry, primary care physicians, and otolaryngologists (ear, nose, and throat specialists) are typically sought for TMJ diagnosis and care. These health care professionals can provide more information on what causes the condition, how it is treated, and other TMJ topics.
There are many treatments for TMJ disorder, including:
- Mouth Guards: Mouth guards are soft plastic protectors that slip over the upper and lower teeth to prevent grinding of the teeth. Guards make it more difficult to clench the jaws, an important first step in TMJ pain relief. Your dentist will take a mold of your upper and lower teeth to custom-fit your TMJ mouth guards for maximum comfort and efficiency.
- Jaw Exercises: TMJ exercises are designed to relax the jaw and eliminate clenching, and also to help in the correction of alignment problems. After careful analysis, your dentist may provide you with an appropriate series of very simple exercises to be performed in front of a mirror. The use of a mirror in TMJ exercises helps you see the misalignment that is one of the factors in TMJ syndrome. Gradually, the exercises will teach you control of the jaw muscles and eliminate clenching.
- Bite Therapy: A process known as TMJ therapy, or bite therapy, is used by dentists to help find the causes of TMJ syndrome and provide long-term pain relief. TMJ bite treatment begins with a careful, detailed analysis of your mouth and jaw to find the causes of your disorder. For some, the issue may be jaw clenching; this can usually be attributed to stress or simply a bad habit. For others, the teeth may not come together evenly, a condition known as malocclusion. This can cause uneven use of the jaw and result in muscle pain. Dentists have several tools at their disposal to measure bite pressure throughout the mouth and formulate a plan for dental work that will correct malocclusion and provide TMJ pain relief.
- BOTOX® Injections: BOTOX® injections can be used as an alternative treatment for TMJ. The injections relax the jaw muscle for up to four months.
- Surgery: When mouth guards and bite therapy cannot provide relief from the symptoms of TMJ, surgery might be a solution. Surgery options range from minimally invasive to open surgery. Arthrocentesis is a minimally invasive procedure that involves removing fluid from the temporomandibular joint. Arthroplasty encompasses all of the different types of open surgeries for TMJ, including disk repositioning, discectomy, and joint replacement.
Because there are several causes of TMJ disorder, the tests required to determine the cause and corresponding treatment cost for each patient's condition will vary. In addition, dental and medical insurance may be very particular as to what treatments they will cover, if any. Dental insurance often excludes those procedures that fall outside of the realm of general dentistry, including orthodontic procedures. Since medical insurers may regard some TMJ treatments as belonging to the realm of dentistry, however, they may exclude them from coverage.
The following is a general pricing guide:
- Mouth Guards: Mouth guards, or stabilization splints, will cost anywhere between $200 and $1,000
- Bite Therapy: If the position of a patient's jaw is determined to be the cause of his or her TMJ, a number of options can be used to establish an optimal bite. Since TMJ bite therapy may encompass a number of procedures, such as orthodontics or dental crowns, the cost will depend on the treatments involved. It could range from a few hundred dollars up to $10,000.
- Surgery: The cost of TMJ surgery varies dramatically according to the procedure and practitioner and can range anywhere from $300 for a minimally invasive procedure to $50,000 for a complex procedure.
- BOTOX® Injections: Depending on the doctor and the number of injections needed, TMJ treatment with BOTOX® injections ranges between $1,000 and $1,500 and may be recommended every three to four months.
If your insurance provider will not cover the cost of TMJ treatment, you may wish to ask your dentist about the financing options available. Many dentists offer payment plans that allow patients to break up the cost of treatment into smaller payments to be paid over a specified length of time. In addition to offering these plans, dentists are often affiliated with CareCredit®.
CareCredit® offers patients a line of credit up to $25,000 to help pay for dental treatments. Much like a credit card, CareCredit® makes it easier for you to get the treatment you need, when you need it, by offering convenient monthly payments. Visit the CareCredit® website or your dentist's office to find out how to apply.
Find a Dentist
TMJ syndrome is a complicated subject within the field of dentistry. The level of training and TMJ treatment experience among dentists varies considerably. DocShop can help you find a dentist in your area with the background necessary to offer a high level of skilled treatment for TMJ.