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November 22, 2009
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Temporomandibular Joint Disorder (TMJ)

Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Melissa Conrad Stöppler, MD

Viewer Comments

Featured patient discussions on temporomandibular joint disorder (TMJ disorder)

"I have suffered from problems with my TMJ since I was a child. When I was 10 years old, my mother used to complain of me "clicking my teeth" on a spoon when I ate. The trouble is, my teeth never came near the spoon. The sound she heard came from my jaw popping. My jaw now dislocates constantly. I can't eat pizza or French bread, or even sing, without it locking. I wake up several times each night having to relocate my jaw. There is no pain just a jaw that can't seem to function normally. Brux guards do nothing. In fact, the only thing that seems to keep my jaw from popping and sticking is applying pressure to the left TMJ. I have to sleep these days with a hard pillow pressing against the joint, or it pops out constantly. It's clear that something is keeping my jaw from aligning properly, but no one seems to be able to help me fix it."


Patient Discussions are not a substitute for professional medical advice, or treatment.
See the disclaimer at the bottom of the comments page.
Doctor to Patient

What is the temporomandibular joint?

The temporomandibular joint (TMJ) is the area directly in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. Within the TMJ, there are moving parts that allow the upper jaw to close on the lower jaw. This joint is a typical sliding "ball and socket" that has a disc sandwiched between it. The TMJ is used throughout the day to move the jaw, especially in biting and chewing, talking, and yawning. It is one of the most frequently used joints of the body.

The temporomandibular joints are complex and are composed of muscles, tendons, and bones. Each component contributes to the smooth operation of the TMJ. When the muscles are relaxed and balanced and both jaw joints open and close comfortably, we are able to talk, chew, or yawn without pain.

We can locate the TMJ by putting a finger on the triangular structure in front of the ear. The finger is moved just slightly forward and pressed firmly while opening the jaw. The motion felt is from the TMJ. We can also feel the joint motion if we put a little finger against the inside front part of the ear canal. These maneuvers can cause considerable discomfort to a person who is experiencing TMJ difficulty, and doctors use them for making the diagnosis.

What are TMJ disorders, and how are they caused?

TMJ disorders are a group of complex problems of the jaw joint. TMJ disorders are also sometimes referred to as myofacial pain dysfunction and Costen's syndrome. Because muscles and joints work together, a problem with either one can lead to stiffness, headaches, ear pain, bite problems (malocclusion), clicking sounds, or locked jaws. The following are behaviors or conditions that can lead to TMJ disorders.

  1. Teeth grinding and teeth clenching (bruxism) increase the wear on the cartilage lining of the TMJ. Those who grind or clench their teeth may be unaware of this behavior unless they are told by someone observing this pattern while sleeping or by a dental professional noticing telltale signs of wear and tear on the teeth. Many patients awaken in the morning with jaw or ear pain.


  2. habitual gum chewing or fingernail biting


  3. dental problems and misalignment of the teeth (malocclusion). Patients may complain that it is difficult to find a comfortable bite or that the way their teeth fit together has changed. Chewing on only one side of the jaw can lead to or be a result of TMJ problems.


  4. trauma to the jaws. Previous fractures in the jaw or facial bones can lead to TMJ disorders.


  5. Stress frequently leads to unreleased nervous energy. It is very common for people under stress to release this nervous energy by either consciously or unconsciously grinding and clenching their teeth.


  6. Occupational tasks such as holding the telephone between the head and shoulder may contribute to TMJ disorders.


Next: What are the common symptoms of TMJ disorders? »

Temporomandibular Joint Disorder (Tmj) - Symptoms Experienced

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Temporomandibular Joint Disorder (TMJ)

What is stress?

Stress may be considered as any physical, chemical, or emotional factor that causes bodily or mental unrest and that may be a factor in disease causation. Physical and chemical factors that can cause stress include trauma, infections, toxins, illnesses, and injuries of any sort. Emotional causes of stress and tension are numerous and varied. While many people associate the term "stress" with psychological stress, scientists and physicians use this term to denote any force that impairs the stability and balance of bodily functions.

If stress disrupts body balance and function, then is all stress bad? Not necessarily. A mild degree of stress and tension can sometimes be beneficial. For example, feeling mildly stressed when carrying out a project or assignment often compels us to do a good job, focus better, and work energetically.

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