TMJ pain is a common complaint that's estimated to affect almost a quarter of Australians. This pain may be experienced in the temporomandibular (TMJ) joints that connect the jaw to the skull and can spread to other areas of the jaw and face.
TMJ pain can have many possible causes and it may be temporary or part of a wider TMJ disorder (TMJD or TMD). If you think you might have TMD or another jaw problem, talk to your dentist so they can diagnose the problem and recommend suitable TMJ treatments or home remedies to relieve the pain.
How do I know if I have a TMJ disorder?
TMJ pain is distinguished from other jaw or face pain by being focused on the sides of the head, just below and in front of the ears. These are the locations of the two temporomandibular joints that allow the lower jaw to move.
Besides TMJ pain, you may have a TMJ disorder if you also have some of the following symptoms:
- pain or tenderness in your jaw, ears, face or neck, especially when eating
- difficulty chewing
- clicking, popping or grinding sounds from your jaw
- stiff or locking jaw when you try to open or close your mouth
- teeth no longer fitting together properly when your jaws are closed
Mild TMJ pain that isn't accompanied by other symptoms can sometimes go away on its own, but you should see a dentist if the pain is severe or if you have other signs of a TMJ disorder.
What causes TMJ pain?
There is no single cause of TMJ issues. The jaw joints may be damaged or strained for a number of reasons, some of the common causes being:
- wear or trauma to the jaw or joints
- jaw conditions such as osteoarthritis or rheumatoid arthritis
- teeth grinding or clenching (bruxism), which may be caused by stress or anxiety
- an uneven bite caused by an orthodontic issue or irregular teeth or dental work
- structural issues with the jaw that may be hereditary
Knowing the cause of your TMJ pain can help to guide your treatment, but it may not be possible to identify a cause in all cases. You may be at higher risk of developing a TMJ disorder if:
- you are undergoing orthodontic treatment, such as braces
- you have poor posture that strains the muscles in your neck or face
- you have poor nutrition
- you have certain medical conditions, such as fibromyalgia or gout
- you don't get enough sleep or have a sleeping disorder, such as obstructive sleep apnoea
Home remedies for TMJ pain
Unless it's a sign of damaged jaw joints or another underlying health problem, TMJ pain and discomfort doesn't always need professional treatment.
Your dentist may recommend over-the-counter painkillers or other home remedies such as applying heat or cold to the joint to help ease the pain or take the strain off your jaw while it heals. Other home care tips could include:
Changing habits
TMJ pain may be avoided or relieved in the short term by making simple changes to your everyday habits that help take the strain off your jaw and joints. These could include:
- avoiding opening your mouth wide (when eating, yawning, singing, etc.)
- not grinding your teeth or clenching your jaw
- improving a bad posture
- avoiding hard, tough, chewy and sticky foods
- cutting food into smaller pieces to reduce biting and chewing
- avoiding chewing gum
- not biting your nails, pencils or other non-food objects
- trying to avoid stress and anxiety as much as possible
Jaw exercises
Depending on the nature of your TMJ problem, your dentist, doctor or other healthcare professional may recommend gentle jaw exercises to help strengthen the jaw and joints or relaxation techniques to reduce stress and help the joints heal.
The following TMJ exercises are recommended by the American Academy of Family Physicians (AAFP) and the Royal Surrey County Hospital to help relieve TMJ pain and restore jaw function. You should talk to your dentist or doctor before beginning any exercise routine.
- Relaxed jaw – place your tongue against the roof of your mouth. Relax your jaw muscles so your teeth come apart.
- Tongue up – place your tongue against the roof of your mouth. Open and close your mouth slowly.
- Goldfish exercise – place your tongue against the roof of your mouth. With one hand, place your index finger in front of one ear (over the TMJ joint). Place the index finger of your other hand on your chin. Let your jaw drop open and then push it closed. Repeat 6 times for one set and aim to do 6 sets per day (depending on your doctor's recommendation).
- Chin tuck – create a double chin by raising your chest and drawing your chin into your neck. Hold for 3 seconds and repeat the exercise 10 times.
- Resisted opening – place one thumb under your chin and push gently upwards as you open your mouth. Hold for 3 to 6 seconds, then slowly close your mouth.
- Resisted closing – hold your chin between the index fingers and thumbs of both hands. Gently squeeze your chin as you slowly close your mouth.
- Side to side movement – place a tongue depressor or similar sized object between your front teeth. Slowly shift your jaw from side to side.
- Forward movement – place a tongue depressor or similar sized object between your front teeth. Slowly shift your bottom jaw forwards.
Treatment for TMJ disorders
If home remedies alone are not enough to stop TMJ pain, your condition may need intervention. Talk to a doctor or dentist so they can examine your jaw and joints to determine the problem and discuss appropriate treatment options.
This will usually involve a physical examination to assess your pain points and range of motion and taking images such as x-rays or a CT or MRI scan to get a more detailed image of the joints for treatment planning.
Depending on your condition and preferences, TMJ treatment options may include:
Medication
Over-the-counter painkillers or anti-inflammatory medications may be recommended temporarily to help relieve TMJ pain and swelling in the jaw while other treatment is ongoing. If your TMJ pain is more severe, your doctor may prescribe stronger pain relief on a limited basis.
Some doctors may prescribe muscle relaxant medication or tricyclic antidepressants that may help to reduce teeth grinding, but these are not always effective and you should be aware of the side effects.
Therapies
You may be referred to a physical therapist who can guide you in jaw exercises or provide therapies involving ultrasound or other techniques.
Counselling services could help you to manage and reduce stress and anxiety and avoid related behaviours such as teeth grinding or jaw clenching.
Dental treatments
Dental or orthodontic treatments can be effective at relieving TMJ pain that has a physical cause related to the teeth, such as an uneven bite or bruxism. These treatments can include:
- Bite splint or night guard worn over the teeth at night to prevent teeth from grinding or clenching together. This may be a temporary or long-term solution for TMJD symptoms.
- Orthodontic treatment using braces or aligners to straighten the teeth and jaws and relieve pressure on the jaw joints. Teeth straightening is a long-term treatment that can take up to several years.
- Dental crowns, veneers or other restorations to cover worn, damaged or misshapen teeth and create a more regular biting surface.
Medical treatments
If other TMJ treatments have not been effective, your doctor may recommend jaw surgery or other medical treatments as a last resort, but this is rare. Their suggestions may include:
- Arthrocentesis, the draining of fluids or debris from the TMJ joints that may be causing inflammation or obstructing movement.
- Arthroscopy (closed-joint) or open-joint surgery to repair or replace the TMJ joint or surrounding structures.
- Injections used for anti-wrinkle treatments may help to relieve TMJ pain when injected into the joint, though research is still ongoing in this area.
Medical procedures to treat TMJ symptoms involve clinical risks and can sometimes make symptoms worse. Your doctor will make sure you understand the possible benefits and risks and that you know what the alternatives are.
Preventing TMJ pain
If you think you may be at risk of a TMJ disorder, or you want to avoid a problem returning, you can lower your risk factor for TMJ pain by:
- not overstretching your jaw
- chewing on both sides of your mouth
- eating soft foods
- maintaining good oral hygiene to prevent problems such as worn, damaged or missing teeth
TMJ treatment in Sydney CBD
If you have pain in your jaw, in front of your ears or other possible signs of a TMJ disorder, our dentists at Sydney CBD Dental can help.
Our dentists have extensive experience helping people of all ages with TMJ disorders and we can discuss the most suitable treatments or home remedies for your case to help ease the pain and restore your normal jaw function.
To book an appointment or find out more, call our team on (02) 9232 3900 or contact us today.
References
Healthdirect. Temporomandibular joint disorder [Online] 2019 [Accessed December 2021] Available from: https://www.healthdirect.gov.au/temporomandibular-joint-disorder
Lung J, Bell L, Heslop M, Cuming S, Ariyawardana A. Prevalence of temporomandibular disorders among a cohort of university undergraduates in Australia. J Investig Clin Dent. 2018 Aug;9(3):e12341. doi: 10.1111/jicd.12341. Epub 2018 Mar 31. PMID: 29604182.