In recognition of National Temporomandibular Joint (TMJ) Awareness Month, Dr. Seema Kurup, associate professor and division chair of Oral Medicine and Orofacial Pain at the UConn School of Dental Medicine answers the most frequently asked questions about TMJ and temporomandibular disorders (TMD).

What makes up the TMJ, or temporomandibular joint?

The temporomandibular joints are the two joints that connects the jawbone (mandible) to the skull and is located in front of each ear. This complex joint along with muscles, ligaments, and disc (soft tissue in the joint space) allow the jaw to move smoothly for talking, chewing, and other jaw movements.

What are temporomandibular disorders, or TMD?

Temporomandibular disorders are a group of more than 30 conditions that cause pain and dysfunction in the jaw joint and the surrounding muscles that control jaw movement. “TMDs” refers to the disorders and “TMJ” refer to the temporomandibular joint itself.

What are the most common symptoms of TMD?

Common symptoms of TMD include:

• Joint pain or tenderness
• Difficulty or pain when chewing. Sometimes, bite changes.
• Clicking, popping or grating sounds in the jaw
• Limited jaw movement or locking
• Pain in and/or around the neck, head or face
• Ringing, feeling of “fullness or pressure” in the ears

What are the main causes of TMD?

TMD can develop from a wide range of factors that manifest in unique ways for each individual. Because these factors often interact and reinforce each other, it’s challenging to isolate a single root cause.

Some of these contributing factors are:

• Physical or pathological: Injury to the jaw or face, arthritis, joint degeneration, inflammation and rarely malignancy.
• Behavioral: Habits-like teeth grinding (bruxism), jaw clenching, or poor posture put additional pressure on the joint.
• Psychological and sleep related: Stress and anxiety can lead to muscle tension, especially in the jaw and neck, exacerbating symptoms.
• Anatomical variations: Developmental disorders of the joint or bite alignments that make them more susceptible to TMD.

Is there any way to prevent TMD?

While there’s no guaranteed way to prevent TMD, being aware of contributing factors, habits, and health conditions can help reduce your risk. Here are some tips:

• Avoid overusing the jaw: Take it easy with hard, chewy foods, and limit gum chewing.
• Reduce stress: Practice relaxation techniques to avoid clenching or grinding.
• Maintain good posture: Good posture helps relieve strain on the neck and jaw.
• Consider a mouthguard: A custom-made mouthguard can protect against nighttime grinding.
• Prioritize quality sleep: Use good sleep hygiene to improve sleep quality.
• Be mindful at the dentist: Take breaks if your mouth is open for long periods, and let your dentist know if you hear any joint sounds.

 What are the most effective treatment options?

Treatment options for TMD may vary based on the severity of the condition and include:

• Self-care practices (soft diet, jaw exercises, warm or cold compresses)
• Medications (NSAIDS, anti-inflammatories, muscle relaxants)
• Physical therapy
• Diaphragmatic breathing, yoga, medication and/or mindfulness
• Mouthguards for bruxism, other occlusal appliances
• Injections for trigger points, Botox
• Surgery (in severe cases where other treatments have failed)

Whom should someone with TMD see for diagnosis and treatment? Are there TMD specialists?

For TMD diagnosis and treatment, it’s best to see orofacial pain (OFP) specialists who are dentists with advanced training in managing TMD and other conditions involving jaws, face and head pain. For severe cases that require surgical intervention as a last resort, an oral surgeon may be involved. If TMD is related to systemic causes such as arthritis, nerve problems and/or other chronic pain conditions, the orofacial pain specialist typically works with a rheumatologist, neurologist or pain management physicians.