Temporomandibular Disorders

What are temporomandibular disorders (TMDs)?

From: MedlinePlus, National Library of Medicine

Temporomandibular disorders (TMDs) are a group of more than 30 conditions that affect your temporomandibular joints (TMJs). You have two TMJs; one on each side of your jaw. They connect your lower jaw to your skull.

TMDs can cause problems in your jaw joint and your muscles that control jaw movement. These problems can include pain, stiffness, and trouble chewing.

There are three main types of TMDs:

• Disorders of your jaw joints
• Disorders of the muscles you use for chewing
• Headaches from a TMD

Many TMDs last only a short time and go away on their own. However, in some cases they can become chronic (long lasting)

What causes temporomandibular disorders (TMDs)?

From: MedlinePlus, National Library of Medicine

Sometimes an injury to the jaw or TMJ can cause a TMD. But in most cases, the cause is not known.

Research suggests that certain factors may play a role in why a TMD starts and whether it will be long lasting:

• Genetics
• Psychological and life stressors
• How someone perceives pain

Who is more likely to develop a temporomandibular disorder (TMD)?

From: MedlinePlus, National Library of Medicine

Anyone can develop a TMD, but it is more common in women than in men. It is most common in women between 35 and 44 years old.

What are the symptoms of temporomandibular disorders (TMDs)?

From: MedlinePlus, National Library of Medicine

The symptoms of TMDs may include:

• Pain in the chewing muscles and/or jaw joint. This is the most common symptom.
• Pain that spreads to the face or neck.
• Jaw stiffness.
• Limited movement or locking of the jaw.
• Painful clicking or popping in your jaw joint when you open or close your mouth. However, clicking or popping without pain is common and is not a sign of a TMD.
• Tinnitus (ringing in the ears), hearing loss, or dizziness.
• A change in the way the upper and lower teeth fit together.

How are temporomandibular disorders (TMDs) diagnosed?

From: MedlinePlus, National Library of Medicine

There is no standard test used to diagnose TMDs, and some other conditions can cause some similar symptoms. This can make TMDs hard to diagnose.

To find out if you have a TMD, your health care provider or dentist:

• Will take a detailed medical history, which includes asking about your symptoms. They will want to know: Where the pain is When you have it What makes it better or worse If it stays in one area or spreads to other parts of your body If you have any other pain conditions such as headache or back pain
• Will examine your head, neck, face, and jaw for: Tenderness Jaw clicking or popping Problems moving your jaw
• May order imaging studies such as an x-ray, MRI, or CT

What are the treatments for temporomandibular disorders (TMDs)?

From: MedlinePlus, National Library of Medicine

For many people, the symptoms of TMD are temporary. To help you feel better, your provider or dentist may suggest that you:

If those do not help, your provider or dentist may suggest other treatments such as:

If you are still having severe symptoms from a TMD, your provider or dentist may suggest surgery, including implant surgery, or another procedure.

It's important to be careful, because sometimes surgery or another procedure may not work or may even make your symptoms worse. Before any surgery or other procedure, it is very important to get opinions from more than one provider and to completely understand the risks. If possible, get an opinion from a surgeon who specializes in treating TMDs.

• Eat soft foods.
• Apply heat or cold to the face and do some exercises to gently stretch and strengthen your jaw muscles.
• Take over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
• Stop clenching your jaw, chewing gum, and biting your nails.
• Physical therapy
• Self-management and behavioral health approaches, which can include: Cognitive behavioral therapy (CBT), a type of psychotherapy. It can help you identify negative thoughts and change them. It can also teach you coping skills. Biofeedback, which involves using electronic devices to teach you to control certain body functions, such as your heartbeat, blood pressure, and muscle tension. For example, it can detect when you tighten your jaw muscles. You can learn how to recognize when this happens and then relax your muscles.
• Medicines such as: Anti-anxiety medicines Antidepressants Anti-seizure medicines Prescription pain relievers
• An intraoral appliance, which is a device that fits over your teeth. Types of intraoral appliances include oral splints and mouth guards. If you are going to use one, it's important to: Know that there is not a lot of evidence that they improve TMD pain. Make sure that the appliance you have is not designed to permanently change your bite. Let your provider or dentist know if it makes your pain worse.
• Complementary treatments, which are treatments that are used along with mainstream medical care. There is limited evidence showing that they help with TMD symptoms. But some providers and dentists may recommend acupuncture and transcutaneous electrical stimulation (TENS). TENS involves using a device to send a gentle electric current to your nerves or muscles. It may help treat pain by interrupting or blocking the pain signals.

Which doctor should you see?

The suggested department for discussing Temporomandibular Disorders is Dentistry, with a dentist / relevant dental specialist as the relevant type of clinician. Dentist / Relevant dental specialist; paediatric services for children as appropriate.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which teeth, gum tissues or oral structures are affected?
• What is the purpose of any proposed dental imaging or procedure?
• What oral-care routine is suitable while the problem is being treated?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.