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TMJ and Night Guards

Temporomandibular joint disorder (TMJD or TMD), or TMJ syndrome, is an umbrella term covering acute or chronic inflammation of the temporomandibular joint, which connects the mandible to the skull. It is found next to your ears and moves like a (door) hinge every time you open and close your mouth. The dysfunction can result in significant pain and impairment of nearby muscles and ligaments. Because the disorder overlaps between several healthcare disciplines—in particular dentistry and neurology—there are a variety of treatment approaches. 

The temporomandibular joint (TMJ) is susceptible to many of the conditions that affect other joints in the body, including ankylosis, arthritis, trauma, dislocations, and developmental anomalies.

An older name for the condition is “Costen’s syndrome,” after James B. Costen, who partially characterized it in 1934. Signs and symptoms of temporomandibular joint disorder vary in their presentation and can be very complex. Usually symptoms will involve more than one of the numerous TMJ components: muscles, nerves, tendons, ligaments, bones, connective tissue, and the teeth. Ear pain associated with the swelling of proximal tissue is a symptom of temporomandibular joint disorder as well.

In between this joint is a condyle and disk. The dysfunction involved is most often between the condyle of the mandible and the disc, which connects to the upper jaw (maxilla).The sounds produced by this dysfunction are usually described as a “click” or a “pop” when a single sound is heard and as “crepitation” or “crepitus” when there are multiple, rough sounds.

Symptoms associated with TMJ disorders may be:

  • Migraine (particularly in the morning).
  • Headache (particularly in the morning).
  • Biting or chewing difficulty or discomfort.
  • Tinnitus (ear ringing).
  • Clicking, popping, or grating sound when opening or closing the mouth.
  • Dull, aching pain in the face.
  • Hearing loss.
  • Jaw pain or tenderness of the jaw.
  • Reduced ability to open or close the mouth.
  • Earache (particularly in the morning).
  • Neck and shoulder pain.
  • Dizziness.

How you can reduce symptoms:

Dr. Goodman recommends several things to improve jaw pain:

  • Heat pack.
  • Massage.
  • Limited mouth opening, do not open to the maximum, carefully with overstretching, yawning, etc.
  • No chewing gum.
  • Nightguard, which is specialty made to custom fit your teeth and will oftentimes alleviate pain.

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