Temporomandibular disorders (TMD) are problems with the jaw muscles, temporomandibular joints, and the nerves linked to chronic facial pain. Any problem that prevents the complex system of muscles, bones, and joints from working together in harmony may result in temporomandibular disorder.

The temporomandibular joints (TMJ) are the two joints that connect your lower jaw to your skull. The joints slide and rotate in front of each ear. They include the lower jaw (mandible) and the temporal bone (the side and base of the skull). The TMJs are among the most complex joints in the body. These joints, along with several muscles, allow the mandible to move up and down, side to side, and forward and back. When the mandible and the joints are correctly aligned, smooth muscle actions can take place. These include chewing, talking, yawning, and swallowing. When the structures (muscles, ligaments, disk, jawbone, temporal bone) are not aligned, they don't move well together. This may cause several problems.

The National Institute of Dental and Craniofacial Research (NIDCR) classifies TMD by the following:

• Myofascial pain. This is the most common form of TMD. It causes discomfort or pain in the connective tissue covering the muscles (fascia) and the muscles that control the jaw, neck, and shoulder.
• Internal derangement of the joint. This means a dislocated jaw or displaced disk. A disk is the cushion of cartilage between the head of the jawbone and the skull. Or it may mean an injury to the condyle. This is the rounded end of the jawbone that fits into the temporal skull bone.
• Degenerative joint disease. This includes osteoarthritis or rheumatoid arthritis in the jaw joint.

You can have more than one of these conditions at the same time.

In many cases, the cause of TMD may not be clear. Sometimes it's too much strain on the jaw joints and the muscles that control chewing, swallowing, and speech. This strain may be due to bruxism. This is the habitual, involuntary clenching or grinding of the teeth.

Other causes include:

• Injury to the jaw, the head, or the neck.
• Arthritis and displacement of the jaw joint disks.
• Another painful health condition, such as fibromyalgia or irritable bowel syndrome. It may overlap with TMD pain or make it worse.

A recent study by the NIDCR identified clinical, psychological, sensory, genetic, and nervous system factors that may put a person at higher risk of developing chronic TMD.

The most common symptoms of TMD include:

• Jaw discomfort or soreness (often most common in the morning or late afternoon).
• Headaches.
• Pain spreading behind the eyes, in the face, shoulder, neck, or back.
• Earaches or ringing in the ears (not caused by an infection of the inner ear canal).
• Clicking or popping of the jaw.
• Locking of the jaw.
• Limited mouth motions.
• Clenching or grinding of the teeth.
• Dizziness.
• Teeth sensitivity without an oral health disease.
• Numbness or tingling feeling in the fingers.
• A change in the way the upper and lower teeth fit together.

The symptoms of TMD may look like other conditions or health problems. See a dentist or your doctor for a diagnosis.

A variety of methods are used to diagnose TMD. They include:

• Health history. Your provider will ask if you have a past history of pain in the face or jaw when you chew, bite, or open your mouth. Your doctor will ask if you have had cracking, popping, or noise when opening or closing your mouth.
• Physical exam. Your provider will check if you have facial or jaw pain when moving your jaw or you can't open your mouth wide. They will also check for TMJ noises when you open or close your mouth.
• Imaging tests. X-rays, CT scans, and MRIs may be used.

Treatment depends on your symptoms, age, and general health. It also depends on how severe the condition is and what's causing it.

Treatment may include:

• Resting the temporomandibular joint (TMJ).
• Medicine or pain relievers.
• Relaxation methods and stress management.
• Behavior changes (to reduce or stop teeth clenching).
• Physical therapy.
• An orthopedic appliance or mouthguard worn in the mouth to reduce teeth grinding.
• Posture training.
• Diet changes, such as eating soft foods (to rest the jaw muscles).
• Ice and hot packs.
• Surgery.

TMD symptoms can come back during times of stress. Be aware of what triggers your symptoms so you can do things to prevent it from happening again. See your provider on a regular basis so your TMD can be checked.

• Temporomandibular disorders (TMD) are disorders of the jaw muscles, temporomandibular joints, and the nerves linked to chronic facial pain.
• It may be caused by too much strain on the jaw joints and the muscles that control chewing, swallowing, and speech. This may be due to teeth grinding, injury to the jaw, head, or neck, or arthritis.
• Symptoms may include jaw pain, headaches, earaches, limited mouth motions, and jaw clicking, popping, or locking. There may also be pain in the face, shoulder, neck, or back.
• Treatment may include resting the temporomandibular joint, physical therapy, medicine, behavior changes, or an orthopedic appliance or mouthguard.
• TMD symptoms can come back during times of stress. It helps to be aware of what triggers your symptoms so you can prevent it from happening again.

Tips to help you get the most from a visit to your health care provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.