Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Temporomandibular Joint (TMJ)

Temporomandibular Joint (TMJ)

What is TMJ?

The Temporomandibular Joint is MJ is a small joint located in front of the ear. The TMJ is the place where the lower jaw (mandible) meets the skull (temporal bone). This joint is made up of several parts. The main parts are the bones, the cartilage, the disc and the capsule. The inside part of the capsule is lined by a special tissue call synovium. The synovium makes synovial fluid, which is the fluid that lubricates the joint. When all these parts are healthy the jaw motion is unrestricted, smooth, noiseless, and painless.

TMJ disorders are fairly common and range in severity from fairly innocuous to very severe. Common symptoms associated with these disorders are joint noises (clicking, popping and grating), pain, and difficulty opening or closing the mouth.  These disorders can also be associated the muscle pain, headaches and ear pain.

Many different conditions like disc disorders, arthritis, dislocations and rarely tumors can affect this joint. As it can be expected, the treatment for each condition is different. Therefore, the most important step in treating this condition is to make the correct diagnosis.

Diagnosing TMJ

The signs and symptoms listed above are not only seen in patients with TMJ problems, but are also seen in patients with others conditions like myofascial pain, fibromyalgia, headaches, bruxism (grinding and clenching of the teeth)

Therefore, diagnosing TMJ disorders can be complex and may require several diagnostic procedures.

A comprehensive evaluation by an oral and maxillofacial surgeon is necessary. This evaluation will include a detailed medical history and physical examination, radiographs and in some instances, an MRI or CT scan, which will help to develop an effective treatment plan.

If symptoms of TMJ persist, an oral and maxillofacial surgeon should be consulted. Oral and maxillofacial surgeons at Houston Methodist Hospital have expertise in diagnosing and treating these problems.

Treating TMJ

There are several courses of action for treating TMJ – from non-surgical medical and dental care to complex surgeries.

Based on the diagnosis, the Oral and Maxillofacial Surgeon may treat the TMJ disorder with medications, a bite plate, splint or guard or may possibly recommend stress management counseling. Other non-surgical treatment options may include resting the jaw, the adoption of a soft diet or applying heat to the muscles.

However, if there is clear evidence that there is joint damage, surgery may be recommended. Some surgical options include:

  • Arthrocentesis: flushing fluid from the joint and gently stretching it.
  • Arthroscopy: using a miniature-telescoping instrument to diagnose and repair the joint.
  • Arthrotomy: open surgery for more complex cases.

Facts about TMJ

  • The temporomandibular joint is the most constantly used joint in the body.
  • Three to five percent of Americans seek professional advice annually for temporomandibular disorder (TMD).