TMJ Disorders

What Is the TMJ?

The temporomandibular joint (TMJ) connects the lower jaw to the skull. You can feel your two TM joints and their movement by placing your fingers directly in front of your ears and opening your mouth. What you're feeling are the rounded ends of the lower jaw as they glide along the joint socket of the temporal bone, which is the part of the skull that contains the inner ear and the temple.

What Are TMJ Disorders?

TMJ disorders (also called temporomandibular disorders, or TMD) can cause:

• pain in the head, neck, jaw, or face
• problems chewing or biting
• popping or clicking sounds when opening and closing the mouth
• occasionally, a jaw that can lock open or lock shut

TMJ disorders can affect kids of any age, but are much more common in teens, especially girls.

What Causes TMJ Disorders?

Often, it’s not clear what causes TMJ disorders, but many things can contribute to them.

Bruxism (jaw clenching or teeth grinding) can make a TMJ disorder more likely. It overworks the TMJ, which can lead to a disc in the joint wearing down or moving out of place. Grinding and clenching also can change the way that top and bottom teeth line up and can affect muscles used for chewing. Sometimes people don't even realize that they're clenching or grinding and might even do it during sleep.

Stress can influence TMJ symptoms by making kids more likely to grind their teeth, clench their jaw, or tighten their jaw muscles.

TMJ disorders also are more common in those with other dental problems (like a bad bite), joint problems (like arthritis), muscle problems, or a history of trauma to the jaw or face.

When Should We See a Dentist?

If your child has symptoms of a TMJ disorder, let your dentist know. The earlier a TMJ disorder is diagnosed and treated, the better.

The dentist will ask questions, do an exam, and might order imaging tests (like X-rays, a CT scan, or an MRI) to confirm a TMJ disorder.

If your child's jaw is locked open or locked shut, call the dentist to ask if you should see an oral surgeon or go to the emergency room.

How Are TMJ Disorders Treated?

For some kids with TMJ disorders, treatment can be as simple as resting the jaw for a few days.

Offer your child soft foods and help them avoid any habits that can aggravate the TM joint or the muscles of the face (such as chewing gum, clenching or grinding the teeth, or opening the mouth extra-wide while yawning). Apply ice packs or heat to the side of the face to help your child feel more comfortable.

In some cases, more treatment is needed. A jaw that’s locked will need to be manipulated until it can open or close. Sometimes, a doctor will do this while the child is under sedation.

For pain due to clenching the jaw or grinding the teeth, the dentist may fit your child with a splint or biteplate to wear at night to help reduce clenching and grinding. The dentist also can prescribe medicine to help relieve the pain or relax the muscles.

If a problem with your child's bite is adding to the TMJ disorder, the dentist may recommend braces or other dental work to correct it.

Occasionally, symptoms do not respond to other treatments. Then, a child might need surgery to repair damaged tissue in the joint. But most kids won't need surgery.

Can TMJ Disorders Be Prevented?

Lots of kids develop TMJ disorders or joint pain from grinding their teeth or clenching their jaw repeatedly. Often, they don’t know they’re doing it. Teach kids to notice them when they happen (for example, during a test at school, when angry or upset, etc.) so they can learn to stop them. These behaviors can be due to stress, so help your child get plenty of exercise and enough sleep. Avoid over-scheduling, and encourage relaxing activities. Breathing exercises also can help kids relax.

Ask your dentist for more tips on avoiding TMJ disorders.