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Temporomandibular Disorder (TMJ) and Orofacial Pain in our Practice

  • What is Temporomandibular Disorder (TMJ)
  • Orofacial Pain (Craniofacial Pain)
  • TMD: An Understanding
  • What Causes TM Dysfunction?
  • Management

What is Temporomandibular Disorder (TMJ)

The mandible, or jaw, is attached to the skull by two joints, one on either side of the head, right in front of the ears. These joints are called the Temporomandibular Joints (TMJ) because they connect the jaw (mandible) to the temporal bone of the head.

The TMJ is the most used joint in the body, allowing the mouth to open and close when talking, chewing, singing, shouting, and yawning. It's not hard to understand how the role of this joint is so important.

This joint is operated by a complex balance of numerous muscles of the jaw, head, and neck which allow it to do all this work, and by the nervous system which control it.

Inside each joint there is a disc (or fibrous pad) which acts like a cushion between the joint itself and the bone of the skull socket. This disc allows the joint to work smoothly, without discomfort. It also protects the joint from wearing out prematurely by insuring that the joint moves in the skull socket like a well-machined gear.

TMJ dysfunction or TMD refers to the malfunctioning of the Temporomandibular Joint or associated muscles, ligaments and bones. This can mean that the disc has been dislocated or damaged, or both or that the muscles operating the joint are not working properly. There are many factors and situations that cause TMJ dysfunction, and there are many symptoms, including pain. In severe forms, TMJ dysfunction can be disabling.

Dentists who have had experience in TMJ dysfunction can diagnose dysfunction in the joints, muscles, bones and teeth, and offer treatment and management therapy.


Orofacial Pain (Craniofacial Pain)

(Craniofacial Pain) refers to any pain in the "oral" or "facial" or head area. Them are many different sources of these pains from neck injury, to pain from internal structures, eyes, sinuses, ears, nose and of course the mouth and throat. The reason for many orofacial pain is usually some form of injury or improper function of the jaw joints, muscles and or teeth. Some pains occur as headaches, others occur as shooting, stabbing or throbbing pains. Some pains are continuous and others are intermittent.


TMD: An Understanding

  • Do you ever wake with tired muscles and jaws?
  • Do you have frequent headaches?
  • Do you hear popping, clicking or cracking sounds when you chew?
  • Do you have stiffness, pressure or blockage in your ears?
  • Do you hear ringing or buzzing sound in either or both of your ears?
  • Do your jaws feel like they "catch"?
  • Do your jaws feel tight, difficult to open?
  • Do you wake with sore facial muscles?
  • Do you clench or grind your teeth during movements of frustration or concentration?
  • Do you grind your teeth at night?
  • Have you ever been hit in the Jaw?
  • Have you had a whiplash injury?
  • Do your jaws ache after eating?
  • Are you under a lot of stress?
  • Do you wake with sore facial muscles?
  • Do your ears hurt?
  • Does it hurt to move your jaw sideways?
  • Do your neck, back of your head, or shoulders hurt?

There are two main areas of concern when dealing with TMD problems. The first are the muscles of the head and neck that moves the jaw and the second is with the joints themselves. The muscles in the temple and cheek areas may feel tight or painful especially when pushed or rubbed. Headaches and/or earaches are a common complaint. Joint problems may include clicking or grinding noises while chewing or opening, especially to yawn. This may not be painful at the start but could progress to pain or locking of the joint in future. Symptoms are also some-times mistaken for tension, migraine headaches, sinus trouble, ear infection or toothaches.


What Causes TM Dysfunction?

There is never one single contributor to TMD problems but rather a variety of reasons. Some of the contributing factors may include stress, accidents, your bite (the way your teeth fit together), skeletal imbalances and clenching and grinding of teeth.



Management involves a wide range of treatment, depending on the severity of the problem. It can include stress management, physiotherapy, night appliances and other more advanced forms of appliance therapy. It often involves a multi-disciplinary approach using other health care professionals.

For additional information on the management, physiotherapy, night appliances and other more advanced forms of appliance therapy on the temporomandibular joint, please contact our office.

Dr. Gerald Wexler
General Dentistry,  practice limited to TMD and Orofacial Pain
105-2197 Riverside Drive, Ottawa, Ontario K1H 7X3
Copyright 2006 Dr. Gerald Wexler