Can Temporomandibular Syndrome Be Treated?
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Temporomandibular Syndrome

Published on Apr 15, 2022 and last reviewed on Aug 07, 2023   -  4 min read


Temporomandibular syndrome is an acquired set of conditions that cause chronic facial or joint pain. Read the article to learn about the condition.

What Is TMJ Dysfunction?

Temporomandibular syndrome or dysfunction is a combined group of conditions that affect and involve the orofacial musculature attached to the temporomandibular joint. Though normal temporomandibular joint issues can be corrected by the surgeon or self-limiting with resolving medications over a span of time, TMJ dysfunction or syndrome can become a long-term and severe disorder causing chronic pain and fatigue or tension within the masticatory muscles.

Restricted movements of the lower jaw (mandible) and discomfort while swallowing, speaking, and chewing actions, can cause psychosocial limitations to the patient on palpation or touching the affected region. Pain increases in the patient that may be a result of various causes impacting the joint or the joint space like the derangement, displacement, disc dislocation (luxation or subluxation and dislocation with or without reduction), structural disorder impacting the particular joint surfaces, adherence, adhesion, and joint deviation.

Often this group of dysfunction can be caused due to trauma upon the temporomandibular joint or the facial bones, as in the case of facial bone fractures. Inflammation of the synovial joint (synovitis) and of the capsular ligament of the joint (capsulitis) can cause continuous pain and extreme tenderness of the joint even upon palpation.

What Are the Symptoms of TMJ Dysfunction?

The symptoms of this syndrome can possibly occur in any age group, but more incidents in adults between 20 to 40 years group. Patients with TMD may frequently suffer or report headaches and otological symptoms such as otalgia, tinnitus, or even vertigo.

Aural fullness and hearing impairment are long-term consequences found in chronic patients of TMJ dysfunction. These groups of TMJ disorders need to be differentiated from similar clinical symptoms that are more common in myofascial disorders. In myofascial disorders, the cause is believed to be due to the disturbance in the embryological origin of middle ear structures and masticatory muscles.

The physical examination by the dental or maxillofacial surgeon should warrant signs of enamel wear out, bruxism or grinding, abnormal mandibular or jaw movements, tenderness of muscles of mastication, neck, and shoulder, pain, and lastly, the assessment of postural asymmetry must be done by the dentist or physician. A neurologist should be referred to in case of suspicion of cranial nerve abnormalities by the dental surgeon. Careful palpation of muscles of mastication or the surrounding neck muscles helps identify trigger points.

What Can Be Affected in the TMJ?

The muscles involved in temporomandibular disorders are the masticatory muscles that help us in chewing food, i.e., temporalis, masseter, medial and lateral pterygoid muscles. Also, three major ligaments that stabilize the joint are: temporomandibular, stylomandibular, and sphenomandibular ligaments. The primary blood supply of the joint is through the superficial temporal and maxillary branches of the external carotid artery. Other accessory branches include the anterior tympanic, deep auricular, and ascending pharyngeal arteries. The TMJ has its sensory innervation from the auriculotemporal and masseteric branches of the mandibular nerve (V3), i.e., a branch of the trigeminal nerve or cranial nerve V.

When TMJ Dysfunction Requires Specialist Referral?

The red flag set of symptoms that require a specialist referral from the dentist to either a neurologist or ENT special would include the following abnormalities that would pose a challenge greater than just temporomandibular joint dysfunction, i.e., they can be linked to further systemic complications, these are

  • Worsening pain, i.e., chronic or persistent with time.

  • Trismus or limited mouth opening.

  • Cranial nerve abnormalities.

  • Neurologic dysfunctionalities.

  • Systemic illness or immunosuppressive patients having TMJ dysfunction.

  • Sudden or recent weight loss.

  • Asymmetrical facial swellings.

  • Unilateral hearing loss.

  • Vestibular dysfunctions such as unilateral tinnitus or a ringing sensation in the ears.

Several factors lead to the pathogenesis of TMJ dysfunction:

  • Stress.

  • Parafunctional habits like bruxism.

  • Abnormal posture.

  • Psychological conditions like depression, anxiety.

  • Autoimmune diseases.

Other intra-articular causes include trauma, capsular inflammation, osteoarthritis, hypermobility of the joint, and inflammatory diseases (e.g., commonly rheumatoid arthritis).

How Is TMJ Dysfunction Diagnosed?

Magnetic resonance imaging (MRI) is the gold standard or the preferred imaging study to assess the TMJ due to its capacity to accurately show effusion within the joint space, disc displacement, or soft tissue problems or disorders. Even though a simple panoramic X-ray can help in evaluating the mild to moderate TMJ disorders like dislocation or derangement, assessing the state of the dentition and joint tends to be important in identifying the causes of permanent TMJ dysfunction.

CT scans are beneficial in highlighting the key causatives like severe joint degeneration, fractures, and dislocations. Ultrasonography also shows the disc position, but it does not help or is ineffective in diagnosing osteoarthritis, which is the leading cause of joint dysfunction.

Computed tomography (CT) and magnetic resonance imaging (MRI) are hence preferred and more beneficial in severe, chronic, or suspected structural abnormalities of TMJ. Currently, dental and maxillofacial surgeons have adopted newer techniques of nerve blocks or botulinum toxin injections that have proved to be of significant diagnostic benefit apart from other recently developed techniques like arthrography and mandibular motion data assessment.

How Is the TMJ Dysfunction Managed?

Conservative treatment is adopted by the dentist to reduce clinical symptoms in almost 50 to 90% of patients reported with major or chronic joint dysfunctions. The patient's morale should be boosted through proper awareness that includes patient reassurance and education on the joint care and daily regimen. Lifestyle modification can be done with a soft diet, jaw rest, warm compresses applied to the painful area, and passive stretching of the muscles. Some dentists can give a referral to the orthodontist for occlusal and non-occlusal splints for TMD. However, the research remains elusive about the impact of these splints on permanent or long-term patient prognosis.

Anti-inflammatory drugs (NSAIDs) and Benzodiazepines are the first line drugs prescribed for cases of recurrent masticatory muscle spasms, especially in bruxists (individuals predisposed and have grinding habits). When relaxation techniques or stress-relieving techniques also fail, only then do tricyclic antidepressants may be prescribed by the surgeon since they improve symptoms of TMJ dysfunction just like other chronic pain disorders.


TMJ dysfunction or syndrome can have a long-term impact, causing stress and psychosocial limitations to the affected individuals. These conditions develop primarily due to trauma or insult to the temporomandibular joint. In case the person have any traumatic habits like bruxism that should also be tackled with appropriate measures as it can create chronic stress in the joint area. Management by the maxillofacial surgeon and timely referral to the ENT specialist or the neurologist in case of systemic involvement like craniofacial abnormalities will result in a good prognosis.

Frequently Asked Questions


How Much Time Does It Take for TMJ Syndrome to Disappear?

The symptoms of TMJ disorders can go without treatment in some cases. The symptoms resulting from TMJ syndrome can last for three weeks. However, in severe cases of TMJ dysfunctions like bruxism or arthritis, the symptoms can last months or even years, depending on the condition's severity. 


What Treatment Can Be Done to Fix TMJ Syndrome?

Medications can treat the TMJ syndrome, like painkillers or anti-inflammatory drugs like over-the-counter drugs like Ibuprofen. Tricyclic antidepressants like Amitriptyline can relieve bruxism, insomnia, or sleeplessness. Muscle relaxants are used for a few days to reduce the pain caused by muscle spasms in TMJ disorders. Occlusal appliances like mouthguards or oral splints can help reduce the pain resulting from TMJ syndrome. Surgical procedures are performed to reduce or remove the TMJ syndrome when medications and therapies do not work.


How Does TMJ Syndrome Affect Your Life?

When left untreated, the temporomandibular disorder can lead to several health problems, like severe pain, and inflammation around the joint region. It can result in pain during the opening and closing of the mouth, bruxism, or various bite issues leading to tooth erosion. Long-term conditions can result in sleeplessness, stress, anxiety, and depression.


What Are the Treatments Suggested by Dentists?

Medications like muscle relaxants, inflammatory medications, painkillers, and anti-anxiety drugs are suggested by dentists for treating the symptoms and pain caused by temporomandibular syndrome. Certain relaxation techniques or exercises are recommended to strengthen the muscles in the jaw and stretch the entire mouth, which helps reduce the pain caused by the syndrome. Oral appliances like night guards and oral splits are advised to be worn to avoid grinding or clenching the teeth while sleeping.


Which Doctor Should You Consult for TMJ Syndrome?

TMJ syndrome can be considered both a medical and dental problem. It can be caused by medical conditions like fibromyalgia, resulting in jaw pain. Another medical problem that causes temporomandibular joint syndrome is arthritis. If it is caused by any problems involving the teeth, it is considered a dental problem like bruxism or grinding of the teeth.


How to Detect TMJ Syndrome?

TMJ syndrome is initially diagnosed by listening to and feeling the joint while opening and closing the mouth. The range of motion is recorded. Dental X-rays are taken to evaluate the jaws and teeth if any problem persists during inspection and palpation. Computer tomography or CT scan, will help create a detailed picture of the joint. MRI or magnetic resonance imaging, helps diagnose problems in the articular disc or the soft tissue surrounding the temporomandibular joint. 


Can Avoiding Stress Reduce TMJ Syndrome?

Reducing stress can result in improving the symptoms associated with TMJ syndrome. Increased stress levels are a main contributing factor to temporomandibular joint syndrome. During stress, there is a chance of clenching the jaw or grinding the teeth during the day and night, subconsciously resulting in the wearing away of the teeth and cracked teeth resulting in TMJ disorders.


Can TMJ Surgery Result in Physical Pain?

Arthroplasty or arthrotomy Is an open surgical procedure done under anesthesia and lasts up to one to two hours. The recovery time for arthroplasty is longer, usually five weeks, and it is more painful than arthrocentesis. An incision is made in front of the ear, the TMJ space is opened, and the correction is made. The reshaping of the temporomandibular joint is called arthroplasty.


Can TMJ Syndrome Be Considered a Neurological Disorder?

The branches of the trigeminal nerve supply the temporomandibular joint. Thus, the temporomandibular syndrome can cause inflammation in the peripheral nervous system and have systemic effects on the brain and cranial nerves. It is considered a temporomandibular syndrome.


How Does Homeopathy Help Fix TMJ Syndrome?

Homeopathic medicines can be used to treat TMJ syndrome. Rhus toxicodendron can help reduce the stiffness of the TMJ. Kava root helps reduce stress and anxiety and can help calm the nervous system, thereby reducing the symptoms caused by TMJ disorders. Magnesia phosphorica helps relax the muscles and can help reduce stiffness, resulting in an antispasmodic effect.


Is Surgery Necessary for TMJ Syndrome?

Most of the symptoms of temporomandibular syndrome can be reduced with the help of medications and therapy. If it does not help, then only surgical procedures are suggested, like arthrocentesis, an invasive surgical procedure involving the insertion of a small needle into the joint that helps irrigate the fluid from the joint to remove inflammatory debris. Injections help reduce the pain associated with TMJ syndrome.


What Other Body Parts Are Affected by TMJ Syndrome?

In severe cases of TMJ syndrome, it can cause pain and discomfort in other body parts, like the face and eyes. When temporomandibular syndrome affects the eyes, a pressure build-up will occur behind the eye socket. It can result in blurry vision, headache, and pain surrounding the eyes. Other symptoms like watering of the eyes and sensitivity to light can also be associated with temporomandibular joint syndrome.

Last reviewed at:
07 Aug 2023  -  4 min read




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