Temporomandibular disorder: why it develops and how it is treated
Temporomandibular disorder (TMD) is a common cause of jaw and facial discomfort that can affect daily activities such as eating and speaking.
In this article, consultant oral and maxillofacial surgeon Mr Parkash Ramchandani outlines the underlying causes of temporomandibular disorder and the treatment options available.
What is temporomandibular disorder?
The temporomandibular joints are located just in front of each ear and allow the jaw to open, close and move from side to side. Temporomandibular disorder refers to a group of conditions affecting these joints, the surrounding muscles and associated structures. Problems may involve the joint itself, the muscles that control jaw movement or both, leading to altered jaw function.
Why does TMD develop?
In most cases, TMD does not have a single cause. It usually develops due to a combination of contributing factors.
Muscle tension and overuse
Clenching or grinding the teeth, often associated with stress or anxiety, places increased strain on the jaw muscles. Over time, this can lead to muscle pain, fatigue and reduced jaw movement.
Jaw joint problems
The jaw joint contains a small cartilage disc that helps it move smoothly. If this disc becomes displaced or damaged, it may result in clicking, locking or pain within the jaw joint.
Injury or trauma
Injuries to the jaw, face or neck, including whiplash type injuries, can alter normal jaw function and contribute to the development of temporomandibular disorder.
Bite and dental factors
While bite problems are rarely the main cause of TMD, changes in how the teeth meet, recent dental treatment or missing teeth may play a role in some individuals.
Common symptoms of TMD
Symptoms of temporomandibular disorder can vary, but commonly include:
- Pain or tenderness in the jaw, face or around the ears.
- Clicking or popping sounds when opening or closing the mouth.
- Difficulty opening the mouth fully or episodes of jaw locking.
- Headaches, neck pain or facial muscle discomfort.
Symptoms may fluctuate and are often worse during periods of increased stress.
How is TMD treated?
Treatment for TMD is usually individualised and begins with conservative, non-surgical measures.
Self-care and lifestyle measures
Many patients improve with advice on jaw rest, avoiding hard or chewy foods, applying heat and reducing clenching or grinding habits.
Physiotherapy and jaw exercises
Physiotherapy and guided jaw exercises can help improve movement, reduce muscle tension and relieve pain.
Splints and medication
Dental splints may be used to reduce strain on the jaw, particularly in patients who grind their teeth at night. Pain relief or anti-inflammatory medication may also be prescribed when appropriate.
Specialist treatment
If symptoms persist or are severe, referral for specialist assessment may be required. In a small number of cases, minimally invasive procedures or surgery may be considered.
Understanding why TMD develops and addressing symptoms early can help prevent long-term problems. Persistent jaw pain, clicking or restriction of movement should be assessed to ensure the most suitable treatment plan is provided.