American College of

Prosthodontists

National Prosthodontics Awareness

Perfect Your Smile: Esthetics
Boost Your Confidence: Dental Implants
Change Your Life: Dentures
Pain in the Jaw: TMJ/TMD
The Hidden Risk: Oral Cancer
A Bright Future: A Career in Prosthodontics
Top 5 Reasons To Refer To A Prosthodontist
21 Reasons to Join the ACP

TMJ Disorders

TMJ Disorders
Temporomandibular joint and muscle

disorders, commonly called TMJ or TMD are

a group of conditions that cause pain and
dysfunction in the jaw joint and the muscles
that control jaw movement.

TMJ Disorders
For most people, pain in the area of the jaw

joint or muscles does not signal a serious

problem. Generally, discomfort from these
conditions is occasional and temporary, often
occurring in cycles. The pain eventually goes
away with little or no treatment. Some people,
however, develop significant, longterm
symptoms.

What are the signs and

symptoms?
radiating pain in the face, jaw or

neck
jaw muscle stiffness
limited movement or locking of the
jaw
painful clicking, popping or grating in
the jaw joint when opening or closing
the mouth
a change in the way the upper and

What is the Temporomandibular

Joint?
The temporomandibular joint connects the lower

jaw (the mandible) with its condyle, to the bone

at the side of the headthe temporal bone. If
you place your fingers just in front of your ears
and open your mouth, you can feel the joints.
Because these joints are flexible, the jaw can

move smoothly up and down and side to side,

enabling us to talk, chew and yawn. Muscles
attached to and surrounding the jaw joint control
its position and movement.

What is the Temporomandibular

Joint?
To keep this

motion smooth, a
soft disc lies
between the
mandibular
condyle and the
temporal bone.
This disc absorbs
shocks to the jaw
joint from chewing
and other
movements.

What are TMJ

Disorders?
TMJ disorders fall into three main categories:
Myofascial pain, the most common temporo-

mandibular disorder, involves discomfort or pain in the

muscles that control jaw function.

Internal derangement of the joint involves a

displaced disc, dislocated jaw, or injury to the condyle.

Arthritis refers to a group of degenerative or

inflammatory joint disorders that can affect the

temporomandibular joint

What are TMJ Disorders?

A person may have one or more of these

conditions at the same time. Some people

have other health problems that coexist with
TMJ disorders, such as chronic fatigue
syndrome, sleep disturbances or fibromyalgia,
a painful condition that affects muscles and
other soft tissues throughout the body.

What are TMJ Disorders?

How jaw joint and muscle disorders progress

is not clear. Symptoms worsen and ease over

time, but what causes these changes is not
known.
Most people have relatively mild forms of the

disorder. Their symptoms improve

significantly, or disappear spontaneously,
within weeks or months.
For others, the condition causes longterm,

persistent and debilitating pain. The condition

is more common in women than in men.

What are TMJ Disorders?

Prosthodontic treatment, in order to stabilize

the occlusion as a result of a TMD articular

diagnosis such as localized osteoarthritis or
degenerative joint disease (DJD), may be
required once the condition has been
successfully stabilized.
The degenerative process creates a smaller
condyle which often alters the jaw posture
causing an uneven bite. Thus, it may become
necessary to re-establish a more stable
occlusion as a result of changes within the
joint.

What causes TMJ

Disorders?
Trauma to the jaw or temporomandibular joint

plays a role in some TMJ disorders. But for

most jaw joint and muscle problems, scientists
and clinicians dont know the causes.
There is no scientific evidence that clicking
sounds in the jaw joint lead to serious prob
lems. Jaw noises alone, without pain or limited
jaw movement, do not indicate a TMJ disorder
and do not always indicate that treatment is
needed.

What causes TMJ

Disorders?
The roles of stress and tooth grinding as major

causes of TMJ disorders are also unclear. Many

people with these disorders do not grind their teeth,
and many longtime tooth grinders do not have
painful joint symptoms.
Scientists and clinicians note that people with sore,
tender chewing muscles are less likely than others to
grind their teeth because it causes pain.
Stress may play a role in many persons with jaw joint
and muscle disorders that is more likely the result of
dealing with chronic jaw pain or dysfunction than the
cause of the condition.

How are TMJ Disorders Treated?

Because more studies are needed on the

safety and effectiveness of most treatments

for jaw joint and muscle disorders, experts
recommend using the most conservative and
reversible treatments when possible.
Reversible treatments do not cause
permanent changes in the structure or posi
tion of the jaw or teeth. Even when TMJ dis
orders have become persistent, most patients
still do not need aggressive types of
treatment.

How are TMJ Disorders Treated?

Treatment by a Prosthodontist may be needed

for other reasons such as to restore severely

worn, damaged, or diseased teeth or to replace
teeth for the purpose of improving chewing,
providing enhanced support for your lips or
cheeks, or improving the appearance of your
smile.
Extensive prosthodontic treatment should only
be provided after the TMJ disorder has been
adequately diagnosed and its pain successfully
managed.

Conservative Treatments
Most jaw joint and muscle problems

are temporary and do not get worse.

Treatment is based on a proper
diagnosis which should be
conservative and reversible.
Self-Care Practices
Pain Medications
Stabilization Splints
Prosthodontic Treatment

Self-Care Practices
Your Prosthodontist may
recommend steps that you can
take that may be helpful in
easing symptoms, such as:

eating soft foods,

applying ice packs to recommended
areas,
avoiding extreme jaw movements (such
as wide
yawning, loud singing, and gum
chewing),
learning techniques for reducing stress,

Pain Medications
For many people with TMJ disorders,

short-term use of over-the-counter

pain medicines or nonsteroidal antiinflammatory drugs (NSAIDS), such
as ibuprofen, may provide temporary
relief from jaw discomfort.
When necessary, your dentist or

doctor can prescribe stronger pain or

antiinflammatory medications,
muscle relaxants, or antidepressants
to help ease symptoms.

Stabilization Splints
Your Prosthodontist may recommend

an oral appliance, also called a

stabilization splint or bite guard,
which is a plastic guard that fits over
the upper or lower teeth. Stabilization
splints are the most widely used
treatments for TMJ disorders.
If a stabilization splint is
recommended, it should be used only
for a short time and should not cause
permanent changes in the way your
teeth bite together when the splint is
removed from your mouth.

Prosthodontic Treatment
Occlusal splints

may also be used to

reestablish the bite
prior to
prosthodontic
treatment.
It is used when the
bite is not
contacting evenly
due to missing or
worn teeth and may
relax the muscles.

Prosthodontic Treatment

Additional Information?
Portions of this American College of

Prosthodontists TMJ Disorders presentation

were derived from The National Institute of
Dental and Craniofacial Research (NIDCR), of
the National Institutes of Health (NIH) TMJ
DISORDERS Document # 06-3487.
Additional information may be found at:
www.prosthodontics.org and
www.nidcr.nih.gov

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