The TMJ is the most used joint in our entire body, it’s made to open 2500-3000 times per day. However, it is the least taken care of! We chew, we talk, we crunch, we grind, we clench, every movement using this key joint. Let’s first talk a little bit about the anatomy of the joint.

TMJ stand for temporomandibular joint. Temporo-stands for the temporal bone which is the bone right behind and above to your ears. Mandibular-refers to your mandible, the bone where your bottom teeth connect to. There is a disc in between these two bones, ligaments, muscles and a capsule that connects the joint together. An important thing to remember is that the disc seperating the two bones has no pain receptors. Only the ligaments and the capsule have these receptors. So, the only way to actually feel pain in the joint is when the disc has been worn away from dysfunction and it is now bone of bone contact, or there is some dysfunction that is causing the ligaments to be stretched. So, you actually might have some dysfunction in this joint and until there’s major trauma in it, you won’t feel a thing.

What about popping and clicking? Remember the disc separating the joint. That’s what you are hearing. Often times one side of the TMJ joint is jammed, and the other side is too loose because it’s compensating. What happens is that disc gets stuck as you are opening your mouth, and then quickly tries to catch up and slips over the joint (that’s the “click” you hear) See image 2.

As you can see from image 1, the mandible only connects at this joint. So what causes TMJ dysfunction? Think of it this way, think of the mandible which has the condyle as the window, and think of the temporal bone as the frame. The temporal bone connects to all of the other bones in the head. If there is any dysfunction in any of these other bones, then the window will not fit in the frame.

Here are some ways the window won’t fit in the frame:

• Direct trauma to the joint, like a blow to the jaw, very rare.
• Ascending problem, there are receptors in the pelvis that talk to receptors in the TMJ. So if you have any instability down below, you could have compensatory TMJ dysfunction. This is why women giving birth are taught to not clench their jaw, because it won’t allow the pelvis the relax.
• The most common, is a descending problem from the head. If there are compressions from birth(we all have) in your cranium, or all these bones that connect to the “frame” are not moving synchronously, then there will be compensation in this joint. Additionally, if your bite and the way your teeth hit isn’t supportive to these movements, you can have asymmetries in the movement of this joint. This is turn can cause the ligaments and muscles to stretch, the disc to be displaced and pain to creep in.
• Stress. When you are stressed you usually clench your teeth more which can cause dysfunction.

If there is significant clenching, treatment might include bite adjustments, or fabrication of an occlusal (bite) splint orthotic to protect the jaw and muscles from clenching and grinding. And sometimes more involved procedures are necessary like orthodontics (braces) to move teeth into a more balanced position. This is usually how we screen kids to grow them out of a lot of these dysfunctions so they don’t experience it in their lifetime.

Since the temporal bone has a connection with all of these other bones, any dysfunction in this system can cause a variety of different symptoms. The ear in general is right next to this joint, so hearing difficulties, ringing in the ears, fullness in the ears, ear infections, vertigo can be really common symptoms.

Other symptoms from cranial dysfunction include headaches, neck pain and tightness, light sensitivity, difficulty reading, sleep apnea, blurry vision, and more…

The key is to NOT look at the joint itself because it is usually coming from somewhere else. Unfortunately most professions don’t know this information. Even dentists unless they are functional dentists don’t know much about this joint and the 4 causes. Often times they will give patient’s expensive mouth guards that go on the top teeth which make the whole system worse because they don’t allow these bones to move. They move with every breath we take so when they can’t move they cause the whole system to dysfunction further.

I hope this cleared up some confusion about this complicated, yet important joint. If you have any further questions don’t hesitate to ask. And if you know anyone suffering from any of these complaints, please let them know they don’t have to suffer through chronic pain.

Have a great week! And Happy Holidays!