Temporomandibular Disorder

(TMD; Temporomandibular Joint Disorder; Temporomandibular Joint Dysfunction; TMJ Syndrome; TMJ Osteoarthritis)


Temporomandibular disorder (TMD) is a painful condition in the joint that lets the jaw move. These temporomandibular joints are the small joints in front of each ear. They attach the lower jaw (mandible) to the skull. The disorder may affect the jaw joint or the muscles surrounding it. The disorder can include:
The Temporomandibular Joint
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The exact cause of TMD is often unclear. Possible causes include:

Risk Factors

TMD is more common in women aged 30-50 years old. Other factors that increase your chance of TMD include:


TMD may cause:


You will be asked about your symptoms and medical history. A physical exam will be done. The physical exam may include:
Images may be needed of your jaw to check for abnormalities causing TMD. This can be done with:


Usually, the least invasive measures will be tried first. Treatment may include:

Lifestyle Measures

The area will need time to heal:
  • Rest the jaw with a soft diet
  • Restrict movement with smaller bites, avoiding wide yawning, and gum chewing
  • Apply ice or heat packs for pain relief
  • Gentle jaw stretching and exercises


The most commonly used medications include:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
  • Muscle relaxants
  • Antidepressants
Some medication may be injected into the jaw such as:
  • Pain relievers, such as cortisone or lidocaine
  • Botulinum toxin (Botox)—may offer temporary relief if pain or clicking are major symptoms

Physical Therapy

To help reduce pain and allow muscles to relax:
  • Gentle massage or stretching exercises
  • Gentle strengthening exercises or muscle balance exercises to retain alignment
  • Transcutaneous electrical nerve stimulation (TENS)

Stress Reduction

Some may benefit from counseling to learn stress management and relaxation techniques, such as:

Dental Procedures

A splint or mouth guard can be made to relax the jaw muscles, and prevent clenching and grinding of the teeth. The guard is usually worn at night. Unfortunately, there is not a lot of proof it works.
Correction of bite abnormalities by a dentist or orthodontist is sometimes needed.

Surgical Procedures

Surgical correction is a last resort. Many of the available procedures have not been well-studied for their effectiveness.


There are no current guidelines to prevent TMD.


Mouth Healthy—American Dental Association

The TMJ Association


Canadian Dental Association

Canadian Society of Otolaryngology—Head & Neck Surgery


National Institute of Dental and Craniofacial Research website. Available at: Updated July 10, 2014. Accessed May 16, 2016.

Temporomandibular joint (TMJ) dysfunction . EBSCO DynaMed website. Available at: Updated May 11, 2015. Accessed May 16, 2016.

Haley DP, Schiffman EL, et al. The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain. J Am Dent Assoc. 2001;132(4):476-481.

Borodic GE, Acquadro MA. The use of botulinum toxin for the treatment of chronic facial pain. J Pain. 2002;3(1):21-27.

DynaMed's Systematic Literature Surveillance Turner JA, Mancl L, Aaron LA. Short- and long-term efficacy of brief cognitive-behavioral therapy for patients with chronic temporomandibular disorder pain: a randomized, controlled trial Pain. 2006;121(3):171-172.

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