Temporomandibular Joint Dysfunction (TMJ)

What is temporomandibular joint dysfunction?

The temporomandibular (TMJ) joint is what allows people to talk and chew comfortably; over-exertion of this joint can lead to a variety of disorders referred to as temporomandibular joint dysfunction (TMD).

  • The TMJ is the most constantly used joint in the body.
  • Minor problems can be caused by teeth clenching and grinding that often occur as a result of emotional stress or anxiety.
  • This can trigger joint symptoms, as well as spasm of the chewing muscles, headaches, and neck pain.
  • If your child has trauma in his lower jaw, it can cause rapid shearing of the joint, which may require treatment.

What is the temporomandibular joint?

The temporomandibular joint (TMJ) is located at the spot where the lower jaw meets the skull base. The muscles and ligaments surrounding the joint work together to allow it to move. The health of those surrounding muscles and ligaments — and the health and position of your child’s teeth —all contribute to the proper alignment and functioning of the TMJ.

TMD can arise because of over-exertion of your child’s TMJ. Some examples of conditions that can cause this over-exertion are high levels of stress or anxiety, grinding or clenching of the teeth, or trauma to the jaw.

This is a common problem, which can often be treated at home. More severe cases of TMD may require physical therapy, dental treatments, or surgery.

Who develops TMD?

Children and adolescents are more likely to develop TMD as a result of stress or trauma to the jaw. In younger children, congenital jaw deformities can lead to TMD.

What are the symptoms of TMD?

If your child has any of the following symptoms, you may want to check with a doctor:

  • difficulty opening the mouth
  • difficulty closing the mouth
  • jaw pain
  • jaw fatigue
  • ear aches or ringing in the ear
  • unexplained headaches
  • popping or clicking of your joint with pain
  • locking of the jaw
  • asymmetrical jaw opening
  • uneven vertical or lateral movements of the jaw
  • pain when touching the TMJ
  • swelling around the TMJ
  • jaw asymmetry or malocclusion

What causes TMD?

TMD can be caused by several factors:

  • teeth clenching or grinding
  • stress or anxiety
  • trauma to the jaw or the joint
  • muscle spasms
  • misalignment of the jaw (malocclusion)
  • arthritis

What sort of treatment will my child need?

Treatment depends on the severity of your child’s condition. It ranges from range-of-motion jaw exercises and medications to physical therapy, joint injections and/or surgery.

Long-term outlook

If your child’s symptoms are mild, home care and anti-inflammatory medications can help. If the condition is more severe, physical therapy, dental treatments or joint surgery may be needed.

Questions to ask your doctor

Many parents are concerned about TMD and can have lots of questions about the condition and how it can affect their child.

You may find it helpful to jot down questions as they arise. When you talk to your doctor, you can be sure that all of your concerns are addressed.

Here are some questions to get you started:

  • What is causing my child’s TMD?
  • Are there any tests we should do to confirm the diagnosis?
  • What can we do at home to help relieve the pain?
  • Will my child have to have surgery?
  • Do the medications you’re prescribing have any significant side effects?
  • Will the symptoms of TMD go away? What is my child’s long-term outlook?

How we care for temporomandibular joint disfunction

Less pain, faster recovery

The surgeons at the Center for Robotic and Minimally Invasive Surgery at Boston Children's Hospital are dedicated to helping your child get better faster.

Arthrocentesis is a minimally invasive procedure to treat TMD.

  • Two needles are inserted through the skin into the temporomandibular joint space and sterile fluid is injected to break up adhesions and to cleanse the joints.
  • Medications to lubricate the joint may be added at the end of the procedure to help reduce inflammation or pain.