What causes temporomandibular disorder (TMD)?

Dr. Jeanne Morrison, PhD
Family Practitioner

Physical and emotional stress, or a combination of the two, may lead to a variety of temporomandibular disorders. Emotional stress may lead to grinding or clenching of teeth, which causes muscle strain leading to pain. Anatomical issues can be a cause, as when the jaw becomes dislocated. Degenerative joint diseases, like arthritis of the jaw or osteoporosis, can be a cause. Hypermobility (when the ligaments that support the jaw become too loose) and ankylosis (loss of jaw movement due to calcification of the jaw joint) are other possible causes.

If you suspect you have temporomandibular disorder (often just called "TMJ" or "TMD"), a dentist can help identify the source of the pain with a thorough exam and appropriate x-rays. Often, the pain may be from a sinus problem, a toothache or an early stage of periodontal disease. But for some types of pain, the cause is not easily diagnosed. The pain may be related to the facial muscles, the jaw or the TM joint.
Some TM problems result from arthritis, dislocation or injury. All of these conditions can cause pain and dysfunction. Muscles that move the joints are also subject to injury and disease. Injuries to the jaw, head or neck, and diseases such as arthritis, might cause some TM problems. Other factors relating to the way the upper and lower teeth fit together (the bite) may cause some types of TM disorders. Stress and teeth grinding are also considered as possible factors. 

Diagnosis is an important step before treatment. Part of the dental examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving. Your complete medical history may be reviewed, so it’s important to keep your dental office records up-to-date. Your dentist may take x-rays and may make a "cast" of your teeth to see how the upper and lower teeth fit together. Your dentist may also request specialized x-rays for the TM joints. Depending on the diagnosis, the dentist may refer you to a physician or another dentist.
Trauma to the jaw or jaw joint may play a role in temporomandibular disorder, or TMD, but in most cases the exact cause of this disorder is unknown. Experts suggest that certain tasks, either mental (stressful situations) or physical (teeth grinding), may trigger or aggravate TMD. Most of the discomfort is due to overuse of the jaw or mouth muscles, specifically clenching the teeth (bruxism). These excessive habits tire the jaw muscles and can lead to headaches or neck pain.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.