First off, a little anatomy lesson is in order. The temporomandibular joint is the joint that connects your lower jaw to your skull. It is held in place by a series of ligaments and muscles that form a sling on the inside and outside of the jaw bone. At the point where the joint articulates or hinges with the skull, there is a fibrocartilaginous disc that acts as a “shock absorber” between the articulating {condylar) head of the lower jaw and the fossa of the skull. This disc serves the important role of protecting the two bony surfaces from damage as the jaw opens and closes. The disc also moves with the lower jaw providing further protection throughout the full range of motion. Speaking of which, our lower jaw goes through an interesting disarticulation to achieve maximum opening—the first half of opening is due to the rotation of the joint, while the second half is due to a translation or “glide” of the lower jaw forward along the fossa in our skull. This allows us to open 50mm on average, or about the width of three fingers. Very cool!

A lot of people begin to develop TMJ symptoms in their teens, but it is most commonly reported in women between the ages of 20 and 40. Fortunately, most TMJ symptoms resolve on their own with time, especially if the symptoms involve joint noises or mild locking/catching. More concerning issues involve pain, especially if the pain gradually worsens. There are some at-home treatments that can be employed when TMJ symptoms flare up, especially when symptoms are acute and the onset is sudden. The application of ice and moist heat to the offending jaw joint or sore muscle, along with the ingestion of an anti-inflammatory (ibuprofen or aspirin), can help reduce pain and inflammation. It is also a good idea to stay on a soft diet, limit opening wide and avoid any habits that place pressure on the jaw joint (examples include gum chewing, side sleeping, leaning on the lower jaw with the palms of the hands, or cradling a phone between the shoulder and cheek). Also, be mindful not to hold tension in your jaws or clench your teeth during the day. Repeat the mantra “lips together, teeth apart”. There are also some exercises that can be performed to stretch and massage the muscles to help them relax.

As stated earlier, TMJ problems are multifactorial, and the presence of a malocclusion (or “unfavorable” bite) does not necessarily mean that problems with one’s jaw joints or function are looming around the corner. There are many, many people with very poor bites that have no problems with their TMJ, and there are many patients with normal occlusions that suffer from TMJ signs and symptoms. Research has shown that patients who have malocclusions characterized by deep, impinging bites (100% coverage of their bottom teeth by their top teeth and tipped back upper teeth), open bites {only occluding on a few back teeth) and crossbites of the posterior teeth (where there is also a shift upon closure) have a tendency to experience more complications with jaw problems, especially in conjunction with other factors such as stress, trauma, wear or disease.

If you have any questions about your bite or are experiencing jaw issues, discuss your concerns with your dentist. A referral to the orthodontist, oral surgeon or TMJ specialist may be in order. Fortunately TMJ therapy and intervention has advanced in recent years and there are many good treatment modalities if home remedies do not provide relief.