Temporomandibular joint (TMJ) pain refers to discomfort or dysfunction in the jaw joint and surrounding muscles. It can manifest as pain, tenderness, clicking, popping, or difficulty in opening and closing the mouth. Causes include teeth grinding, jaw clenching, arthritis, injury, stress, or misalignment of the jaw.
Clinically, many of our patients present after having dental work done, where the mouth was open for extended periods and they have residual unresolved pain following the procedure for weeks or longer. Other common causes are typically associated with previous jaw trauma, clinching, stress and/or chronic tension in the neck/shoulders, which transfers to the jaw through fascial and muscle attachments of the neck and shoulder girdle.
Most commonly, patients with TMJ present with inability to fully open and/or pain when trying to open or chew and eat foods. Treatments in our office primarily focus on the muscles that open the jaw, which are the most common culprits. The muscles that open the jaw are the pterygoid muscles, and they are located waaaaaay in the back of the jaw; they are accessed using a gloved finger along the top gum line inside the mouth; it is not comfortable, but it has been incredibly effective at resolving TMJ related pain. The external muscles that close the mouth are much less commonly involved.
TMJ Anatomy of Pterygoid Muscles
Clicking, popping sensations and sounds are generally not treatment goals that we seek to resolve; most of these joint noises are just that - asymptomatic joint noise or crepitus that occurs with changes over time. Typically they are non-painful by themselves and while they may represent signs of long term instability, they are not a direct focus of treatment nor will they necessarily resolve with treatment. Pain, improved range of motion and ability to eat foods without symptoms respond excellent to treatment.
If you suffer from TMJ pain or know someone that is, give our office a call today at 319.832.3363 to schedule a consultation and get back to eating foods you enjoy!
Dr. Nathan Weber
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