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What are TMJ disorders?

Located on each side of the jaw and in front of the ears, the two temporomandibular joints (TMJ) connect the jawbone to the skull. They act as a sliding hinge and comprise the lower jaw or the mandible and the temporal bone (the side and base of your skull). These joints are amongst the most complex in the body. Along with several muscles, these joints allow the lower jaw to move up and down, side to side, as well as forward and back. When properly aligned, the mandible and temporomandibular joints allow for functional movements such as chewing, speaking, yawning, and swallowing. Improperly aligned TMJs present several problems in the mouth. 

“TMD” or temporomandibular joint dysfunction are conditions that affect the jaw muscles, temporomandibular joints, and the nerves associated with chronic facial pain. These conditions prevent the complex system of muscles, joints, and bones in the mouth from working together properly. An individual may have one or more of these conditions simultaneously. TMJ conditions can occur alone or with other medical conditions, such as headaches, sleep problems, fibromyalgia, back pain, and irritable bowel syndrome. 

The National Institute of Dental and Craniofacial Research categorizes TMD into the following:

• Disorders of the joints: Some examples include joint pain or arthralgia, disc disorders, and bone destruction (degenerative joint disease).
• Disorders of the masticatory muscles: These muscles are used for chewing. These conditions can involve two types of pain, including myalgia or pain that gets worse when pressure is applied to one area, or myofascial pain, i.e., pain that spreads beyond the point where it started. 
• Headaches: Certain TMDs can be associated with frequent headaches or migraines.

Treatments offered by TMJ doctors near you

 Sometimes, TMJ disorder symptoms may resolve without the need for treatment. However, if your symptoms persist, your doctor might suggest a variety of treatment options, often combining several methods simultaneously.

Medications

To alleviate TMJ disorder pain, your doctor may recommend certain medications alongside other nonsurgical treatments:

• Pain relievers and anti-inflammatories - If over-the-counter pain relievers aren't sufficient, your doctor or dentist might prescribe stronger medications, such as prescription-strength ibuprofen, for short-term use.
• Tricyclic antidepressants - Though primarily used for depression, medications like amitriptyline can help relieve pain, control bruxism, and address sleeplessness when taken in low doses.
• Muscle relaxants - These drugs can be prescribed for a few days or weeks to ease pain caused by TMJ-related muscle spasms.

Therapies

Several nondrug therapies can be effective in managing TMJ disorders:

• Oral splints or mouth guards (occlusal appliances) - Wearing a soft or firm guard over your teeth can help alleviate jaw pain. However, the exact reasons for their effectiveness are not well understood.
• Physical therapy—This includes exercises to stretch and strengthen the jaw muscles and treatments like ultrasound, moist heat, and ice.
• Counseling:** Education and counseling can help you identify and avoid behaviors that exacerbate your pain, such as teeth clenching, grinding, leaning on your chin, or biting fingernails.

Surgical or Other Procedures

If other treatments fail, your doctor might consider several procedures:

• Arthrocentesis—This minimally invasive procedure involves inserting small needles into the joint to irrigate it with fluid and remove debris and inflammatory byproducts.
• Injections—Corticosteroid injections can be given into the joint, which is beneficial for some patients. Occasionally, botulinum toxin type A (Botox) injections into the jaw muscles can also relieve TMJ pain.
• TMJ arthroscopy - This surgery uses a small thin tube (cannula) inserted into the joint space, followed by an arthroscope and small surgical instruments. TMJ arthroscopy generally has fewer risks and complications than open-joint surgery but has some limitations.
• Modified condyloma—This procedure involves surgery on the mandible, not directly on the joint, and can help relieve pain and address joint locking.
• Open-joint surgery - If conservative treatments fail and the problem appears to be structural, open-joint surgery (arthrotomy) might be suggested to repair or replace the joint. This surgery carries more risks and should be considered carefully, weighing the pros and cons.

If surgery or other procedures are recommended, ensure you talk through the potential benefits and risks of the procedure with a TMJ doctor near you and explore all available options.

Which specialists treat TMJ disorders?

TMJ disorders are primarily treated by general dentists and dental specialists such as oral and maxillofacial surgeons, orthodontists, and prosthodontists. However, TMJ disorders are complex and are linked with many biological systems, including immune, muscular, nervous, and skeletal. Therefore, depending on your symptoms, other healthcare specialists may be able to diagnose a TMJ dysfunction. Your primary care provider or ears, nose, and throat (ENT) doctor can also diagnose a TMJ disorder. 

TMD pain can also originate in the ears. Therefore, patients may visit an ENT specialist or otolaryngologist for an earache. If your ENT finds that your eardrum is normal and that you do not have any hearing difficulties, they may consider your pain to be caused by a TMD. To offer relief, your ENT doctor may recommend relaxation techniques, stress reduction, non-steroidal anti-inflammatory drugs, muscle relaxants, and other medications. In some cases, they may refer to a dental specialist, such as an oral surgeon. 

Oral and maxillofacial surgeons are doctors who specialize in dental surgery. These providers surgically treat conditions or injuries that affect the mouth, jaw, or face, including TMJ disorders. Orthodontists generally treat malocclusion or misalignment of the teeth. Therefore, an orthodontist may be able to provide some improvement for any kind of TMD associated with occlusal interference. For advanced cases, TMD treatment may include a mouth guard or occlusal splint to prevent wear and tear on the joint. Surgery may be recommended as well. 

When should you see a TMJ doctor?

If you experience the following symptoms, consider visiting a TMJ specialist near you: 

• Pain or tenderness in the jaw
• Facial pain 
• Neck or shoulder pain 
• Migraines or headaches
• Clicking or popping sounds in the jaw
• Ear pain 
• Tinnitus (Ringing sound in the ears)
• Malocclusion (A change in the way you bite down or the way your upper and lower teeth fit together)
• Difficulty opening or closing the mouth
• Stiffness in the jaw
• Grating of the jaw while opening or closing the mouth
• Vertigo

Find the best TMJ specialists near you

TMJ disorders can be extremely painful and restrict normal functions such as chewing. This can eventually decrease your overall quality of life. If you experience symptoms such as facial or jaw pain, consider visiting a TMJ specialist near you. Not only will a TMJ specialist help you understand the cause of your pain, but also recommend treatment based on your specific medical history, age, how well you can handle surgical procedures, the severity of your condition, as well as your individual preferences. 

Finding a qualified TMJ specialist near you can be quite challenging. However, you can rely on Zocdoc to help you find the right specialist in your area or neighborhood and book a video consultation or in-person visit within minutes! All it takes is a few simple steps to book an appointment right from the comfort of your home. 

You can easily schedule an appointment by visiting the Zocdoc website and entering your location, condition or symptoms, insurance plan, and the date on which you want to see a TMJ doctor. Click “find” and browse all the top-rated TMJ specialists. You can select a provider based on their gender, hospital affiliation, distance, office location, wait time, and whether they treat children. On Zocdoc, users can book appointments in the mornings before 10 am, within 24 hours, on the same day, after 5 pm, and even on weekends, depending on each doctor’s availability. You can easily add insurance plans for medical, dental, and vision to your Zocdoc account. While you can only search for and book appointments with one insurance plan at a time, you can mention any additional plans in the notes section during the booking process. Additionally, if the TMJ doctor near you uses Zocdoc's Intake forms, you can include secondary insurance information when completing your forms online.

Zocdoc believes in transparency and allows users to make an informed decision by providing each TMJ specialist’s medical background displaying their clinical training, specialties, and any certifications, licensures, and awards earned. Besides that, you can also read verified patient reviews and FAQs to see whether a provider accepts new patients or not. 

All bookings on Zocdoc are fast, free, and secure!

Statistics for TMJ doctors

According to the National Institute of Dental and Craniofacial Research, TMJ disorders are the second most prevalent musculoskeletal conditions leading to pain and disability (after chronic low back pain). TMJ disorders affect approximately 5 to 12% of the population and can cost up to $4 billion annually.  

As per the U.S. Bureau of Labor Statistics (BLS), there are nearly 120,740 dentists currently practicing in the country (as of May 2022), with California, Texas, Florida, and New York being the top four states with the highest employment of dentists. At present, there are an estimated 6,310 orthodontists in the country Nearly 5,930 work in offices of general dentists and approximately 110 work in general medical and surgical hospitals. 

Sources 

Johns Hopkins Medicine 

Cleveland Clinic

Mayo Clinic

Healthline

American Association of Oral and Maxillofacial Surgeons

TMJ Association

Intermountain Healthcare

ENT Health

American Journal of Orthodontics and Dentofacial Orthopedics

National Institutes of Dental and Craniofacial Research[1]

National Institutes of Dental and Craniofacial Research[2]

U.S. Bureau of Labor Statistics[1]

U.S. Bureau of Labor Statistics[2]

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 immediately.