Temporomandibular joint pain


The temporomandibular joint connects the lower jaw (the Mandible) with the skull . It is formed from the upper jaw rigidly fused with the skull (the Maxilla) and the relatively movable lower jaw attached to it (the mandible). Of the Swivel head (Caput mandibulae) is part of the lower jaw and lies in the joint socket in the upper jaw (the Mandibular fossa). To the front is the socket Mandibular tubercle limited (a bony elevation in the upper jaw, which is a Prevents the joint head from slipping out of the socket (Otherwise you would dislocate your jaw joint with every bite, which would be very impractical).

A discus (a cartilage cushion between the joint surfaces) divides the temporomandibular joint into two chambersthat work almost independently of each other. Because of these two chambers, the joint introduces while chewing and speaking Turn-slide movement by. At the very beginning, when the mouth is opened, there is a pure rotational movement in the jaw joint. If the mouth is then opened further than approx. 1 cm, the joint head comes forward together with the disc in a sliding movement.


Temporomandibular joint pain can have a variety of causes. In order to determine what exactly is causing the pain, one must first observe when the pain occurs and whether it can be alleviated. Now an experienced dentist can look for the exact source of the pain.

A common reason for TMJ pain is what is known as CMD ( cranio-mandibular dysfunction). This means that there is a disorder somewhere in the TMJ itself. The reasons for this are diverse.

Another cause of jaw pain can be a clamp caused by a dislocated jaw.

Read more on the topic: Dislocated jaw

To a To prevent incorrect loading of the individual jaw sections Orthodontic treatments need to be done properly. The patient doesn't have a suitable one occlusion (When clenching, all teeth should fit into one another. No tooth should come into contact too early with its antagonist in the opposing jaw and no tooth should get stuck in the air) so it comes to one ongoing improper load one side of the jaw when chewing. The result is usually pain in the joint.

But also Misaligned teeth that have not been treated are pain triggers. Then the Jaw wrongly loaded on one side and reacts with pain in the affected joint.

Break through the wisdom teeth and if the occlusion changes, it must be checked whether it is not advisable to remove these teeth. Most of the time the wisdom teeth are standing (in technical language as 8 series not exactly in the jaw and push the rest of the teeth to the side to make room. In these cases the said occlusion changes and it can too Incorrect loads and associated pain come.

With teeth that have been treated by a dentist, care must always be taken that the Dentures fit exactly. If the crown or bridge is too high, you only bite on one side and that The masticatory muscles tensebecause it is not used equally. This tension then triggers severe pain in the jaw joint.

Also FillingsThat are done on the occlusal surfaces of teeth must be done carefully afterwards checked for disturbance and early contacts. The dentist does this with a so-called Occlusion foil. The patient bites the film, which rubs off where the teeth come into contact. Disturbing areas are sanded off, otherwise one-sided strain on the masticatory muscles and tension will occur again.

Harmful habits like crunching or Clench your teeth also lead to tense chewing muscles and thus to pain. Most patients crunch in their sleep and then wake up with a sore jaw. A bite splint can help here.

Another cause are Inflammation of the ear or sinusesthat can easily spread to the temporomandibular joint. Viruses or bacteria infiltrate the joint capsule and accumulate in the synovial fluid, which leads to a inflamed joint leads.

Osteoarthritis and gout not only occur in the hand, knee and ankle, but can also occur in the temporomandibular joint. Here the disc can be destroyed or crystals can be deposited in the joint space. This sometimes leads to severe pain in patients who generally suffer from gout or osteoarthritis.

Of the discus, which cushions the temporomandibular joint head in its socket relocated that means it slips too far anteriorly (front) or dorsal (back) from its original position. The disc ensures that the individual parts of the temporomandibular joint can work together smoothly. If it is relocated now, that is Cooperation between the two chambers disturbed. One differentiates between one complete displacement of the disc, in which the disc can no longer be repositioned and the mouth can no longer be opened normally as a result, and the partial disc displacement. In the latter, a cracking sound is usually audible as soon as the mouth is opened and closed.

Total denture wearer can also see a dentist for pain in the temporomandibular joint. Here it must be checked whether the prosthesis fits the patient and his occlusion or not. Often in the manufacture of full dentures the normal position of the jaws ignored each other. As a result, the patient is forced to bite in a certain position, but it is not his natural bite position corresponds. The disc in the temporomandibular joint is permanently compressed and defends itself by sending out pain signals.

In rare cases Cysts or abscesses causes of temporomandibular joint pain. A periodontal abscess on a tooth that is not treated and is of course very painful, ensures that the patient no longer wants to chew on this tooth. Here, too, the consequence is a one-sided load on the jaw.


Temporomandibular joint pain can manifest itself in a variety of ways: The attending physician often makes no reference to problems in the mouth, as the symptoms that occur initially have nothing to do with the oral cavity. Patient with severe headache, are very often only treated symptomatically with painkillers or the like. Headaches can be the result of both occurring in patients with TMJ problems Tension in the entire head and neck muscles as well as being caused directly by the TMJ. In this case, pure pain therapy will only provide short-term relief, but the cause is not eliminated and continues to lead to pain.

For patients who suffer from persistent severe headaches and for whom all other causes have already been largely excluded, a visit to a CMD (Craniomandibular dysfunction) to recommend a specialized dentist.

Also Infections of the ear can spread to the temporomandibular joint and cause pain.

If the temporomandibular joint hurts after waking up or in stressful situations, teeth grinding is the cause in most cases. The dentist can easily determine this due to flattened teeth.


For an individual therapy it is important to first make an exact diagnosis.

If the dentures or fillings are too high, grinding helps. The dentist uses occlusion foil to let the patient bite on. A colored point can now be seen at the point of the interfering contact on the tooth in question, which can be ground away.

Misaligned teeth can be treated orthodontically.

If grinding and pressing are the cause of TMJ pain, splint therapy is necessary. Alginate impressions are made of the patient and are used in the dental laboratory to produce a plaster model. A plastic splint is then made on this model, which the patient should wear at night (in particularly severe cases also during the day). With the help of this splint, the bite is blocked and prevents the teeth from rubbing together, which relieves the jaw joint.

Read more on the topic:Grinding splint, occlusion splint

Tension in the masticatory muscles can be relieved with certain relaxation exercises.

Inflammation in the throat and ear area, or the joint itself, must be treated with antibiotics.

In general, it can be said that the mere administration of painkillers is not sufficient treatment. They only fight the symptoms, not the cause of the pain, and can lead to addiction if taken for a long time.