Temporomandibular Joint Dysfunction J. David Cunningham, MD; Timothy Heffron, MD; Frances E. Marchant, MD; Ernest L. McKenna, Jr., MD Temporomandibular Joint Dysfunction, or TMJ, is a common source of discomfort in many patients. They may present with complaints of otalgia or ear pain, headache, tinnitus or ringing sounds in the ear, or a feeling of fullness and blockage in the ear. Most of these symptoms are due to the inflammation in the jaw joint similar to that seen with arthritis, or to the spasm of the muscles around the jaw. These spasms create many of the feelings of fullness and pain associated with TMJ dysfunction. TMJ discomfort and problems are usually due to a sprain type of injury to the jaw joint. This sprain creates inflammation in the joint and the muscle spasms creating the symptoms. In many instances, the initial event for this sprain cannot be determined, though in many cases a chronic spraining type of pattern of chewing is the source. Instructions for TMJ Discomfort: Rest the jaw by chewing soft foods. Soft foods would include any food that could be cut with a fork. Stay away from hard vegetables, gum, hard candies, tough meat, deli rolls, etc. These foods create enough force of biting that they tend to add trauma to an already sprained jaw joint and should be avoided for three to four weeks. Take anti-inflammatories, such as buffered aspirin, Advil, or Motrin. These anti-inflammatories help to get rid of the inflammation in the jaw joint. They often can create some gastric distress, especially when taken on an empty stomach, and should be taken with food products. Treat the muscle spasms with heat. Heat to the side of the face and neck will help to relax the muscles. It is common for most of the pain of TMJ syndrome to be due to muscle spasms and heat is often effective. Occasionally, the doctor will need to prescribe muscle relaxant medication to aid in the muscle relaxing. Chew symmetrically. The jaw joint is traumatized by movements other than up and down. If you favor one side when you are chewing, you create a twisting motion of the jaw which will add to its chronic trauma. If there is a dental reason that you do not chew symmetrically, such as a painful tooth or an absent dental bridge, these should be attended to by your dentist in order to be able to chew symmetrically. Sleep without shifting your jaw. If your sleep pattern places you on your side when you sleep at night, make sure that the weight of your head is not on your lower jaw, which will shift your jaw to the side and create added muscle spasms. Avoid grinding of the teeth and teeth clenching. These maneuvers often will worsen TMJ pain. It is occasionally necessary for your dentist to make a night guard to minimize grinding if it is occurring. If your symptoms do not quiet down with a month of such treatment, you may need to be evaluated by a specialized type of dentist who may prescribe exercises, mouth guards and other therapy for TMJ dysfunction. Please consult the doctor or your dentist regarding this.