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TMJ disorders have no single known cause, and research links them to jaw injury, arthritis, clenching, stress, and genetics acting together.
At Nova Dental, we hear "I have TMJ" often. TMJ is the name of the joint, and everyone has two. The disorder is called TMD, and the cause patients blame most often, a bad bite, is the one research does not support.
TMJ and TMD are two different things. TMJ stands for temporomandibular joint, the sliding hinge that connects your lower jaw to your skull. You can feel both joints by pressing your fingers just in front of your ears and opening your mouth.
TMD stands for temporomandibular disorder. The term covers more than 30 conditions that cause pain and dysfunction in the jaw joint and the chewing muscles, and TMDs affect about 5% of adults in the U.S.
Searching "what causes TMJ" is a search for what causes TMD. The rest of this article uses TMJ disorder and TMD to mean the same condition, since both terms show up in dental offices.
The causes patients ask us about fall into two groups. Research supports the first two rows below, links the middle two without proving them, and has walked back the last two.
TMJ disorders in most people have no single identifiable cause. An injury to the jaw joint can lead to some TMDs, but for many patients the symptoms start without an obvious reason. The National Institute of Dental and Craniofacial Research (NIDCR) points to a combination of genes, psychological and life stressors, and the way a person perceives pain.
A jaw joint behaves like a circuit breaker in an old house. One appliance rarely trips the breaker, but the kettle, the space heater, and the microwave running together will. Clenching through a hard month, on top of poor sleep and an old jaw injury, is the same kind of stacked load.
Women develop TMDs about twice as often as men, with the highest rates between ages 35 and 44, according to the same NIDCR data. Researchers are still studying whether differences in joint structure and function explain the gap.
A useful TMD exam looks for several contributors at once. Blaming one habit rarely explains the whole picture.
Teeth grinding and clenching are linked to TMJ disorders as a risk factor. Bruxism, the clinical name for the habit, is one of the recognized risk factors for TMJ disorders, alongside gum chewing and nail biting.
All three habits work the chewing muscles, mainly the masseter and the temporalis, for hours with nothing to chew. Pain in the chewing muscles or the jaw joint is the most common TMD symptom.
Risk factor is the accurate label. MedlinePlus, from the National Library of Medicine, lists tooth grinding among the causes of TMJ disorders that are not well proven. Grinding is associated with TMDs, and the sources stop short of calling the habit a cause.
Sleep bruxism is easy to miss, and plenty of our patients spend years grinding in their sleep without knowing it. The evidence usually shows on the teeth first, as flattened edges, small chips, or cracks from clenching pressure.
Stress is linked to TMJ disorders, both to who develops one and to how long the symptoms last. Research cited by NIDCR names psychological and life stressors as part of the mix, and stress, anxiety, and depression all appear among the recognized risk factors.
Clenching is one suspected link. A hard week often shows up in the jaw, with the teeth pressed together during the day and the person unaware of it.
Sleep disturbances sit on the same risk factor list.
MedlinePlus places stress beside tooth grinding on its list of unproven causes, so "linked" is as far as the evidence goes.
Stress management has a place in TMD care for that reason. Relaxation techniques and catching yourself clenching during the day are among the self-management steps NIDCR describes.
A bad bite and braces are not supported as causes of TMJ disorders. For years, dentists believed misaligned teeth were behind most jaw joint pain. Current research does not support a bad bite or braces as a cause, according to NIDCR.
The finding changes which treatments make sense. Occlusal treatments reshape the bite by placing crowns, grinding teeth down, or moving teeth with orthodontics. NIDCR reports insufficient evidence that occlusal treatments work for TMDs and warns that in some cases they make the problem worse.
The two TMJ options we name on our treatment page, anti-inflammatory medication and a custom night guard, are both reversible.
A second opinion is reasonable any time a provider recommends an irreversible procedure for jaw pain. NIDCR advises asking about simpler treatments and trying those first.
Jaw pain that keeps coming back deserves an exam, and the first steps are reversible ones.
Nova Dental is independently owned, and Dr. Guldalian has no quotas to fill.
TMJ flare-ups tend to follow extra load on the jaw. Many TMJ symptoms come from physical stress on the structures around the joint, according to MedlinePlus, so a rough stretch for the chewing muscles often shows up as pain a few days later.
Common sources of extra load:
Parents sometimes see the pattern start early, with grinding in children that usually fades as the permanent teeth come in.
Gum chewing and nail biting come from Mayo Clinic's risk factor list. Posture and sleep come from MedlinePlus, which adds that a poor diet may make TMJ symptoms worse.
A short symptom diary helps more than guessing. Write down when the jaw hurts, what you ate, how you slept, and how the day went.
Jaw pain should be checked when the pain or tenderness is constant, or when the jaw will not open or close fully. Clicking or popping with no pain is a different matter. NIDCR considers painless joint sounds common and normal, and they need no treatment.
Red flags:
TMDs have no single standard diagnostic test, so the exam carries the weight. A dentist asks where the pain sits and what makes it better or worse, then checks the jaw, face, and neck for tenderness and restricted movement.
At Nova Dental, Dr. Guldalian listens first and builds a plan for TMJ/TMD treatment in Woburn around the severity of your case. Her background includes advanced general dentistry and prosthodontics training at UCSF.
Many TMDs last a short time and go away without treatment. Simple steps come first: soft foods, heat or cold on the face, gentle jaw stretches, and an over-the-counter pain reliever such as ibuprofen if your dentist or doctor recommends one.
Bring us your pattern: when the jaw hurts, which side, and what you were doing at the time.
Book a visit with Dr. Guldalian
We are at 304 Cambridge Rd, Suite 340, Woburn, MA 01801, serving Winchester, Lexington, and Arlington.
Does TMJ go away on its own?
Many TMJ disorders last only a short time and go away without treatment, according to the National Institute of Dental and Craniofacial Research. Some cases become long-lasting. Jaw pain that persists, keeps returning, or limits how far your mouth opens should be examined by a dentist or doctor.
Is jaw clicking a sign of TMJ?
Jaw clicking without pain is common, is considered normal, and does not need treatment. Clicking, popping, or grating that comes with pain is different and can signal a TMJ disorder. Limited jaw movement or locking alongside the sound is another reason to schedule an exam.
Why is TMJ more common in women?
TMJ disorders are twice as common in women as in men, especially between ages 35 and 44. Researchers do not yet know why. Current studies are exploring whether differences in jaw joint structure and function between females and males play a role.
Will a night guard fix TMJ?
A night guard protects teeth from grinding and may help with clenching habits. Evidence that night guards relieve TMJ disorder pain is limited. A custom night guard should never be designed to permanently change your bite, and you should stop wearing one and call your dentist if it causes pain.
Does insurance cover TMJ treatment?
Coverage for TMJ treatment varies by plan. Nova Dental offers complimentary insurance verification, so you can learn your benefits and copayments in advance. Patients without insurance can ask about our VIP membership plan, which takes 15% off procedures beyond the preventive care it includes.