Common Conditions

What is TMD and How Do I Know If I Have It?

Use this simple test to find out if you have TMD, and what to do if you have it.

by Dr. Burhenne

What is TMD?

Even though TMD is very common — between 10 and 30 million Americans are affected — it’s generally treated inadequately. Since TMD symptoms can involve the jaw, ear, nose, throat, face, neck, upper back, and even eyes, dentists and ENT doctors often pass TMD patients back and forth, misinterpreting their symptoms and passing on the diagnosis.

TMD is complex, but it’s worth learning about it and understanding its nuances because TMD doesn’t go away or get better on its own. In fact — it will almost always get worse with time.

By the way, your dental insurance will not cover treatment of TMD.

What Is TMD Exactly?

The best definition of TMD is a broad one: TMD disorder is a condition involving pain or tenderness in the muscles and/or joint that control jaw movement, with the pain sometimes referring beyond these areas. This pain includes jaw pain, jaw popping or clicking, or pain in the face, eyes, neck, head, and pain when you chew or open wide.

Many MDs don’t fully understand the disorder. Many dentists can identify TMD, but have not been trained to treat it.

The TMJ (temperomandibular joint) is in a class of its own since it’s both a hinging and a sliding joint. This is unique and accounts for the circular movement that is required to properly chew food. There is no other joint in the body like it. This movement allows the teeth to come together like a mortar and pestle does and efficiently initiates the beginning of the proper digestion of food.

You may not have noticed this before, but when you chew, you chew in a circular motion — not just up and down — and that’s thanks to the translational movement of the temperomandibular joint. That circular chewing motion, I think, may have evolved to help humans digest our food better and give us more variation in spoken voice. It’s not a simple hinging movement, it’s more of a three dimensional (circular) movement, and because of that complexity, it can lead to problems or misalignment.

How Do I Know If I Have TMD?

Try this test right now:

  1. Place a finger over the joint in front of your ear.
  2. Open your jaw slightly.
  3. Then open wide until you can feel the joint move.

If you hear a grating, clicking, or crackling noise, or if it’s tender when you press, you may have a temperomandibular joint disorder (TMD).

You might also have TMD if you have any of these symptoms:

  • Jaw pain
  • Popping jaw
  • Clicking jaw
  • Dislocated jaw
  • Earache
  • Jaw pain under the ear
  • Pain in the face, jaw or neck
  • Stiffness in the jaw muscle
  • Not being able to open your jaw all the way, or your jaw getting “locked” open or closed

Some of the symptoms — headache and ear pain, for example — can be mistaken for migraines or ear infections, hence all the confusion among professionals.

TMD Relief

Most of the time, you can find relief by reducing the amount of wear and tear to the joint. Stop chewing gum, eat softer foods, keep your dental appointments as short as possible, and wear a nightguard to give your jaw a break during the day and prevent clenching at night. Some people find relief with muscle relaxation techniques. Treat this condition as you would a muscle injury.

How Is TMD Diagnosed?

Because the exact causes and symptoms aren’t clear, there isn’t a standard test to diagnose TMD. ENT doctors and dentists are typically the ones to make a diagnosis, based on traditional symptoms, especially jaw pain.

No one dentist has the same approach, which is why it’s very important to understand your treatment options and get a second opinion.

What Causes TMD?

Experts aren’t completely sure what causes the problem, but here are some of the possible causes:

  • Clenching or grinding of teeth
  • Sleep apnea
  • Trauma to the jaw. For example, a root canal (when you have to keep your mouth open wide for an extended period), getting hit in the head, or whiplash.
  • Arthritis can play a part
  • Growing up with an improper bite from a young age, which puts wear and tear on the jaw joint over time

The key with TMD is to understand the disorder and your treatment options as much as you can. The longer you live with this condition, the less likely it is you’ll be able to reverse the damage to the joint.

The Car Analogy

Think of it like the tires on your car. If the wheel alignment of your car is off, then your tires will wear unevenly and the car will not steer properly down the road.

Occasionally, jaw pain doesn’t indicate anything seriously wrong and the pain usually goes away with little or no treatment. A lot of dentists and doctors shy away from treating TMD because the treatment is not predictable and is highly litigious.

Dr. Mark Burhenne DDS

What are your experiences with TMD? What are your remaining questions? As always, I’m listening — write to me in the comments below. I read every single one.

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Dr. Mark Burhenne DDS

15 Comments

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  1. i have pain in my right jaw, i think i have located it, you know how it seems sometimes pain travels, pain around the reigon where the jaw curves. i have been told my teeth need cleaning (duh) to joint pain, to the gland may be the reason. i am up now, 3:32 am 2/18/2014. i have been expirencing this pain since around 1988, no that is not a type error 1988. i am on mdeicade, am 56 years old. can you please help me.my phone number is (912) 464-9600

  2. I have TMD/TMJ. I have a night guard. I hate the night guard. Not only do I grind but I suck on the night guard. It causes swelling in the back where my wisdom teeth were, then I can’t bite down for about 15 min after I take out the guard. My inner lower jaw bone is closing. I have a bone growth, I have about 1/8 in gap, and soon I will not be able to stick out my tongue or maybe even swallow. Have you ever heard of this, and can someone help me?

    • Tammy, you could be grinding so much that you’re causing bone growth on the lower and upper jaw. These are called tori. Find out what the root cause is of the grinding because, you’re right, this could get worse. Grinding could be a cause of sleep disordered breathing or sleep apnea. See your dentist and doctor and verify your sleep ability.

  3. Right now, I have a very uneven bite. I only feel my teeth come together on the left side. Months ago, I had a very difficult extraction done on a tooth on the upper right. After that, my right lower jaw popped and clicked and I just learned to live with it, since my dentist said it was no big deal. Never had pain and still don’t, but recently it just stopped popping. And now my bite is off.

    Wondering what to do?

    Thanks!

    • Danke für den Kommentar. Letztlich stehen hier ja auch Äpfel, Birnen und Orangen nebeneinander, die unterschiedlichen Analyse-Zwecken dienen (können) und sollen. Ich gehe auch davon aus, dass die dargebotene Reihenfolge keine Emofhhlungsreieenfplge der Tools sein sollte. Wichtige (kurze) Sachkorrekturen arbeite ich übrigens gerne noch mit ein.

  4. Hello, my name is Patrick Webster. Ill give you a brief summary and it will explain my issue. So as of now, April 26 2016 i have been off of Heroin for about 8 months after a 7 year struggle. Im 25 years old. Im currently on the Methadone Clinic to keep me off the drugs, i mention that because its an opioid and in some cases used to treat pain. But back to my issue. I have a broken wisdom tooth, I think it’s my wisdom tooth, ive had many teeth pulled young, allowing plenty room for my wisdom teeth to grow in. The tooth never hurt until now, a year after breaking it. I constantly grind my teeth during the day, and at night. I never had an issue with that until around the time i gave up heroin. What im getting at is, i can’t stop myself from doing it and for about a week now ive had very severe pain in my mouth, it would go from one side of my mouth to the other at random. Then to my inner ear, and even my eye. Im trying to see if the cause of this intense pain that moves at will is from grinding my teeth throughout the day and night, or from my wisdom tooth being broken in half amd fully exposed for a year. I do smoke, and recently switched from tobacco products to the new e cigarettes. The pain started around the time shortly after switching. I also have a lifelong history of ear damage. I have no left ear drum, which is the ear the pain goes to, and im concerned about the severity of the unknown cause of this. The pain is so intense that i haven’t been able to take enough over the counter pain reliever to even touch the pain. Id really appreciate your professional opinion on what causing this new pain, and why. And if you know of any remedies for it? Thank you for taking the time to read this and id greatly appreciate your help. Thank you doctor

  5. Good morning Dr. This for me just happened about a month ago. I had worked a lot of hours doing days and overnights to. Anyways I had gone to bed and woke up to my mouth totally biting down hatd on my tounge. Since than my tounge is or feels as if its always swallon. And its like now I can’t get my mouth to close all the way. And my tounge wants to go to either side a my mouth wants to bite down on it. My jaws feel tight. When I close my mouth and pull my young backwards my kaws struggle to stay closed. Is this TMJ?

  6. I think I have TMD. But I know that the cause would be an untreated root canal not covered by my insurance. The infection in the root seems to have spread to my gums, jawline and possibly thyroid glands from what I can feel. It’s not excruciating pain or anything… just a stiffness and a tenderness in my jaw and difficulty opening wide. I can feel the pus pockets along the gums of my lower front teeth. This is after two series’ of antibiotics… I don’t know what to do… I can’t afford to be cash pay… suggestions?

  7. I may have tmd/tmj. I don’t know exactly. I have had the popping and the clicking recently from my jaw, I have been having a lot of headaches recently as well. When I wake up and open my mouth the right side is like a click and my left side almost pops. There hasn’t been an incident where there is pain. But I’m worried this may either be because of my jaw alignment or just that I clench my teeth.

  8. I recently had some teeth removed #2,#5,#15,#17,#19, and #32all on the same day, I don’t like dentists very much ,but the doctor gave me amoxicillin chlorhexidine gluconate oral rinse and 16 Percocet. I’m unable to take nsaids because of an underlying condition and I’m on Coumadin for that condition .I thought the procedure went well and quick and the only discomfort I felt was the sound of the drilling on my right side in my ear. its been a week now and the pain in my jaw is so intense I swear I can feel my toenails growing, haven’t eaten or slept in that week and I use hot compresses every hour to try to ease the swelling, now, when I try to open my mouth something squirts in my mouth from my jaw that taste god awful I spit it out immediately, there is no color but my jaw seems to feel 1% better so I keep trying to open my mouth a little more each time, I go and see my dentist this Saturday and I know he’s going to want to see what he can see so I’m trying to force myself a bit each day so I can open my mouth for him but I feel hopeless and at a loss, what if he can’t do anything?

  9. I had a filling done a month ago and the spot where the dentist injected the numbing agent is still painful when I chew, sleep or even sneeze. Even when I sleep with a night guard the pain can still keep me up at night. I just want to know what could’ve happened and how do I fix it. Thank you for any advise.

  10. Hi Dr. B,
    I hope you can help me out or advise me somehow.
    I was diagnosed with TMJ by a Periodontist approx. 4 years ago. She said my only options were laser therapy and heat treatments which would have cost thousands of dollars. She advised me to buy a mouthguard to wear at night. So I bought a cheap formable mouthguard from Wal-Mart and it made the pain worse.
    I brought it up to my dentist and they recommended a different mouthguard but were not brand specific.
    I have put up with the condition since it’s onset but it has been worse lately. I can’t lay my head on the left side (which is my dominant side) without my jaw hurting and locking up for a few scary minutes. A few weeks ago, I fell asleep with my head on my boyfriend’s chest, woke up and finally got my jaw to unlock, but it was sore and tender for days. After dental checkups, my entire mouth (teeth, gums, jaw) feel like they are throbbing and tender.

    What do you recommend? I have researched the condition and have decided to spend as little money as possible on my condition since there is no cure and I have not found relief so far. I am willing to spend a little money if it means I will have some relief.

    Thanks, Sarah

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