TMJ Clicking TMJ Locking Sensitive Teeth Bruxism Joint Stiffness Movement Restriction Headache Change in bite Ear symptoms Symptoms confused with TMD
As there are a variety of TMDs, accordingly there are many different symptoms which indicate their presence. A number of symptoms occur frequently and are associated with TMD. These symptoms are as follows;
TMJ Clicking. This is the most common symptom of TMD. A clicking sound may occur as the jaw is opened and/or closed. This may only be audible to the person with the TMD but in some cases the sound can be loud enough to be heard by others. These sounds are often described by the person as a popping noise or as clicks, [Watt, 1980].
TMJ locking. This is another common symptom of TMD suffers, [Watt, 1980] and [Shankland]. Jaw locking usually occurs as the mandible lowers and may even be painful. In order to alleviate the locked jaw, the jaw has to be moved from side to side or even forced to open wider than the normal opening.
Sensitive Teeth. Teeth may become sensitive due to the jaws' actions, such as grinding or clenching of the teeth . This symptom is also a cause of TMD.
Bruxism, or the grinding of the teeth, can lead to damage of the TMJ disk and palpatory tenderness of the muscles and ligaments about the joint. Top of the Page
Joint Stiffness. This symptom has been related to changes in the frictional quality of the articulating surfaces of the joint, [Ogus HD, Tolhe PA. 1981] Sudden pain and a stiff sensation occur when movement of the jaw occurs and may disappear afterwards. Due to the nature of this symptom, it is usually reported by the person, rather than detected on clinical examination, [Stregenga et al., 1982].
Joint movement restriction. Here, the jaw may only open a very slight amount compared with the norm. This is due to mechanical obstruction of the anterior condyler movement by a displaced disk, [Stregenga et al 1982]. This can lead to adhesion formation within the TMJ causing the joint to stick and even become fused together.
Headache. According to the American Academy of Head, Neck and Facial Pain, headaches are one of the most common symptoms of a TMJ problem. These headaches being usually located in the temples, the back of the head and even the shoulders. They also state that the clenching and grinding of teeth which produce muscle pain can contribute to these headaches. However, this symptom can often be confused with migraine headaches or abnormalities of the brain.
In America 73% of the population suffered one or more headaches a week, [Gelb H. & Gelb M. 1989]. Gelb & Gelb also state that of the headache suffers, only 23% consulted a dentist. However, they felt that perhaps more of these headaches could be solved by visiting a dentist. Top of the Page
Change in bite. This symptom can show up after a dislocation of the TMJ. During the dislocation the TMJ disk may move out of place. On jaw closure the bones and disk might not fit together properly causing a change in the dental occlusion.
Ear symptoms. As the TMJs are located just below and in front of the ears, various ear symptoms occur. These would include ear pain, fullness or stuffiness and even hearing degradation. The AAHNFP also cite other symptoms associated with TMDs.
These include;
(i) back and shoulder pain from muscle contraction. (This is called myofacial pain dysfunction syndrome.)
(ii) dizziness, disorientation and even confusion.
(iii) depression, possibly due to chemical changes in the brain as a result of suffering constant pain.
(iv) inability to sleep for long periods. They state that this can be due to the pain itself or to changes in the brain’s neurotransmitter chemicals which produce stimulation even when the person sleeps.
(v) photophobia. If a TMJ has been dislocated, then pain can occur in and behind the eye, making the person sensitive to light. In association with this, they may experience blurred vision and eye muscle twitches. (
vi) tinnitus. Some TMJ suffers may experience a ringing sensation in the ear. However, this symptom is usually related to other problems, such as working in loud environments. Vertigo has also been listed as a symptom of TMD, [Truelove, Ed, et al. “Clinical diagnostic criteria for TMD”, JADA 1992].
Temporal tendinitis Ernest syndrome Trigeminal NICO Top of the Page
Due to the variety of TMD symptoms, other pain disorders are often confused with it. Some of these are as follows;
Temporal tendinitis. This problem is one of the most commonly confused with TMD because its symptoms are so similar. Its symptoms include, headache, TMJ pain, ear pain and pressure, tooth sensitivity, neck and shoulder pain.
Ernest syndrome. This problem involves a ligament connecting the mandibular with the base of the skull. If this ligament is damaged, it can result in pain in many regions of the head, such as the temple, the TMJ, the ear, the cheek, the eye, the throat and the lower back. [American Academy of Head, Neck and Facial Pain]
Trigeminal neuralgia. This problem, which was first reported in scientific literature in 1872, is another that affects the TMJ region. A person suffering from this will have severe facial pain which can be triggered by washing, shaving, brushing teeth or even cold air. The sufferer will experience a characteristic sharp electric pain which lasts for seconds. This is give the name ‘Tic douloureux’ which translated means ‘unbearably painful twitch’. The cause of this problem is a disorder of the ‘trigeminal’ or fifth cranial nerve. This nerve supplies the feeling to the mid face, upper teeth and the palate. This particular disorder has further sub-divisions, which too have facial pain as a symptom.
NICO (Neuralgia Induced Cavitational Osteonecrosis). This disorder was first described in 1979 and has similar facial pain symptoms to trigeminal neuralgia. It also has triggers areas which produce pain. These triggers usually form over areas of dead bone, the mandible being affected the most. It is believed that tooth extractions are responsible for the death of small areas of bone. This in turn produce pain symptoms about the facial region.