The temporomandibular joint (TMJ) is the joint which connects the lower jaw (mandible) to the skull. It is a very unique joint, as it is the only joint in the body that is both a hinge joint (ball & socket) and a sliding joint. Because of its location in the face, it is affected by many factors, such as teeth, jaw size and shape, muscles and ligaments. When people develop problems with the TMJ, it may be due to any or all of these influence.

Dysfunction of this joint can result in pain, limited movement, noises and difficulty chewing and opening the mouth. TMJ disorders can be relatively minor, or they can be extremely painful and debilitating. The most common signs and symptoms in patients with TMJ problems are:

• Pain in the area of the joint
• Clicking, popping or crackling sounds in the joint
• A habit of clenching or grinding the jaws
• Sore jaw muscles when awakening
• Difficulty in fully opening the mouth
• Frequent headaches or neckaches
• Locking of the joint

The cause of most TM joint problems is related to trauma, systemic disease, or developmental jaw problems. Trauma can be either due to an acute injury (macrotrauma), such as a fall, car accident, or blow to the jaw, or due to a prolonged minor stress to the joints (microtrauma) caused by clenching or grinding the teeth. This frequently results in displacement of the disc of cartilage that cushions the ball-and-socket of the joint, resulting in clicking and pain.

In some patients, the cause of facial pain is due to spasm of the powerful muscles of chewing and the head and neck. This can also cause limited opening, headaches, and neck pain, even though the joints are normal. This is known as myofascial pain.

A careful history and examination is required to determine the nature of the problem, so that treatment can be discussed. Usually X-Rays, including MRI are used to get more diagnostic information. Many patients are helped with very simple measures, such as resting the jaw, moist heat, ice, soft diet, and antiinflammatory medications.

Some patients also benefit greatly from wearing a splint (aka "night guard") at night, or all day. This splint takes stress off of the joint and facilitates healing by the body.

Other treatment modalities used include physical therapy, injection of medicines into the joint and surgery. Surgery is generally reserved for severe cases that have not responded to more conservative treatment.