By Lauren Glendenning, For Memorial Regional Health

There’s a hinge that connects the side of the skull to the lower jaw that makes it possible to open and close our mouths. This hinge, the temporomandibular joint (TMJ), can get injured or damaged and cause pain in the jaw, ears and head.

TMJ disorders include TMJ syndrome or temporomandibular disorder (TMD), and they’re caused by injury to the teeth or jaw, misalignment of the teeth or jaw, teeth grinding or clenching, poor posture, stress, arthritis and gum-chewing, according to MedicineNet.

“In most patients, TMJ pain is usually a result of movement or displacement of the cartilage disc that causes pressure and stretches certain sensory nerves,” according to ENT Health, a site by the American Academy of Otolaryngology-Head and Neck Surgery. “Popping or clicking noises occur when the disk snaps into place when the jaw moves. In addition, the chewing muscles may spasm or not function efficiently, causing pain and tenderness.” 

Symptoms and Diagnosis

Patients can see an ENT specialist, dentist or surgeon if they are experiencing pain in the ear.

If the earache is not associated with hearing loss and the eardrum looks normal, a specialist then can determine the pain is associated with a TMJ disorder, according to ENT Health.

“Your pain may be sharp and searing, occurring each time you swallow, yawn, talk or chew, or it may be dull and constant. It hurts over the joint, immediately in front of the ear, but pain can also radiate elsewhere,” according to ENT Health. “It often causes spasms in the adjacent muscles attached to the bones of the skull, face and jaws. Pain can also be felt at the side of the head (the temple), the cheek, the lower jaw and the teeth.”

In order to diagnose a TMJ disorder, a specialist will listen to and feel the jaw when you open and close your mouth, observe the range of motion in the jaw and press on areas around the jaw to identify pain or discomfort. When the doctor suspects a problem, next steps might include a CT scan to provide detailed images of the bones involved, an MRI to reveal problems with the joint’s disk or surrounding tissue or dental X-rays to examine the teeth and jaw.

“TMJ arthroscopy is sometimes used in the diagnosis of a TMJ disorder,” according to the Mayo Clinic. “During TMJ arthroscopy, your doctor inserts a small thin tube (cannula) into the joint space, and a small camera (arthroscope) is then inserted to view the area and to help determine a diagnosis.”

Treating TMJ Disorders

Some cases of TMJ disorders will resolve without any treatment, but for symptoms that persist, a specialist might recommend medications, therapies, surgery or other procedures.

Medication treatments include pain relievers and anti-inflammatories, antidepressants or muscle relaxants, according to the Mayo Clinic.

Non-drug therapies include oral splints or mouth guards, physical therapy and counseling to help patients understand the factors that are contributing or aggravating pain. Your doctor might recommend resting your muscles and joints by eating soft foods, not chewing gum, not clenching or tensing your jaw, or relaxing muscles with moist heat, according to ENT Health.

Surgical procedures include arthrocentesis, a minimally invasive procedure, injections, arthroscopy and modified condylotomy (surgery on the mandible, but not in the joint itself). In the most severe cases that do not resolve with other treatments, open-joint surgery may be suggested.