The Joints

Joints are not moving freely and in unison

If the joints are not moving freely and in unison, one or both of the joints may start to malfunction. Sometimes a click can be noticed (felt / heard) on opening or closing and the path of opening of the lower jaw is not straight. Correctly functioning jaws should open in a straight path to about 50mm (between upper and lower incisors). Malfunctioning jaws often cause pain in the are of the side of the head (Temporal areas). This pain can indeed manifest as headache in its various forms.

The joints then can become inflamed and cause localised pain in the area in front of the ear (and often be confused for ear-ache). Sometimes the muscles that support and activate / mobilise the jaw can compensate and act to protect the joint and become hyperactive. This fatigue of the muscle system tends to cause more diffuse pain in the sides of the head and be felt as a headache and the patient can feel generally unwell.

In turn the supporting muscle systems at the back of the head and the muscles of the neck can become hyperactive to balance the muscles of the jaw and lead to neck-ache. Other related symptoms can include tingling / numbness of the shoulder and arms / hands / fingers due to nerve entrapment in the cervical area of the spine due to chronic compensatory mechanisms.

Other symptoms related to TMJD can involve the ear-system which includes hearing (deafness / tinnitus) and balance (vertigo) problems. Very often a diagnosis of Meniere’s disease is offered when, in fact, a Temporo-Mandibular Joint Dysfunction exists.


Key to the treatment is a correct diagnosis and this is largely done by clinical assessment. Radiographs may also be taken to observe the opening ability of the joints. Categorisation of the type of TMJD is important and will lead to the course of treatment followed. Most treatments will involve the wearing of a particular type of SPLINT being worn to allow the joints move independently of the teeth (i.e. the splint acting to remove the “knit together factor). The splint also acts as a stop, preventing the jaws from closing fully and squashing the damaged joint. This can permit the joint to heal. Splints are worn usually for a few months and then second-phase treatment commences. Some patients choose to continue wearing a splint although this is generally not recommended.

Acute treatment can be followed up by moving the teeth to a position where the jaws can close in a comfortable position. Such treatment is orthodontic / orthopedic in nature. This treatment allows for the patient discontinue wearing a splint and resolving the TMJD long-term.