TMJ Osteoarthritis – symptoms, diagnosis and treatment

Temporomandibular joint (TMJ) disorders affect between 5-12% of the population. The temporomandibular joint is the joint that connects the jawbone to the skull. We have two TMJs, one on each side of the face. Osteoarthritis is one of many TMJ disorders that can develop in either one or both of the TMJs. Development of temporomandibular joint osteoarthritis can be very crippling as it is the joint that allows for the jaw to open and close, making it possible for us to eat, talk and yawn.

Symptoms of TMJ osteoarthritis

Common symptoms of TMJ osteoarthritis are pain and stiffness in the jaw. It may become difficult to chew or yawn due to painful and stiff jaw muscles. Symptoms are similar to those of rheumatoid arthritis and psoriasis arthritis of the TMJ.

Symptoms of TMJ osteoarthritis include:

• Jaw pain and/or discomfort
• Tight jaw muscles
• Difficulties yawning and chewing
• Grinding or cracking sensation in the jaw
• Locking of the jaw
• Headache
• Toothache
• Earache 
• Pain in the face or neck
  

If you experience any of these symptoms you should schedule an appointment with a dentist, orthodontist or a doctor to get a diagnosis.

Several risk factors play a part

There is no single cause for the development of TMJ osteoarthritis and several risk factors tend to contribute to the disease. A main risk factor for TMJ osteoarthritis is repetitive movement of the jaw, such as teeth grinding, jaw clenching or gum chewing over a long period of time.  However, these repetitive movements do not necessarily lead to osteoarthritis or other temporomandibular joint disorders.

TMJ osteoarthritis can also be post-traumatic, meaning that osteoarthritis has affected the jaw as a result of a previous jaw injury. Misaligned teeth and TMJ disorders are also risk factors for TMJ osteoarthritis. Age, female sex and genetics are general risk factors for osteoarthritis in all joints. 

How TMJ osteoarthritis is diagnosed

TMJ osteoarthritis should primarily be diagnosed by a healthcare professional through an assessment based on the patient’s medical history, joint function, jaw sounds and pain level. 

The healthcare professional will also take risk factors into account and keep them in mind when establishing the diagnosis. If you experience pain or stiffness in your jaw and suspect that you may have osteoarthritis, a good first step is to contact your dentist or your primary healthcare center and schedule an appointment to receive the right diagnosis.

In certain cases, a radiographic examination can be performed to supplement clinical findings. However, this is not necessary for diagnosis.

Treating TMJ osteoarthritis

First-line treatment for TMJ osteoarthritis is patient education (learning more about the disease), and jaw exercises/stretching. Individualized exercises for the jaw can help relieve jaw pain and stiffness by relaxing the muscles. These should be coordinated by a physical therapist or a dentist. A physical therapist can also provide manual therapy, which involves hands-on manipulation of the jaw.

If a habit of teeth grinding or jaw clenching is making symptoms worse, a dental guard (usually worn at night) may help to counteract damaging jaw movements. A dental guard can be obtained by a dentist or an orthodontist.

As a complement to first-line treatment, non-prescription painkillers may be used for short periods of time. You should however always discuss the use of painkillers with your dentist or doctor to avoid side effects and drug interaction.

Other treatment methods

If first-line treatment doesn’t provide satisfactory symptom relief, other treatment methods may be necessary. 

On occasion, cortisone injections are used as a complement to treat severe TMJ osteoarthritis. These injections only offer short-term symptom relief and should be administered by an experienced dentist or oral surgeon. Cortisone injections should be used with caution as excessive injections may further damage the joint. 

Surgery can provide good results for many patients, although no surgery is risk-free. With surgery comes the risk of developing blood clots and infections. The most commonly performed operation for osteoarthritis of the TMJ is arthroscopic jaw surgery.  Joint replacement surgery is also an option, although this is a lot more invasive than arthroscopic jaw surgery.