It refers to the disorders of the jaw muscles and of the temporomandibular joint, the hinge at the side of the head that connects the lower jaw or mandible, to the temporal bone of the skull.

Temporomandibular joint syndrome or temporomandibular disorder (TMD) is the most common cause of facial pain after toothache.

TMD can be classified broadly as (1) TMD secondary to myofacial pain and dysfunction (MPD) and (2) TMD secondary to true articular disease.

Associated with pain without apparent destructive changes of TMJ on x-ray, it is characterized by its polyetiological nature and frequently is associated with bruxism and daytime jaw clenching in a stressed and anxious person.

Causes
It results when the chewing muscles, the teeth and the TMJ do not work together correctly. They can range from trauma, such as whiplash or a direct blow to the face; degenerative disease; excessive mental stress.

• Sex: TMD primarily affects women, more so young women. The male-to-female ratio is 1:4

• Age: Highest incidence is among young adults, especially women aged 20-40 years.

Symptoms:

• Pain: Pain usually is periauricular, associated with chewing, and may radiate to the head but is not like a headache. It may be unilateral or bilateral in MPD, and usually is unilateral in TMD of particular origin, except in RA. In MPD, the pain may be associated with history of bruxism, jaw clenching, stress, and anxiety; the pain may be more severe during periods of increased stress.
• Click, pop, and snap: These sounds usually are associated with pain in TMD. The click with pain in anterior disk displacement is due to sudden reduction of the posterior band to normal position
• Headaches: The pain of TMD is not like a usual headache. The TMD may act as a trigger in patients prone to headaches, and when present in association with TMD, they tend to be severe in nature.
• Other symptoms associated with TMD are otalgia, neck pain and/or stiffness, shoulder pain, and dizziness. About one third of these patients have a history of psychiatric problems. History of facial trauma, systemic arthritic disease, and recurrent dislocation also should be elicited.

Treatment list for TMJ Syndrome:
The list of treatments mentioned in various sources for TMJ Syndrome includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

• Soft diet
• Hot compresses
• Muscle relaxants
• Pain relief medications
• Correction of any dental problems
• Treatment of any underlying cause

Physical Therapy
Gentle massage or stretching exercises, transcutaneous electrical nerve stimulation (TENS), and biofeedback may reduce pain and help muscles to relax.

Stress Reduction
Counseling to learn stress management and relaxation techniques may help some patients with TMJ.
Surgical Procedures
Surgical correction may be a last resort if other treatments have not succeeded and the pain becomes unbearable. Many of the available procedures have not been scientifically proven to treat TMJ syndrome.

Types of surgery include:
Arthroplasty - procedures that involve operating on the jaw joint Condylotomy - surgical removal of part of the jaw bone Prevention

There are no guidelines for preventing TMJ. If you have TMJ, the following may help prevent symptoms:

• Ask your dentist if you need a night guard for grinding and clenching of the teeth
• Don't use a pillow for sleeping.

• Try to limit jaw movements and learn to relax your jaw. Block a yawn by putting your fist under your chin.

• Avoid yelling or loud singing.
• Don't chew gum.
• Learn relaxation techniques and better, healthier ways to cope with stress.

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