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Many adults suffer from chronic facial or neck pain. Common symptoms include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth, or headaches.

The lower jawbone, or mandible, is attached to the head by a pair of left and right temporomandibular joints or 쏷MJ. Several jaw muscles, attached by ligaments, make possible opening and closing the mouth, as well as several other movements. All of these jaw components work together when you chew, speak, or swallow.

The TM joints are among the most complex joints in the body. They work together to make many different movements, including a combination of rotating and gliding actions used when chewing and speaking. Several muscles control the lower jaw as it moves forward, backward, and side-to-side. The sliding movements between front and back and side to side of the lower jaw are unique features of the TM joints and is what accounts for their complexity. Each TM joint has a disc between the ball and socket (see diagram). The disc cushions the load while enabling the jaw to open widely and rotate or glide.

Any problem that prevents this complex system of muscles, ligaments, discs, and bones from working properly may result in a painful TMJ disorder. Common dental causes include a misaligned upper and lower teeth or unequal heights of right-side and left-side biting surfaces.

Diagnosis and Treatment

We can help identify the source of the mandibular pain with a thorough exam and appropriate x-rays. Sometimes, the pain may be from a sinus problem, a toothache, or an early stage of periodontal disease. For some types of pain, however, the cause is not easily diagnosed. The pain may be related to the facial muscles, to the jaw, or to an abnormality in the TM joint.

Some TM problems result from dislocation, injury, arthritis, or other diseases. All of these conditions can cause pain and dysfunction. Injuries to the jaw, head, or neck might cause some TM problems. Other factors relating to the way the upper and lower teeth fit together, often described as the bite, may cause TM disorders. Stress and teeth grinding are also considered to be possible factors.

Diagnosis is an important step before treatment. Part of the dental examination includes checking the joints and muscles for tenderness, clicking, popping, or difficulty in moving the jaw. Reviewing your complete medical history helps to identify the cause of the pain, so maintaining up-to-date dental records is important. We may take x-rays of the TM joints and may make a "cast" of your teeth to see how the upper and lower teeth fit together.

There are several treatments for TMJ disorders. They may include stress-reducing exercises, wearing a mouth protector to prevent teeth grinding, orthodontic treatment, and medication. Treatment may involve a series of steps beginning with the most conservative options. In many cases, only minor, relatively non-invasive treatment may be needed to help reduce the pain.