TMJ or temporomandibular joint syndrome as the disorder is commonly called is poorly understood at the present time in terms of how it is caused. While many patients have bruxism or grinding of the teeth at night, others may have had trauma, osteoarthritis, or rheumatoid arthritis. Many times the cause is unknown. For those of you with migraine, the constant clenching of the jaw causes muscle spasms in the temples. This then leads to a migraine.



The symptoms of TMJ may be any or all of the following: pain or tenderness in jaw and/or around the ear, difficulty chewing, a clicking sound when jaw is opened, spasms causing the jaw to "lock" when open or closing, uncomfortable or uneven bite, and finally, headache!

Testing for TMJ

Diagnosing TMJ involves a good history of how you sleep, grinding habits during the day and general tension. An exam of the jaw should involve palpation of the joint both inside and outside of the mouth. Imaging of your jaw may be needed to find out how much damage is in the joint. X-rays, a CT of the jaw or even an MRI would assist the doctor.

Once diagnosed you should be referred to a dentist who specializes in TMJ syndrome.

Treatment of TMJ

Treatment of TMJ may greatly reduce your headaches. But like anything else, a multi-factorial approach to the problem will yield the best results for you. These are the most common treatments for TMJ sufferers who also have migraine.

Overuse of jaw muscles. This is mostly a lifestyle change. You must be willing to recognize when you are grinding your teeth during the day and learn to relax the jaw. Also, try not to eat foods that are difficult to chew until you heal a bit more.

Appliances .Depending on your particular situation, the dentist may make a bite plate or splint to help align your teeth at night. A night guard appliance could also be used to help prevent grinding.

Medications. Various medications may ease your pain and thereby reduce your headaches. A short course of steroids will reduce inflammation, or if the condition is not severe an anti-inflammatory could be used. Spasming of jaw muscles could contribute to the problem, and the ideal medication for this is Elavil.

Dental Repairs. Your dentist may recommend dental work that may not make much sense to you at first. However, correcting bite, repairing teeth and filing down tooth edges that aren't meeting correctly will all serve to decrease TMJ.

Surgery. This is a final option and is reserved for cases where the above options have failed. In this case the joint is so badly damaged that joint reconstruction or replacement may be recommended. And again..your headache and TMJ may be reduced!

If in doubt, see your dentist to begin with and ask about testing for TMJ. Discuss this with your headache specialist also as they are very familiar with the condition. If you do not see a headache specialist, your primary care physician should be able to help.