The American Journal of Medicine says that treatment of TMJ disorder – temporomandibular joint disorder, a painful jaw condition – exposes a critical gap in modern medicine’s understanding of musculoskeletal and pain disorders.
The condition – which can cause a wide range of symptoms, including jaw pain, jaw clicking, the jaw locking up, ear problems, eye problems and dizziness – remains markedly understudied, even though it is on the rise. This lack of knowledge has left an estimated 11-to-12 million Americans affected by TMJ syndrome struggling in an overlooked epidemic.
A comprehensive study of TMJ syndrome by the National Academies that included input from more than 110 patients and experts found that most healthcare professionals, including dentists, have received “minimal or no training” on TMJ disorder and patients are “often harmed [by] overly aggressive” care and the lack of proven treatments.
If you – or anyone you know – has suffered from the condition, you know the pain can be severe. The TMJ Wellness Center says the disorder is a hidden struggle for many, bringing pain and discomfort to even the most basic daily activities.
Susan Beattie, nurse practitioner in Ear, Nose and Throat at Health First Medical Group Gateway in Melbourne, says the pain resembles bone-on-bone arthritis in the jaw.
“TMJ syndrome is extremely hard to diagnose,” says Beattie. “It’s a great mimicker.
“For instance, if it presents as a clogged ear, you’ll most likely be told to put an ice pack on it and take antibiotics – but it’s not an ear infection.
“Diagnosis is usually a process of elimination and can take years to uncover,” she continues. “An ENT will eventually see the patient after other causes have not been found.
“At that point, the patient will usually get an MRI of the jaw, which will show inflamed tendons and muscles” around the jaw joint.”
The TMJ Association says that a major challenge for patients is the lack of coordinated care.
Because the condition occurs at the intersection of dentistry, medicine, neurology and pain management, no single specialty takes clear responsibility. As a result, patients are frequently referred between providers, often receiving inconsistent diagnoses and treatment recommendations.
This fragmentation reflects longstanding structural divides in the U.S. healthcare system, particularly the separation of medicine and dentistry, which has limited access to comprehensive care, standardized diagnosis, and insurance coverage, according to experts.
As Beattie explains, the dental and medical worlds have been separated since the beginning of time, with little communication between the two.
“They keep different medical records. They have different insurance. It’s easy for patients to slip through the cracks.”
Mayo Clinic explains that the temporomandibular joint, also called TMJ, acts like a sliding hinge that connects the jawbone to the skull. There is one joint on each side of the jaw.
The exact cause of TMJ disorder is often hard to determine. The pain may be due to a mix of factors, including habits such as teeth clenching, gum chewing and nail biting; stress; and painful conditions that occur along with TMJ disorder such as fibromyalgia, osteoarthritis or jaw injury.
The TMJ Association says that while both men and women experience these disorders, the majority of those with the most severe symptoms are women in their childbearing years.
Beattie says it’s most common in women aged 20 to 40, partly due to hormonal differences.
TMJ Wellness Center says there are three main reasons for that:
- Women are more responsive to their emotions and to stress.
- Differences in the bone structure and muscle density of women’s jaw bones compared to those of men.
- Estrogen hormones and contraceptives. Researchers are trying to better understand this connection.
The ratio of women to men increases with the severity of symptoms, approaching nine women for every one man with major limitations in jaw movements and chronic, unrelenting pain.
The Association lists common symptoms, including:
- Pain in the jaw muscles.
- Pain in the neck and shoulders.
- Chronic headaches.
- Jaw muscle stiffness.
- Limited movement or locking of the jaw.
- Ear pain, pressure, fullness, ringing in the ears (tinnitus).
- Grating in the jaw joint when opening or closing the mouth.
- A bite that feels “off.”
- Dizziness.
- Vision problems.
“One reason for the current increase in cases is stress,” says Beattie. “People are inadvertently clenching their jaws while they’re sitting at their computers scrolling. Then they wind up taking that stress to bed.”
Cleveland Clinic concurs, stating that left untreated, teeth grinding can lead to TMJ Syndrome.
Beattie says that when it comes to helping people deal with TMJ pain, medical solutions aren’t always the answer. “Physical therapy, exercises to calm down muscles, acupuncture, chiropractors, and massage therapists have all been shown to be very effective.”
Susan Beattie, NP, is a nurse practitioner in Ear, Nose and Throat at Health First. She has a BS in exercise science from University of Florida, and MSN, APRN, and FNP-C degrees from Chamberlain College of Nursing. She is Certified by the American Academy of Nursing Practitioners. Her office is located at Health First Medical Group Gateway, 1223 Gateway Dr., Suite 1E, Melbourne. Call 321-729-8079 for an appointment.
