TMJ Disorder

Temporomandibular disorders describe pain and dysfunction of the jaw joint and the muscles of mastication. They divide usefully into myofascial disorders, where masticatory muscle pain dominates, and intra-articular disorders involving disc displacement or degenerative joint change. This distinction guides treatment: muscle-driven pain responds to load reduction, physiotherapy and behavioural change, while disc displacement with reduction produces clicking that, on its own, needs no treatment at all. Painless clicking is common and not a disease. The natural history is reassuring and shapes the management philosophy. Most cases improve substantially with conservative care within months, which is why guidelines strongly favour reversible interventions and warn against irreversible ones. Occlusal adjustment, full-mouth reconstruction and joint surgery have poor supporting evidence and can leave patients worse, and the historical assumption that bite misalignment causes the disorder has not held up. Contemporary understanding places parafunctional loading, particularly daytime clenching, alongside stress, poor sleep, and central pain sensitisation, which explains the frequent overlap with fibromyalgia, headache and other chronic pain conditions. Effective care combines patient education, soft diet and jaw rest during flares, targeted exercises, awareness training for clenching, and cognitive behavioural approaches. Occlusal splints help some people, likely through behavioural and load-distribution effects rather than bite correction. Magnesium and curcumin have mechanistic rationale without direct trial evidence.

• •Jaw joint or facial muscle pain
• •Clicking or popping on opening
• •Limited mouth opening or locking
• •Pain when chewing
• •Temple headaches
• •Ear fullness or ache without infection
• •Morning jaw tightness

• •Clenching and grinding
• •Muscle overload
• •Disc displacement
• •Degenerative joint disease
• •Jaw trauma
• •Stress and poor sleep
• •Central sensitisation

Parafunctional clenching and grinding, masticatory muscle overload, disc displacement or degenerative joint change, macrotrauma to the jaw, psychological stress and hypervigilance, poor sleep quality, central pain sensitisation with widespread pain comorbidity, and hypermobility syndromes.