The joint between you upper and lower jaws, just in front of your ears, is called the temporomandibular joint (TMJ). Cartilage allows the joint to function by separating the bony surfaces; often this cartilage becomes worn and begins to move out of place. To feel these joints, place your fingers in front of both ears and slowly open your mouth. The muscles on the sides of your head and face control the joints' movements. Your TMJ absorbs stresses generated from chewing.  If your teeth are malpositioned, the forces generated during chewing can cause your jaw to shift out of proper alignment.  This stresses the joint and can lead to temporomandibular disorders

   Temporomandibular disorders (TMD) refer to a collection of medical and dental conditions affecting the temporomandibular joint (TMJ) and/or the muscles of mastication. Although specific causes such as degenerative arthritis and trauma underlie some TMD, as a group, these conditions have no common cause or biological explanation and comprise a mixed bag of health problems whose signs and symptoms are overlapping, but not necessarily identical. TMD has been used to characterize a wide range of conditions diversely presented as pain in the face or jaw joint area. The severity of these symptoms may range from noticeable (but clinically insignificant) to debilitating pain or dysfunction.

TMD Signs & Symptoms

• Abnormal occlusal wear
• Arthritis in the jaw joint (degenerative joint disease)
• Closed or open lock of the TMJ (dislocated jaw or displaced disc)
• Clicking or popping sounds in the jaw joint
• Dizziness
• Earaches
• Headaches
• Limited mouth opening
• Masticatory musculature hypertrophy
• Pain and discomfort in the muscles controlling jaw function
• Pain and discomfort in the neck and shoulder muscle groups (myofacial pain)
• Secondary symptoms may include ear aches, head aches, neck and shoulder pain, and ringing in the ears

Causes Of TMD

   Most experts suggest that certain tasks, either mental or physical, cause or aggravate TMD, such as strenuous physical tasks or stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism). These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain.

Prolonged mouth opening such as during a long dental appointment.

Stress is a major contributor to TMD; it often manifests in bruxism and nocturnal grinding.

Trauma to the jaw can cause TMD. Arthritis in the jaw may result.

An unstable bite can in some cases trigger TMD.

Conditions Affecting TMD

• Arthritis
• Ankylosis
• Condyle fracture
• Growth disorders
• Recurrent dislocation
• Neoplasia (cancer)
• Systemic illness

TMD Recommendation

   Consensus has yet not been developed across the practicing community regarding many issues including which TMD problems should be treated and when and how they should be treated. The predominance of research does not support any one method for initial management of most TMD problems. Because most patients experience relief of their symptoms with conservative treatment, the vast majority of TMD patients generally receive initial management using noninvasive, reversible therapies. Therapies that permanently alter the patient's bite are generally not recommended on the basis of current data