TMJ: causes, symptoms and treatment of temporomandibular dysfunction

The temporomandibular joint (TMJ) is one of the most complex joints in the human body, connecting the jaw to the skull and enabling essential functions such as speaking, chewing, and yawning. When this joint does not function correctly, TMJ dysfunction can occur – a problem that affects thousands of people and can seriously compromise quality of life.

Dr Cláudio Alferes, a dentist specialised in orthodontics and occlusion, dedicates his clinical practice to the diagnosis and treatment of these conditions, with an individualised approach based on identifying the root cause of each case.

What is TMJ dysfunction?

TMJ dysfunction occurs when jaw movements are no longer harmonious, causing pain, clicking, limited opening, or other associated symptoms. It is a multifactorial condition: in some patients it is related to habits such as bruxism, in others it results from bite problems (malocclusion), or even from postural factors.

Although common, it is often underdiagnosed since symptoms can be mistaken for neurological, ENT, or even muscular problems.

Main causes of TMJ dysfunction

TMJ dysfunction is multifactorial: it results from the interaction between the joint, masticatory muscles, the articular disc, and occlusion (the way the teeth fit together). In many cases there is a primary cause (e.g. bruxism or malocclusion) and aggravating factors (e.g. stress, posture, parafunctional habits). For this reason, before starting any treatment, Dr Cláudio carries out a detailed exploratory process, including medical history, functional clinical examination, and CBCT, to identify the root cause and understand what maintains or worsens symptoms in each patient.

It is also common for two or more causes to coexist (for example, bruxism + malocclusion + cervical tension), which justifies a personalised approach combining pain relief strategies with correction of the mechanical factors involved.

Among the most common causes are:

• Bruxism (night-time and/or daytime): Grinding or clenching teeth, often linked to stress. Increases the load on the condyle and articular disc, leading to muscle pain (masseter/temporal), clicking, tooth wear, and morning headaches.

• Dental malocclusion: When teeth do not fit together correctly (e.g. deep overbite, crossbite, misalignment), the joint and muscles compensate, causing overload and functional asymmetry. Here Dr Cláudio’s expertise in orthodontics and occlusion is crucial.

• Stress and muscle tension: Stress promotes parafunctions (clenching), hypertonia of the jaw and neck muscles, and increases pain perception. Without stress management, symptoms tend to persist.

• Trauma or repeated microtrauma: Impacts to the face/jaw or situations such as “mouth kept open for long periods” (e.g. during extensive dental treatments) may inflame tissues, alter disc position, and trigger pain and limited opening.

• Postural changes (cervical/shoulder): Forward head posture (due to prolonged computer/phone use) alters muscle dynamics and the force vector on the TMJ, contributing to pain and joint fatigue.

• Degenerative diseases (arthritis/arthrosis): Inflammatory and degenerative processes can directly affect the joint, causing pain, stiffness, and limited function. CBCT helps document bone changes and guide therapy.

• Parafunctional habits: Nail-biting, chewing pen tops/lids, excessive gum chewing, or resting the chin on the hand create repeated micro-loads on the TMJ and masticatory muscles.

• Ligament laxity / hypermobility: In some patients, loose ligaments favour subluxations/dislocations and joint instability, with episodes of clicking, locking, or “giving way” when opening the mouth.

• Hormonal and individual factors: In certain cases, hormonal changes and individual anatomical characteristics appear to be linked to greater susceptibility to TMJ symptoms, particularly in women.

Why is it so important to identify the cause?

Because treatment changes completely depending on the underlying problem. That is why Dr Cláudio always performs a thorough exploratory analysis (clinical evaluation + CBCT + individual occlusion study) before proposing a plan. Only in this way is it possible to address the root cause, reduce pain in the shortest possible time, and restore function sustainably.

Symptoms of TMJ dysfunction

TMJ dysfunction can present in many different ways, as it involves muscles, the joint, nerves, and even nearby structures such as the ears. This is precisely why symptoms are often mistaken for other medical conditions: from neurological problems to ENT disorders.

One of the most important points to understand is that symptoms do not always appear all at once. In some cases, they manifest only as mild, localised pain; in others, as a set of signs that gradually worsen over time. Recognising these early is essential to seek specialist help and prevent the condition from progressing to more disabling stages.

The most common symptoms include:

• Jaw, facial, or neck pain: constant or only when speaking or chewing.

• Clicking or crepitus when opening/closing the mouth, often with discomfort.

• Difficulty fully opening the mouth: feeling of locking or functional limitation.

• Frequent headaches: especially in the temple or occipital region.

• Tinnitus or ear pressure: auditory symptoms linked to joint function.

• Dizziness or imbalance: due to the TMJ’s proximity to the inner ear.

• Pain when chewing or speaking: from muscle and joint overload.

• Joint stiffness: a sense of tightness limiting simple movements.

• Cervical pain: related to postural and muscular compensations.

Do you recognise any of these signs? You may be experiencing TMJ dysfunction.

How is TMJ dysfunction diagnosed?

Accurate diagnosis is key to successful treatment.

At Dr Cláudio Alferes’ clinic, the process begins with a detailed clinical evaluation, during which all patient signs and symptoms are recorded. To ensure maximum precision, Dr Cláudio always uses CBCT imaging (cone-beam computed tomography), which provides a complete three-dimensional view of the joint. Based on this data, a personalised study of each case can be carried out.

Dr Cláudio’s approach: because every case is unique

Dr. Claudio's method is structured into three phases:

1. Specialised diagnosis

   1. Clinical assessment and CBCT to gather all necessary data and understand the origin of the problem.

2. Individual occlusion study

   1. Based on the diagnosis, a detailed study is carried out, involving the patient in the process and providing clear explanations of the causes of dysfunction.

3. Tailored treatment

   1. Each plan is unique. The focus is on addressing the root cause, reducing pain as quickly as possible, and restoring the patient’s comfort and quality of life.

Treatment of TMJ dysfunction

The treatment of TMJ dysfunction is never the same for all patients. Each case has its own origin and characteristics, so success depends on an accurate diagnosis and a personalised treatment plan. Dr Cláudio Alferes always prioritises an approach that tackles the root cause of the problem, avoiding temporary solutions that only mask symptoms.

Depending on clinical assessment and test results (such as CBCT), treatment may include different approaches:

• Joint deprogramming splints: Used to reduce pressure on the joint and protect teeth and surrounding structures. They contribute to muscle relaxation and pain relief.

• Corrective orthodontics: Indicated when malocclusion is present. By properly aligning the teeth and improving the bite, chewing forces are redistributed, relieving TMJ overload.

• Specialised physiotherapy: Includes techniques for muscle strengthening, joint mobilisation, and postural correction. It acts not only on the joint but also on muscle chains such as the cervical and dorsal regions, which often influence the problem.

• Stress management measures: Essential in cases where bruxism (grinding or clenching) is a key factor. Reducing psychological and muscular tension is fundamental to control flare-ups and improve treatment outcomes.

• Ongoing clinical follow-up: The progression of TMJ dysfunction is monitored regularly, allowing the plan to be adjusted whenever necessary. This monitoring ensures greater effectiveness and prevents relapses.

The ultimate goal of treatment is always the same: to eliminate pain, restore joint function, and give the patient back a comfortable, limitation-free life as quickly as possible.

When should you seek specialist help?

If you experience jaw pain, frequent headaches, clicking when opening your mouth, or any of the other symptoms described, you may be suffering from TMJ dysfunction. Early diagnosis and appropriate treatment are essential to avoid complications and regain quality of life.

Dr Cláudio Alferes is a specialist in orthodontics and occlusion, with extensive experience in the diagnosis and treatment of TMJ dysfunction. Book your diagnostic consultation with Dr Cláudio Alferes today.