Dr. Nguyen Huu Loc, Master of Science, from Bach Mai Hospital, states that the temporomandibular joint (TMJ) acts as a "hinge" connecting the lower jaw to the skull, facilitating mouth opening, chewing, speaking, and swallowing. Temporomandibular disorder (TMD) encompasses conditions causing pain or dysfunction in the jaw joint and its controlling muscles. While not life-threatening, prolonged TMD can significantly reduce quality of life.

When the jaw joint, chewing muscles, or joint disc become unbalanced, patients may experience difficulty eating and chewing. Pain can also radiate to the temples, in front of the ears, and to the neck, shoulders, and nape, affecting sleep, communication, and daily work.

Key symptoms of the condition include clicking, popping, or grating sounds when opening the mouth, chewing, or yawning. Patients may also report jaw fatigue, pain in front of the ears or temples, which can spread to the neck, shoulders, nape, or trigger migraines. Difficulty opening the mouth, a deviated jaw opening, stiffness, or jaw locking are also common signs.

Other indicators include tinnitus, dizziness, swelling and pain on one side of the face, quick fatigue during chewing, or favoring one side for chewing. Individuals should seek early medical attention if pain persists for over one to two weeks, if opening the mouth becomes difficult, if the jaw locks, if pain increases rapidly, if there is facial trauma, or if symptoms affect eating and sleeping.

Causes of this condition can stem from daily habits, such as continuous gum chewing, consuming overly hard or chewy foods, resting the chin on a hand, nail-biting, and excessively wide yawning. Stress also contributes by increasing unconscious jaw clenching or teeth grinding, particularly at night. Additionally, malocclusion, missing teeth, misaligned teeth, ill-fitting dental restorations, or dental interventions altering bite points can be factors. Facial trauma, arthritis, joint degeneration, or co-existing chronic pain conditions are also potential causes.

A patient undergoes a temporomandibular examination. *Photo: Le Nga*

Dr. Loc explains that treatment prioritizes conservative, individualized approaches based on the underlying cause. For mild cases, patients can adopt lifestyle changes at home, such as eating soft, cut-up food, and avoiding gum and chewy or hard items. Patients may also apply warm or cold compresses, perform gentle massage, practice jaw relaxation exercises, and limit wide mouth opening.

Pain relievers, anti-inflammatory drugs, or muscle relaxants should be used strictly as prescribed and not self-administered for extended periods. Other therapies include occlusal splints, which reduce joint load and protect teeth from grinding. Orthodontics or dental restoration are considered solutions when malocclusion is present.

Physical therapy, encompassing jaw exercises, ultrasound, laser, heat therapy, or other rehabilitation interventions, can help alleviate pain and improve movement. Surgical intervention is only considered for severe cases, prolonged jaw locking, clear arthritis or joint degeneration, or when conservative methods have failed.

The doctor emphasizes that not all sounds from the jaw joint indicate a serious condition. However, it is important to seek medical attention if jaw sounds are accompanied by pain, difficulty opening the mouth, jaw locking, rapidly increasing pain, or any symptoms affecting eating, sleeping, and daily activities.

Le Nga