Understanding "Lockjaw" and TMJ: Causes, Symptoms, and Treatment Options

Lockjaw and temporomandibular joint (TMJ) disorders are terms often heard together but refer to distinct, though related, conditions that affect the jaw and its ability to function properly. TMJ disorders are a common but sometimes misunderstood group of conditions that can cause pain, discomfort, and, in some cases, difficulty opening the mouth. Lockjaw, a symptom of severe TMJ dysfunction or other issues, can severely impact daily activities, including eating and speaking.

What is Lockjaw?

Lockjaw is a term used to describe a condition where the jaw becomes "locked" closed or unable to fully open. This can happen for a variety of reasons, such as:

• Severe muscle spasms: Tight, overactive muscles around the jaw can cause the joint to become stiff and immobile.

• Disc displacement: The TMJ has a small disc that acts as a cushion between the bones. If the disc becomes displaced, it can cause a locking sensation.

• Severe inflammation or degeneration: Chronic inflammation from arthritis or another underlying condition can result in joint dysfunction, leading to symptoms like lockjaw.

The joint is made up of a bony head, called a condyle, a disc, and the area where it sits within the skull, called the articular eminence.

When this joint is affected by micro or macro traumas, injury and inflammation, it can lead to changes in the bony structure or the disc moving out of place (what is known as disc displacement without reduction).

People who experience lockjaw may have a history of clicking or popping noises in their jaw joints, followed by one incident of trauma leading to the lockjaw incident.

Another common reason for limitation in opening is a myospasm, or spasm of the masseter or temporalis muscles. If these muscles spasm, or enter a prolonged contraction, jaw opening becomes limited.

Seeing a trained specialist can help determine what the cause is for your lockjaw and devise the appropriate treatment plan that will best benefit you.

Common Causes of Lockjaw:

• Injury or Trauma: A blow to the face, whiplash, or other types of trauma can damage the TMJ or surrounding structures, leading to pain and limited jaw mobility

  
  

• Teeth Grinding or Jaw Clenching: Chronic teeth grinding (bruxism) and jaw clenching, often related to stress, can put significant strain on the TMJ, leading to inflammation and dysfunction

  
  

• Arthritis: Osteoarthritis and rheumatoid arthritis can affect the TMJ, causing inflammation, joint degeneration, and pain

  
  

• Stress and Tension: Emotional stress and anxiety are often linked to muscle tension and jaw clenching, which can exacerbate TMJ problems

Treatment for Lockjaw and TMJ Disorders

Treatment for TMJ disorders depends on the severity of the condition and the underlying cause. Here are some common treatment options:

Conservative Therapies

• Rest and Ice: Applying ice or heat to the affected area can help reduce inflammation and muscle tension.

• Jaw Exercise: Gentle jaw exercises can help improve range of motion and strengthen the muscles around the TMJ.

• Stress Management: Since stress is a major contributor to TMJ dysfunction, relaxation techniques like meditation, yoga, or cognitive behavioral therapy (CBT) can be beneficial.

  
  

Medications

• Pain relievers: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can help reduce pain and inflammation.

• Muscle relaxants: If muscle spasms are contributing to the lockjaw, muscle relaxants prescribed by a healthcare provider can help relieve symptoms.

• Anti-anxiety medications: In cases where stress and anxiety are major contributing factors, anti-anxiety medications or antidepressants may be prescribed.

Dental Appliances

• Nightguards or orthotic splints: These devices can help reduce teeth grinding (bruxism) and jaw clenching during sleep, thus preventing further strain on the TMJ.

Physical Therapy

• Physical therapy for TMJ disorders may involve manual therapy techniques, ultrasound, or exercises to strengthen the jaw muscles and improve mobility.

Surgical Options

• Surgery is typically a last resort and is considered only in severe cases where other treatments have failed. Surgical options may include arthroscopy, joint replacement, or realignment procedures.

  
  

Botox Injections

Botox has been used as an off-label treatment for TMJ disorders. It can help relax the jaw muscles, reduce clenching, and improve pain levels.

When to See a Doctor

If you're experiencing persistent jaw pain, clicking or popping noises, or difficulty opening your mouth, it’s important to consult with a healthcare provider. Early intervention can help prevent the condition from worsening and improve overall quality of life. An orofacial pain specialist may be able to offer a diagnosis and recommend an appropriate treatment plan.

References:

1. National Institute of Dental and Craniofacial Research (NIDCR). (2021). Temporomandibular Joint Disorders. (https://www.nidcr.nih.gov/health-info/tmj)

2. American Dental Association. (2023). Temporomandibular Joint Disorders: Causes, Symptoms, and Treatment. (https://www.ada.org)

3. Mayo Clinic. (2022). TMJ Disorders. (https://www.mayoclinic.org/diseases-conditions/tmj/symptoms-causes/syc-20350780)