Temporomandibular Joint Syndrome Clinical Presentation

Updated: Sep 30, 2017
  • Author: Vivian Tsai, MD, MPH, FACEP; Chief Editor: Herbert S Diamond, MD  more...
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Presentation

History

Symptoms of temporomandibular joint syndrome consist of the following:

  • Chronic pain in the muscles of mastication described as a dull ache, typically unilateral
  • Pain may radiate to the ear and jaw and is worsened with chewing
  • Locking of the jaw when attempting to open the mouth
  • Ear clicking or popping, usually when displacement of the articular disk is present
  • Headache and/or neck ache: In some cases, patients may complain of headache without localized pain in the temporomandibular joint
  • A bite that feels uncomfortable or different from usual
  • Neck, shoulder, and back pain
  • Bruxism, teeth clenching
  • Increasing pain over the course of the day
  • History of jaw and/or facial trauma
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Physical

Characteristic findings on physical examination include the following:

  • Limitation of jaw opening (normal range is at least 40 mm as measured from lower to upper anterior teeth)
  • Palpable spasm of facial muscles (masseter and internal pterygoid muscles)
  • Unilateral facial swelling
  • Clicking or popping in the TMJ
  • Tenderness to palpation of the TMJ via the external auditory meatus (the tips of the fingers placed behind the tragi at each external acoustic meatus and pulled forward while the patient opens the jaw)
  • Crepitus over joint (in advanced disease)
  • Lateral deviation of mandible
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