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Marshall James Nev, PLC | Causes of TMJ (Tempromandibular Joint) Pain in Richmond

Lexington-Richmond Headache Clinic
Marshall James Ney, DMD, FAAOP
Fellow American Academy of Oral Facial Pain

527 W. Main St.
Richmond, 40475
(859) 623-3761

Causes of TMJ (Tempromandibular Joint) Pain


Sometimes the parts inside the joint are out of place. For instance, the cartilage slips forward, so that instead of separating the ball (condyle) of the joint from the socket, it slips forward allowing the ball (condyle) to pinch the tender ligaments behind the cartilage against the socket. This causes the joint itself to hurt and does not allow you to open your mouth very wide.

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Figure 1 shows the cartilage properly located between the condyle of the lower jaw and the socket. This keeps the condyle of the lower jaw from rubbing directly against the bony socket.


Figure 2: Cartilage Out Front Can Cause Extreme Pain


Notice in the above Figure 2 that the cartilage is not between the condyle and the socket. Instead, the cartilage is out front so that the condyle pushes on the very tender elastic ligament behind the cartilage. This can cause extreme pain, as the whole joint becomes very sore and can send the wrong messages to the brain, causing the muscles to contract when they should not.

Figure 3: Out of Position Cartilage Can Break Down


Once the cartilage is out of postion, then the cartilage can break down as we see in the above figure 3. Since the cartilage is out in front of the condyle, it has no shape or form and can no longer keep the condyle of the lower jaw from rubbing against the socket.

Surgery Is Not Usually Recommended

The tempromandibular joint is a complicated joint. It is actually two joints in one. When the left side moves, so does the right. Both sides must coordinate to work together. The other unusual part of this joint is that it can come out of the socket, allowing the jaw to move forward.

Back in the 1980's, surgery was preformed when there was a problem inside the joint. Today, we very rarely do surgery. The problem of a disk being in front of the condyle of the lower jaw can prevent the lower jaw from opening. (This condition is also called closed lock). 98% of the time we canget the cartilage back up on the top of the condyle by using injections in the joint.

We also do not see surgery as an option if there is no pain associated with the joint problem. Dr. Ney has not recommended TMJ surgery since the early 1990's.

Another question that arises is "Does it matter if the joint makes sounds on opening or closing?" No! If there is no pain associated with the sound, then there is no indication for surgery.


Richmond Dentist | Causes of TMJ (Tempromandibular Joint) Pain. Marshall James Ney is a Richmond Dentist.