What Causes TMJ?

John Miller Physiotherapist

Article by John Miller

Understanding the Root Causes of TMJ Dysfunction

Temporomandibular Joint (TMJ) dysfunction is a complex musculoskeletal disorder that can bring about a range of discomforts, affecting various aspects of daily life. This condition arises from a combination of factors that impact the intricate workings of the jaw joint and associated muscles.

Unravelling the Complexity of TMJ Dysfunction

TMJ dysfunction, a term encompassing a multitude of symptoms, is not simply rooted in a singular cause. Rather, it emerges from a symphony of factors that influence the mechanics of the jaw joint. Masticatory muscle dysfunction, derangement or displacement of the TMJ articular disc, and the grinding of teeth (bruxism) all play pivotal roles. Occlusal issues, characterised by poor bite alignment or asymmetry, further contribute to the intricate web of causes. Additionally, contributing factors like mandibular malalignment resulting from occlusal appliances or orthodontic treatments, wisdom teeth extraction, prolonged mouth opening during dental procedures, poor cervical posture, myofascial pain, neuropsychological elements, stress, and less common triggers such as trauma and anatomical anomalies add to the complexity.

What Causes TMJ?

TMJ dysfunction arises from various factors that impact the musculoskeletal system. It’s a multifaceted disorder encompassing diverse causes, including:

  • Masticatory muscle dysfunction,
  • Derangement or displacement of the TMJ articular disc,
  • Nocturnal teeth grinding (bruxism) leading to heightened TMJ pressure and uneven movement,
  • Occlusal problems like poor bite, asymmetry, or retrognathic conditions.

Contributing elements consist of:

  • Secondary mandibular misalignment due to orthodontic treatment or occlusal appliance,
  • Wisdom teeth extraction,
  • Prolonged mouth opening during dental procedures,
  • Suboptimal cervical posture,
  • Myofascial pain,
  • Neuropsychological factors,
  • Stress,
  • Less common triggers like whiplash, trauma, infection, polyarthritic conditions, tumours, and anatomical irregularities.

Categorising TMJ Dysfunction for Better Understanding

To better comprehend the manifestations of TMJ dysfunction, it’s essential to classify them into distinct clinical categories. These classifications include painful jaw muscle movement, articular disc displacement, and arthralgia or arthritis. Each category represents a facet of the intricate dysfunction that can arise within the TMJ structure. With these classifications in mind, TMJ healthcare professionals can develop targeted treatment plans tailored to each individual’s specific symptoms and needs.

The typical presentations of TMJ dysfunction fall into three clinical diagnostic categories:

  • Painful jaw muscle movement,
  • Articular disc displacement,
  • Arthralgia or arthritis.

(Source: Dworkin SF, LeResche L., 1992)

What Triggers Jaw Clicking?

Jaw clicking signifies articular disc displacement, often managed by a TMJ physiotherapist. Clicking might occur while opening, closing, or both. Seek assessment from a TMJ physiotherapist for precise diagnosis and a tailored treatment plan.

Common Causes of TMJ Dysfunction and Jaw Pain

TMJ or jaw discomfort stems from multifaceted origins. Two primary culprits stand out: abnormal jaw opening or closing.

TMJ Dysfunction – Irregular Opening

Most cases of TMJ dysfunction result in incomplete or uneven jaw opening. Fortunately, physiotherapy assessment and intervention yield swift and positive outcomes in these instances, as teeth occlusion isn’t a concern.

TMJ Dysfunction – Abnormal Closing

Closing issues can stem from both teeth occlusion and TMJ incapacity to close seamlessly. If it’s primarily joint stiffness or muscle timing, physiotherapy proves highly effective. However, occlusion-related matters warrant evaluation by a dental surgeon to assess bite alignment.


In conclusion, TMJ dysfunction is a multifaceted condition that stems from a combination of intricate factors impacting the temporomandibular joint. From muscle dysfunction to occlusal problems and various contributory elements, the causes of TMJ dysfunction are wide-ranging and interconnected. By understanding these underlying causes and classifications, individuals and healthcare practitioners alike can better navigate the complexities of this condition. Whether through physiotherapy, dental assessment, or other interventions, addressing the multifaceted origins of TMJ dysfunction holds the key to alleviating discomfort and enhancing quality of life.

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