The temporomandibular joint the TMJ is the hinge that connects the lower jaw to the skull, just in front of the ear on each side. It is one of the most complex joints in the human body, capable of hinging, sliding, and rotating simultaneously to allow the wide range of movements involved in chewing, speaking, and swallowing.
When something goes wrong with this joint or with the muscles that control it the result is a temporomandibular disorder (TMD), commonly referred to as TMJ disorder or simply “TMJ.” The symptoms range from mildly inconvenient to severely debilitating, and they are frequently misdiagnosed or undertreated because they overlap with headache disorders, neck pain, and ear symptoms that lead patients to neurologists, ENT specialists, and general physicians before they find their way to a dentist or oral surgeon.
Novo Care’s clinical team at the Tesfaye Gizaw Building in Bole manages TMJ disorders across the full spectrum from early-stage muscle dysfunction that responds to conservative treatment to advanced joint degeneration that requires surgical intervention.
Recognising TMJ disorder — the symptom picture
TMJ disorders present differently in different patients, but the core symptoms cluster around the joint, the jaw muscles, and their downstream effects:
Joint sounds. Clicking, popping, or crepitus (a grinding sensation) within the joint during opening, closing, or chewing. A click represents the articular disc the cushion between the joint surfaces temporarily displacing and then repositioning. Early clicking without pain is common and may be managed conservatively. Clicking accompanied by pain, or that evolves into locking, indicates progressive disc displacement.
Limited mouth opening. Difficulty opening the mouth fully normal maximum opening is approximately 35–50mm between upper and lower front teeth. Reduced opening (under 30mm) may indicate muscle spasm, disc displacement without reduction, or joint degeneration.
Locking. Acute locking occurs when the displaced disc prevents the jaw from opening beyond a narrow range. This is painful, alarming, and requires prompt clinical assessment. Chronic limited opening due to disc adhesion or joint degeneration requires different management.
Pain. Jaw joint pain, typically in front of the ear, aggravated by chewing and wide opening. Referred pain to the temple, forehead, ear, or neck. Earache without ear pathology is a common TMJ symptom that is frequently misattributed to middle ear conditions. Headaches, particularly morning headaches, often reflect nocturnal grinding (bruxism) that is loading the joint excessively during sleep.
Bite changes. A feeling that the teeth no longer meet correctly a sudden change in bite can indicate acute joint inflammation causing the jaw to sit in a different position.
The causes of TMJ disorders
TMJ disorders are multifactorial rarely the result of a single cause, more often the product of several interacting factors:
Bruxism (teeth grinding and clenching) is the single most common contributing factor. The forces generated during bruxism often occurring during sleep without the patient’s awareness are many times greater than the forces of normal chewing. Sustained loading of the joint during grinding causes muscle fatigue, disc displacement, and eventually joint surface wear.
Disc displacement occurs when the fibrocartilage disc that cushions the joint surfaces moves out of its normal position. This can result from trauma, sustained loading, or laxity of the supporting ligaments.
Osteoarthritis of the TMJ occurs with age and is more common in patients with a history of bruxism, disc displacement, or previous joint injury. The articular cartilage degenerates, the joint surfaces become irregular, and the characteristic crepitus (grinding sensation) of degenerative joint disease develops.
Trauma. A blow to the jaw, a road traffic accident, or even prolonged mouth opening during a dental or medical procedure can initiate TMJ symptoms.
Stress — specifically, the muscle tension patterns associated with psychological stress is a significant contributor to TMJ muscle dysfunction. Jaw clenching, both during sleep and during waking hours, is a common stress response.
The treatment pathway at NovoCare
Treatment of TMJ disorders at NovoCare is individualised based on clinical assessment, imaging (MRI for soft tissue evaluation of the disc, CT for bone assessment of the joint surfaces), and the stage and nature of the disorder.
Conservative (non-surgical) treatment is the first line for the majority of TMJ patients:
A custom occlusal splint (nightguard) fabricated from impressions of your teeth repositions the jaw in a therapeutically optimal position during sleep, reduces the loading on the joint, and interrupts the bruxism cycle. This is the single most effective conservative intervention for most TMJ patients. At NovoCare, splints are precision-made, not stock appliances the difference in therapeutic effect is significant.
Physiotherapy – targeted exercises for the jaw muscles, manual therapy techniques to improve joint mobility, and postural correction work that addresses the relationship between cervical spine posture and jaw function.
Anti-inflammatory medication – for acute flare-ups and early-stage disc displacement, a course of NSAIDs reduces joint and muscle inflammation and provides a window for conservative measures to take effect.
Intra-articular injection – corticosteroid injection directly into the joint space under imaging guidance, for acute arthritis or disc inflammation that has not responded to splint therapy.
Surgical treatment is indicated when conservative measures have failed, when imaging demonstrates significant structural damage, or when the nature of the disorder (condylar hyperplasia, severe disc adhesion, ankylosis) is inherently surgical:
Arthrocentesis — the least invasive surgical procedure, performed under local anaesthetic, in which the joint space is irrigated with saline to remove inflammatory mediators and break down adhesions. Effective for acute closed lock and early-stage adhesion.
Arthroscopy — minimally invasive surgery in which a small camera is inserted into the joint under general anaesthetic, allowing the surgeon to visualise the disc and joint surfaces, release adhesions, reposition the disc, and remove degenerative tissue.
Open joint surgery — for advanced degenerative disease, failed arthroscopy, or complex structural problems, open surgery allows direct access to the joint for disc repositioning (discopexy), disc removal with or without replacement, and in severe cases, total joint replacement with a custom prosthesis.Novo Care provides TMJ assessment and treatment in Addis Ababa at the Tesfaye Gizaw Building, Bole. If you have jaw pain, clicking, or difficulty opening book a specialist assessment.