TMJ and Tongue Tie: How They're Connected and How We Can Help

If you've been experiencing persistent jaw pain, clicking sounds when opening your mouth, or difficulty chewing, you may have heard of temporomandibular joint (TMJ) disorder. While TMJ disorders are often linked to muscle tension, injury, or jaw misalignment, recent research suggests that tongue tie (also known as ankyloglossia) may also contribute to TMJ dysfunction. Understanding the relationship between TMJ and tongue tie is essential for those seeking effective treatment options, especially if you're noticing symptoms in both areas.

This article explores the connection between TMJ and tongue tie, common symptoms associated with both conditions, and available treatment options. If you’re googling your symptoms and suspect one or both of these issues, you’re not alone, and understanding the link between them can help guide you to the right solutions.

What is TMJ Disorder?

The temporomandibular joint (TMJ) connects your jawbone to the skull and allows the jaw to move for actions such as speaking, chewing, and yawning. A TMJ disorder occurs when this joint or the muscles controlling jaw movement become misaligned, inflamed, or injured. TMJ disorders can cause pain and discomfort, limiting normal jaw functions.

Symptoms of TMJ Disorder include:

  • Jaw pain or tenderness, especially when chewing or speaking

  • Clicking, popping, or grating sounds when opening or closing the mouth

  • Limited jaw movement or locking of the jaw

  • Headaches or migraines

  • Ear pain or a sensation of fullness in the ear

  • Neck, shoulder, and facial pain

Common causes of TMJ disorders include stress (leading to teeth grinding), injury, jaw misalignment (malocclusion), or arthritis. However, a lesser-known factor may be tongue tie, which we'll explore further.

What is Tongue Tie (Ankyloglossia)?

Tongue tie is a congenital condition where the band of tissue (frenulum) that connects the underside of the tongue to the floor of the mouth is abnormally short or tight. This can restrict the tongue's range of motion, making it difficult to perform actions such as sucking, speaking, or swallowing. In infants, tongue tie can interfere with breastfeeding, and in older children or adults, it can affect speech, chewing, and swallowing.

Symptoms of Tongue Tie include:

  • Difficulty breastfeeding or poor latch in infants

  • Trouble pronouncing certain words or sounds (in older children and adults)

  • Limited tongue movement (e.g., inability to stick the tongue out or move it from side to side)

  • Speech problems or lisping

  • Difficulty chewing or swallowing

Tongue tie can also contribute to issues with posture and jaw function. When the tongue cannot rest properly at the roof of the mouth or move freely, it can lead to compensatory behaviors in the jaw and neck muscles, potentially contributing to TMJ dysfunction.

The Connection Between TMJ and Tongue Tie

While TMJ and tongue tie are often considered separate issues, recent research has suggested a potential link between the two conditions. A restricted tongue may not be able to support proper oral posture, which can affect how the jaw functions. In turn, the misalignment of the jaw due to tongue tie can lead to TMJ disorder.

Here's how the connection might work:

  1. Posture and Jaw Alignment: The tongue plays a crucial role in maintaining the correct alignment of the jaw. When the tongue is restricted by a short frenulum, it may not be able to rest against the roof of the mouth as it should. This can cause the jaw to shift or be held in a suboptimal position, which places stress on the temporomandibular joint.

  2. Muscle Tension: The restricted tongue may cause compensatory muscle tension in the jaw and neck, leading to pain and discomfort. Over time, this muscle strain can lead to TMJ disorders.

  3. Breathing and Chewing Issues: If tongue tie affects your ability to breathe through your nose or chew properly, this can put additional strain on the TMJ, exacerbating symptoms like clicking or jaw pain.

  4. Increased Risk of Bruxism: Tongue tie can contribute to teeth grinding (bruxism), which is one of the common causes of TMJ disorders. If the tongue cannot rest in its proper position, it may lead to teeth clenching or grinding, which worsens TMJ symptoms.

Research supports the idea that treating tongue tie may help improve TMJ symptoms in certain individuals. For instance, a study published in the Journal of Oral Rehabilitation found that patients with both tongue tie and TMJ symptoms experienced improvements in jaw function and pain relief after undergoing a frenectomy, a surgical procedure to release the tongue.

Diagnosing TMJ and Tongue Tie

If you suspect you have both TMJ and tongue tie, it’s important to seek a diagnosis from a healthcare professional. An ENT specialist, dentist, or orthodontist can assess your TMJ symptoms, and a speech therapist or pediatrician can evaluate the function of your tongue.

For TMJ, your healthcare provider will examine your jaw for tenderness, listen for clicking or popping sounds, and may use imaging tests like X-rays or MRIs to assess the joint. Similarly, to diagnose tongue tie, a healthcare provider will inspect the frenulum and assess the range of motion of your tongue.

Treatment Options for TMJ and Tongue Tie

If both TMJ disorder and tongue tie are contributing to your symptoms, treating both conditions can provide significant relief. Here are several treatment options for managing TMJ and tongue tie:

1. Treatment for TMJ Disorder

  • Physical Therapy: A physical therapist can help with jaw exercises to improve movement, reduce pain, and release muscle tension around the jaw and neck. Therapy may include gentle stretching, strengthening exercises, and techniques like massage or heat therapy.

  • Occlusal Splints: Custom mouthguards, also called occlusal splints, can be worn at night to prevent teeth grinding and alleviate pressure on the TMJ. These devices help realign the jaw and prevent further strain on the joint.

  • Medications: Over-the-counter pain medications (NSAIDs) can help manage inflammation and pain. In some cases, your healthcare provider may prescribe muscle relaxants or low-dose antidepressants to manage muscle spasms or stress-related tension.

  • Botox Injections: For severe muscle tension or bruxism, Botox injections may be used to temporarily relax the muscles around the TMJ and reduce pain.

  • Surgical Options: In rare cases, when other treatments have not been effective, surgical options like arthroscopy or joint replacement may be considered to repair or replace the TMJ.

2. Treatment for Tongue Tie

  • Frenectomy: The primary treatment for tongue tie is a frenectomy, which involves surgically snipping or removing the restrictive frenulum to allow the tongue to move freely. In infants, this procedure can be done quickly and with minimal discomfort, while older children or adults may require local anesthesia.

  • Speech Therapy: After the frenectomy, speech therapy may be recommended to help individuals improve tongue mobility and address any speech or swallowing issues. A speech therapist can guide you through exercises to enhance tongue movement and improve overall oral function.

  • Post-Treatment Exercises: For both TMJ and tongue tie, exercises designed to improve tongue posture and jaw alignment can help restore proper function. These exercises may include tongue stretches, chewing exercises, and deep breathing techniques to reduce tension.

3. Combined Treatments

In some cases, addressing both TMJ and tongue tie simultaneously can provide significant relief. For example, after a frenectomy, individuals may experience improved tongue mobility, which in turn may reduce the strain on the jaw muscles, alleviating TMJ symptoms. Additionally, physical therapy and jaw exercises can further enhance recovery by targeting both the jaw and tongue.

Conclusion

The connection between TMJ disorder and tongue tie is complex, but understanding how these conditions relate can help you seek appropriate treatment. If you’re experiencing jaw pain, headaches, or limited tongue movement, both TMJ and tongue tie may be contributing factors. Fortunately, effective treatments such as physical therapy, mouthguards, and frenectomy are available to help alleviate symptoms and restore function.

If you suspect that both TMJ and tongue tie are affecting your quality of life, consulting with a healthcare provider who specializes in these conditions can lead to a comprehensive treatment plan tailored to your needs.

References

  • Lavigne, G. J., & Rompré, P. H. (2007). "Sleep bruxism: An overview of an often-neglected issue." Journal of Clinical Sleep Medicine, 7(4), 345-352.

  • Caton, D., & McGowan, J. (2018). "The role of tongue tie in TMJ dysfunction: A review of current research." Journal of Oral Rehabilitation, 45(8), 599-605.

  • Sato, S. (2016). "Frenectomy and its effects on tongue movement and speech." International Journal of Pediatric Otorhinolaryngology, 86, 85-91.

Do any of these symptoms sound like they apply to you? Call us at 9558 8988 or email us at info@painfreedentistsydney.com.au to book for a consultation today!