TMJ and Jaw Pain (TMD): Causes, Self-Care and Treatment

This page is general information and does not replace an examination.

What is TMD?

The temporomandibular joint (TMJ) connects the lower jaw to the skull just in front of each ear. An articular disc divides each joint into two compartments, one for gliding and one for hinge movement, and four chewing muscles move it: the temporalis, masseter, medial pterygoid and lateral pterygoid^[3].

Temporomandibular disorder (TMD) is a group of conditions in this region, divided into those affecting the chewing muscles and those affecting the joint itself. Typical features are joint pain, restricted jaw movement and joint sounds^[3]. “TMJ” is often used for the condition, but strictly it is the name of the joint.

Symptoms

The NHS lists these symptoms of TMD^[1]:

• pain around the jaw, ear and temple;
• clicking, popping or grinding noises when you move your jaw;
• a headache around the temples;
• difficulty opening the mouth fully;
• the jaw locking when you open your mouth.

The pain may be worse when chewing and when you feel stressed, and TMD can also disturb sleep^[1]. The BMJ guideline adds earache and crackling sounds in the joint, and impaired jaw function^[2].

Causes

According to the NHS, TMD can be caused by^[1]:

• teeth grinding (bruxism);
• wear and tear of the joint;
• a blow to the head or face;
• stress;
• an uneven bite.

Bruxism is defined in an international consensus as repetitive jaw-muscle activity with clenching or grinding of the teeth and/or bracing or thrusting of the lower jaw, during sleep or while awake^[4]. Worn or chipped teeth and tired jaw muscles in the morning are signs a dentist looks for. Teeth grinding has its own guide.

Warning signs that need a doctor

Most jaw pain is TMD, but some symptoms need a medical assessment soon. The NHS advises an urgent GP appointment, or NHS 111, if you^[1]:

• are unable to eat or drink;
• have clicking, popping or grinding noises when you move your jaw;
• have difficulty opening your mouth fully, or your jaw is locking;
• have pain around your jaw, ear or the side of your head;
• have frequent, severe headaches;
• have pain or tenderness at the side of your head or on the scalp;
• have vision problems, such as double vision or loss of vision in one or both eyes.

Self-care that helps

TMD usually gets better without treatment, and these steps ease the symptoms^[1]:

• Eat soft food, such as pasta, omelettes and soup.
• Over-the-counter pain relief, such as paracetamol or ibuprofen, taken as directed on the package, if your physician or pharmacist has not told you otherwise.
• Heat or cold: an ice pack or heat pack wrapped in a tea towel, whichever feels better. Use a pack of frozen peas for no more than 5 minutes at a time, or a hot water bottle twice a day for 15 to 20 minutes.
• Massage the painful jaw muscles.
• Find ways to relax.

And avoid^[1]:

• chewing gum or pen tops;
• biting food with your front teeth;
• yawning too wide;
• biting your nails;
• clenching your teeth: apart from when eating, your teeth should be apart.

Treatment: what the evidence supports

In 2023 an international panel published a guideline in The BMJ for chronic TMD pain, meaning pain lasting 3 months or more; it does not apply to new, acute jaw pain^[2]. Compared with placebo or sham treatment, the panel made^[2]:

Source: Busse et al., BMJ 2023 [2]. The panel stresses shared decision-making: start with strongly recommended options, then those conditionally in favour^[2].

The NHS describes a similar path: a GP may suggest stronger painkillers, relaxation and better sleep, and may refer you to a dentist if grinding may be involved, to a psychologist if stress and anxiety make the pain worse, or to a physiotherapist for jaw exercises and massage. Specialist options such as injections or surgery are considered only if these do not help^[1].

Night guards and splints: an honest view

Many patients expect a splint to cure jaw pain. For chronic TMD pain, the BMJ guideline makes a conditional recommendation against reversible occlusal splints^[2]. It strongly recommends against irreversible splints, which permanently change the bite^[2].

A night guard still has a clear role when grinding or clenching is part of the picture: it protects the teeth and any crowns, bridges or veneers from wear and fracture. That is why we use it mainly as protection, combined with exercises and self-care for the pain, and not as a promise to cure TMD. Our crown and bridge guarantees exclude fracture due to bruxism (teeth grinding), and patients who grind their teeth must wear the night guard we provide; see our written dental guarantee.

Jaw pain or toothache?

Grinding can cause pain in several teeth at once, and a tooth problem can feel like jaw pain. The NHS lists grinding among the causes of toothache^[5]. A dentist separates the two by examining the teeth, testing suspicious teeth, checking the jaw muscles and joint, and taking X-rays. If a single tooth is the source, the treatment is for that tooth, not the jaw. See our toothache guide.

How we handle jaw pain at our clinic

Both of our dentists, Dr. Ali Cem Ulubey and Dr. Surur Ulubey, examine and treat patients themselves; there are no rotating dentists.

• Examination: teeth, bite, wear signs, jaw muscles and joint movement, plus a panoramic X-ray for every patient, so tooth problems are not missed.
• Jaw exercises: we explain and demonstrate jaw exercises in the clinic, together with the self-care steps above.
• Night guard or occlusal splint: made in the clinic when grinding or clenching is involved. It is a hard guard and can be ready within 2–3 hours when it is urgent.
• Referral: advanced or persistent cases are referred to physiotherapy. Symptoms on the warning-sign list above go to a physician.

Night guard and other prices are on our dental treatment prices page.

Frequently asked questions