Jaw pain, clicking, headaches near the temples and a jaw that sometimes catches or locks are often lumped together as “TMJ.” Dentists are commonly the first professionals people see about these symptoms, partly because they show up during dental visits and partly because night guards are so often mentioned. This guide explains what the terms mean, what the research says about causes and treatments, and how to work with a dentist or doctor on jaw pain.
TMJ vs. TMD
The National Institute of Dental and Craniofacial Research (NIDCR) draws a clear distinction. “TMJ” refers to the temporomandibular joint itself, the jaw joint. You have two, one in front of each ear. “TMD” refers to temporomandibular disorders, which NIDCR describes as a group of more than 30 conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement.
NIDCR groups TMDs into three broad categories: disorders of the joints (including disc problems), disorders of the chewing muscles, and headaches associated with a TMD. A person can have more than one at the same time.
How common is it?
NIDCR states that TMD affects about 5% of adults in the U.S., while noting the figure varies depending on who is studied and how the condition is assessed. NIDCR also reports that TMDs are twice as common in women as in men, especially women between 35 and 44.
Many TMDs last a short time and resolve on their own, according to NIDCR. Some become chronic, and they can occur alongside other conditions such as headaches, back pain, sleep problems, irritable bowel syndrome and fibromyalgia.
What causes TMD
NIDCR explains that injury to the jaw joint can lead to some TMDs, but in most cases the exact cause is unclear, and symptoms often start without an obvious reason. Research suggests that a combination of genes, psychological and life stressors, and how a person perceives pain may play a role.
One important point: NIDCR says research does not support the belief that a bad bite or orthodontic treatment such as braces causes TMDs. That matters when you are offered treatments aimed at “fixing” the bite.
Symptoms
NIDCR emphasizes that clicking or popping sounds in the jaw joint without pain are common, considered normal, and do not need treatment. Symptoms that may signal a TMD include:
- Pain in the chewing muscles or jaw joint, the most common symptom.
- Pain that spreads to the face or neck.
- Jaw stiffness.
- Limited movement or locking of the jaw.
- Painful clicking, popping or grating when opening or closing the mouth.
- Ringing in the ears, hearing loss or dizziness.
- A change in the way the upper and lower teeth fit together.
Jaw and facial pain can also come from other problems, such as a tooth infection or sinus issues. If you have swelling, fever, or pain after an injury, see our guide to dental emergencies.
Clenching and grinding often come up alongside jaw pain; our guide to teeth grinding and night guards covers the signs and how teeth are protected.
How TMD is diagnosed
NIDCR notes there is no widely accepted standard test for TMD. A dentist or doctor will take a detailed history, asking where the pain is, when it happens, what makes it better or worse, and whether you have other pain conditions. They will examine the head, neck, face and jaw for tenderness, sounds and movement problems, and may order imaging such as X-rays, MRI or CT. Part of the work is ruling out other causes.
Treatment: start conservative
NIDCR’s guidance is notably cautious. Because evidence for many TMD treatments is limited, experts recommend conservative treatments and avoiding treatments that permanently change the jaw joints, teeth or bite, or that involve surgery. Since many cases improve without treatment, simple measures may be enough.
Self-care first
NIDCR lists steps a provider may suggest when discomfort starts:
- Eating soft foods.
- Applying heat or cold combined with gentle stretching and strengthening exercises.
- Over-the-counter pain relievers such as NSAIDs, if appropriate for you.
- Reducing habits like jaw clenching, gum chewing and nail biting.
Physical therapy
NIDCR says research suggests manual therapy, in which a therapist stretches the soft tissues and muscles around the joint, can help improve function and relieve pain.
Self-management and behavioral approaches
Learning about your specific TMD, noticing and reducing clenching, relaxation techniques, and approaches such as cognitive behavioral therapy and biofeedback can help some people manage symptoms, according to NIDCR.
Medications
A provider may recommend over-the-counter or prescription medicines. NIDCR notes limited evidence on which work best and that some can be addictive or have serious side effects, so make sure you understand how long to take anything prescribed.
Night guards and splints
This is where dentists often come in. NIDCR describes intraoral appliances, also called night guards, splints or stabilization appliances, as devices that fit over the teeth, protect them, and may help with habits like clenching. They do not change the teeth or bite. NIDCR is candid that there is not a lot of evidence on whether they improve TMD pain. If one is suggested, ask how long to wear it, and stop and contact the provider if it increases pain or changes your bite.
Treatments to approach with caution
Given NIDCR’s recommendation to avoid permanent changes, be wary of plans that start with irreversible steps, such as grinding down teeth to adjust the bite, extensive crowns, or orthodontics purely to treat TMD pain. Get a second opinion before any surgery or permanent bite change.
Which professional should you see?
A general dentist is a reasonable starting point, especially if you also grind your teeth. Depending on findings, you might be referred to an oral and maxillofacial surgeon, an orofacial pain specialist, a physical therapist or a physician. Orofacial pain is one of the dental specialties recognized by the ADA National Commission. Our guide to dental specialists explains the main roles, and you can search for practices in the dentist directory.
Cost factors
We do not quote prices. Costs depend on whether imaging is needed, whether a custom appliance is made, the number of physical therapy sessions, and whether care is billed to dental or medical insurance; some TMD care is handled under medical plans. Ask the office which applies before treatment.
Frequently asked questions
Is jaw clicking a sign of TMD?
Not by itself. NIDCR says clicking or popping without pain is common, considered normal and does not need treatment.
Do braces or a bad bite cause TMD?
NIDCR states research does not support the belief that a bad bite or orthodontic treatment causes TMDs.
Will a night guard cure TMD?
NIDCR says there is not much evidence on whether intraoral appliances improve TMD pain. They can protect teeth and may help with clenching, and they should not change your bite.
Does TMD go away on its own?
NIDCR notes that for many people symptoms go away without treatment, though some cases become chronic.
Should I have surgery for TMD?
NIDCR advises conservative treatment and avoiding treatments that permanently change the jaw, teeth or bite, or involve surgery. Get a second opinion before any irreversible procedure.
Photo: Néo Rioux / Pexels
Sources
- NIH / NIDCR – TMD (Temporomandibular Disorders)
- ADA National Commission – Recognized Dental Specialties
By the Dentist Review Editorial Team.
This is general information, not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
