What is TMJ?
TMJ is short for temporomandibular joint, the hinge just in front of each ear where the lower jaw meets the skull. You have two, and they work with the muscles of your face and temples every time you talk, chew or swallow. When people say they have TMJ, they usually mean trouble with those joints or the muscles around them.
Signs of a jaw joint problem
A click on its own, with no pain and no locking, is common and often needs nothing more than keeping an eye on. What deserves a closer look is any of these:
- Pain in the jaw, in front of the ear or across the face, often worse after chewing.
- Clicking or popping when you open or close your mouth, especially with pain.
- A jaw that locks, catches, or will not open as wide as it used to.
- Headaches around the temples, especially on waking.
- Worn, chipped or flattened teeth.
What causes jaw pain?
Usually more than one thing. Clenching or grinding, often at night and often without knowing it, overworks the muscles and loads the joints. Stress tends to make clenching worse. The way your teeth meet can play a part, and so can arthritis in the joint itself.
Daytime clenching is easy to miss. If you catch your teeth pressed together while you drive or work at a screen, that is clenching. At rest, the lips are together and the teeth are slightly apart.
What an evaluation looks at
We start with questions: where it hurts, when, what makes it worse, and whether anyone has told you that you grind at night. Then we look at the joints, feeling and listening for clicks as you open and close, and checking how wide you can open. We press gently on the chewing muscles along the jaw and temples to find the sore ones, check how your teeth meet, and look for wear, chips and cracks that show how hard your teeth are being worked.
Not all face pain comes from the jaw. A toothache, a cracked tooth or sinus trouble can feel much the same, so part of the job is ruling those out.
Start with the simple things
Jaw trouble is treated conservatively first, because it often settles without anything more. These are the first steps, and you can start them today:
- Softer foods for a while, cut small, and no chewing gum.
- Rest for the jaw: no wide yawns, nail biting or chewing on pens.
- Heat or ice on the sore side, whichever feels better.
- Notice daytime clenching, and let the jaw relax: lips together, teeth apart.
A custom oral appliance
When the simple steps are not enough, or you grind at night, a custom appliance can help. It is a thin, hard guard made to fit your teeth and worn while you sleep. It protects the teeth from grinding and can take some of the strain off the muscles and joints.
We recommend one only when it is likely to help, adjust it so your bite meets it evenly, and check it at later visits. It is not a cure, and it works alongside the simple steps rather than instead of them. It is also a different device from the one used for sleep apnea, which holds the lower jaw forward.
If grinding has already worn or cracked teeth, they can be repaired once the grinding is under control, sometimes with a crown.
When it needs more than a general dentist
Some jaw problems need more than a general dentist should do: a joint that stays locked, pain that does not improve with conservative care and an appliance, or arthritis that is getting worse. Then we will refer you to a specialist or back to your physician, and explain why. If you have hurt your jaw and think it may be broken, go to an emergency room.
Questions patients ask
Can TMJ go away on its own?
Often it does. Many flare-ups settle with softer food, rest for the jaw, heat or ice, and less clenching. If the pain keeps coming back or is getting worse, it is worth having it looked at.
Is jaw clicking a problem?
Not necessarily. A click with no pain and no locking is common and often needs nothing more than keeping an eye on. Clicking with pain, or a jaw that catches or locks, is worth an evaluation.
Will a night guard stop me grinding?
No. A custom guard protects your teeth from grinding and can ease the strain on the jaw, but it does not stop the habit itself. That is why it works alongside noticing and relaxing daytime clenching rather than replacing it.
Can stress cause jaw pain?
It can contribute. Many people clench their teeth when they are stressed or concentrating, often without noticing, and that tires the jaw muscles. Noticing it and letting the jaw relax, lips together and teeth apart, helps.