The Complete Guide to Temporomandibular Joint Disorder (TMD, TMJ)

TMD treatment options range from jaw relaxation techniques to surgery and everything in between. Here's what you need to know to choose the right TMD treatment option for you.

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The Complete Guide to Temporomandibular Joint Disorder (TMD, TMJ)

If you have TMJ pain, I think you’ll agree with me that it’s one of the most frustrating conditions to have. It can be jaw pain, ear pain, neck pain, or even a headache—and you never know when it’s going to show up.

Not only is it painful, it can feel impossible to treat—you’ve probably been told to stop chewing gum and just “wait and see” if it gets better. The lack of a clearcut solution combined with intense, unpredictable pain is enough to drive anyone crazy.

The key thing with treating TMD is to go slowly. I’ve outlined everything you need to know and do, step-by-step, below.

But first, what is TMJ disorder? Is it the same thing as TMD? How do you know if you have it? What are treatment options? Who do I see for treatment? We’ll break down this and more in this article.

What is TMJ Disorder (TMD)?

TMJ is the anatomical abbreviation for the temporomandibular joint, which is the joint connecting your lower jawbone to the base of your skull. It allows us to form words and chew food, and open our mouths for breathing. The TMJ is referred to as single joint, but there are actually two hinge points in front of each ear that enable movement. To accomplish all of these movements, the joint has the ability to rotate in several different directions and essentially create a hinging, or translatory, gliding movement. One example of this motion is chewing. The TMJ allows for rotation, gliding and hinging all at the same time by being relatively mobile within the socket. And this is where it gets complicated. There are a series of complex tendons, muscles and joint pads (called the meniscus) that help move and help protect the joint while it is in motion. Because of this anatomical and functional complexity, the TMJ is susceptible to having many things go wrong.

Because this joint is one of the most frequently used joints in the body, when it gets inflamed, it can be very painful and impact many aspects of normal activities. Problems with the TMJ are called TMD, temporomandibular disorder, or TMJ disorders. But people (and often even dentists) often simply refer to this condition as “TMJ”.

More than 15 percent of American adults suffer from chronic facial pain, such as jaw pain, headaches or earaches all of which may be related to TMD. The disorder disproportionately affects women ages 20-40. Sometimes it only lasts for a few weeks or months before resolving on its own, but often it can last indefinitely.

What are TMD symptoms?

TMD affects many people differently. Many sufferers end up seeing multiple doctors for various other symptoms before realizing that they are originating from the TMJ. Symptoms include:

  • Pain and tenderness around jaw, cheeks, ears, and neck
  • Headaches or migraines
  • Jaw pain or stiffness
  • Popping, grating, or clicking jaw
  • Earache
  • Inability to open jaw completely, locking jaws
  • Painful chewing
  • Tired feeling in face
  • Change of facial expression
  • A change in how your lower and upper teeth fit together, e.g., can’t make one side of one’s bite or the other meet

How is TMD diagnosed?

Unfortunately, no one type of doctor is responsible for diagnosing or treating TMD. Many TMD sufferers may be become frustrated by the amount of time it takes to diagnose, since they may have previously visited an ENT for ear pain, their dentist for tooth pain, or a neurologist for headaches.

If you suspect you have TMD, talk to your primary care physician or your dentist. They will be able to check for symptoms and help you develop a treatment plan. You may consider visiting a TMD specialist in your area for further treatment if the problems persist.

If you truly believe your symptoms are due to TMD your best choice for a correct diagnosis and efficacious treatment is to seek out a dentist that specializes in the treatment of TMD (link to a TMD list of doctors?) To diagnose, the dentist will ask you questions about symptoms and areas of pain, and will physically inspect the joint as you move your jaw around. They will check your bite to inspect how your teeth come together.

In checking your bite, the dentist may check for a CR/CO discrepancy. CR stands for “centric relation” and CO stands for “centric occlusion”. In layman’s terms, CR is the ideal state of your upper and lower jaw positioning and CO is the actual state of affairs. To simplify this concept, consider this analogy…. if the front wheels of your car are not in alignment the suspension joints will wear prematurely and cause other alignment issues with your car. Similarly if your TMD is out of alignment the joint will wear prematurely and cause cause pain and inflammation.

In some cases, your doctor or dentist may recommend other tests to rule out other possibilities, such as lupus, arthritis, or gout. They may also recommend imaging tests, such as x-rays, CTs, MRIs, or ultrasound to look more closely at the joint and surrounding tissue.

What causes TMD?

There is no one cause of TMD. Anything that causes tension in the jaw and temporal muscles or a CR/CO discrepancy can lead to problems with the TMJ. There are often multiple factors that coincide to cause the disorder and pain. These could be:

  • Injury to the jaw or neck (e.g. hit in the face or whiplash): This is one of the most frequent causes of sudden onset of severe pain
  • Grinding or clenching your teeth (also called bruxism)
  • Sleep disordered breathing occurring when your airway collapses while you’re asleep blocking your breathing. the lower jaw’s instinct is to clamp down or thrust forward in an attempt to open the airway
  • Arthritis: arthritis can occur in any joint, including the TMJ
  • Dislocation or erosion of the joint
  • Improper bite alignment
  • Poor dentistry, such as high crowns or fillings, that change how your teeth are coming together

Stress is often considered a cause of TMD. However in my experience I have seen stress as exacerbating a condition that already exists.

I prefer to DIY. What are some at-home remedies for TMD?

Many doctors and dentists will recommend at home treatments as a first step for treating mild TMJ disorder. Since it is a joint, with tissue and muscle, like any other in the body, the treatments are similar to how you would treat any other inflamed joint or muscle with rest and relaxation.

Here are some easy, at-home treatments to try:

  • Rest the joint: eat soft food, avoid gum chewing
  • Apply ice in the beginning and later heat packs to decrease muscle inflammation
  • Experiment with different pillows to allow for proper neck support. Practice jaw exercises to stretch and relax the muscles
  • Over-the-counter pain medicines or anti-inflammatories can help provide short term relief
  • Correct your posture: slouching can push your lower jaw forward, putting stress on the TMJ. This often happens with people who spend many hours at a desk
  • THC/marijuana treatment (if you’re in a state where it’s legal)
  • In addition to direct muscle relaxation, decreasing your stress levels can help treat the symptoms and causes of TMD. Practicing stress reduction techniques such as meditation, yoga, or mindfulness are great additions to any TMD treatment plan.

What to discuss with your dentist and doctor: TMD Treatment Options

Since TMD symptoms can involve the jaw, ear, nose, throat, face, neck, upper back, and even eyes, dentists and ENT doctors often pass TMD patients back and forth, not really knowing what to do with them or how to treat them. This makes things difficult when deciding which TMD treatment is right for you. Take it slow and make sure you fully understand your options, and any potential side effects, before agreeing to treatment.

I’ve listed these treatments for TMD in the order you should approach them—start at the beginning of the list and work your way down. It’s best to conservatively treat in the beginning to see if TMD symptoms go away first before getting to the more serious treatment options, like surgery. All of these should be chosen in consultation with your dentist, TMD specialist, or ENT doctor, or a combination.

Also be aware: There are several things that can be the root cause. Sometimes TMD can heal quickly on its own, and sometimes it can take months of treatment or even surgery to resolve. For some people, it never fully resolves, and it’s a matter of learning how to reduce the pain so you can get back to your life. Depending on your unique situation, your doctor or dentist may recommend more than one treatment.

Give your jaw a break: In many milder cases, TMD symptoms will go away just by letting the overworked jaw muscles rest. If you’re getting clicking or popping when you yawn or open your mouth wide, try not to open wide for the next several days. Cut smaller pieces of food so that you don’t have to open as wide to take a bite or chew as hard. Limit the amount of tough chewing with a softer diet. Cut out chewing gum.

Treat it like a muscle injury: Try treating your jaw the same way you would a pulled muscle. Massage the jaw muscle, put a hot washcloth on it, take an anti-inflammatory like ibuprofen, and let it rest.

Try muscle relaxation exercises: Just like a muscle that cramps from overuse, the jaw can cramp from too much use. Simple exercises can help you learn how to correct abnormal jaw positioning and relax tense jaw muscles that can contribute to TMD pain. All exercises should be done during times when you do not have any pain. If your jaw starts to hurt while you are performing the exercises, stop and rest. Jaw positioning exercises should be done in front a mirror so you can watch your progress. Many people who have TMD have a deviation in the way the joint moves, but are capable of learning a new, more correct position. Put a small sticker on the middle of your chin and open your mouth. If your jaw shifts to the side when you open your mouth, the sticker will shift also. When you see this happening, make a conscious effort to keep your jaw perfectly aligned when you open your mouth. It may feel unnatural at first but over time it will feel more normal and you may notice a reduction in your joint pain. Muscle relaxation and stretching exercises can be done anywhere, at home, in the car or while you read a book. Gently open your mouth as wide as you can without discomfort. Close your mouth slowly. Once your muscles have loosened up, you can use your hand very carefully to open your mouth a little bit wider. This type of stretching can prevent your jaw from becoming locked or unable to open and close smoothly.

Check your posture: Poor posture places the spine in a position that causes stress to the jaw joint. When people slouch or hunch over, the lower jaw shifts forward, causing the upper and lower teeth to not fit together properly, and the skull moves back on the spinal column. This movement puts stress on muscles, joints and bones and, if left untreated, can create pain and inflammation in muscles and joints when the mouth opens and closes.

Get a sleep study: TMD is often caused by grinding the teeth at night, which is a sign that you’re struggling to keep your airway open while you sleep. Recent studies are showing that TMD symptoms are often indicators of a larger disorder – and that includes sleep apnea. A mandibular advancement device, which is made by your dentist and used to treat sleep apnea, often cures TMD because it positions the jaw in a such a way that forces it to relax completely. Assuming the device is worn at night, eight hours of forced relaxation every day can be very effective in reversing TMD symptoms.

Check your stress levels: We often clench without realizing it—and TMD can often be resolved by treating a root cause of major stress, unhappiness in work or at home, etc.

Bite guards: Many dentists will recommend custom bite guards to reduce clenching and grinding of teeth at night to reduce stress on the TMJ. These guards will help the jaw alignment so that the joint can rest. However, make sure that you and your dentist have ruled out sleep apnea as a night guard has the potential to interfere with your sleep and make your grinding worse.

Sleep apnea treatment: A sleep apnea specialist will work with you to design a specific treatment plan if you are diagnosed with sleep apnea. Grinding all night long to keep your airway open is not conducive to TMJ health.

Medical marijuana: if you’re in a state where medical marijuana is legal, your doctor may be able to prescribe it for stress and pain relief. This is palliative only and will not treat the root cause of your TMD.

Join a support group: The TMJ Association is a non-profit organization that focuses on patient advocacy. Especially for severe sufferers of TMD, this is important because you don’t want doctors and dentists pressuring you into treatment you don’t need.

Invisalign: If the root cause of your TMD is an occlusion issue, Invisalign may be able to fix the alignment your jaw, and thus help TMD symptoms. Also, many Invisalign patients achieve immediate relief from their TMD symptoms as the liners prevent you from biting in a misaligned position.

Take over-the-counter meds: Taking ibuprofen, or another anti-inflammatory, can give you immediate relief by reducing swelling or tenderness in the jaw, face, head, or neck. This kind of treatment, however, won’t work in the long term. Being dependent on painkillers is no way to live your life. Pain is also the body’s way of telling you to stop hurting yourself—and taking this away can cause you to further damage your body. Painkillers are great for immediate relief, but be sure you are searching for and treating the root cause. Be wary of any TMD specialist, dentist, doctor or medical professional that advises you to treat your TMD with painkillers alone.

Try occlusional equilibration: This method can take several visits that are weeks apart until the muscles adjust and find a new position. What your dentist will try to do here is aim to equilibrate your bite in a way that gets rid of your jaw pain or other TMD symptoms. Many people have an “actual” bite that differs from their “ideal” bite. Bringing the two positions into harmony is key in treating TMD. This requires strong 3D thinking and premodeling on a model by your dentist in order to treat your TMD and make the teeth less of a trigger point for grinding. A stable well balanced bite puts less stress on the jaw joint. You may need work done to reshape your teeth or jaw through braces or other appliances. A dentist can also fit you with a mouth guard that will help you stop clenching your jaw and grinding your teeth at night. Think of this like an orthotic shoe insole for the mouth. It works to attain that balance and comfort, at least while you’re wearing it.

Orthodontic treatment to adjust for proper bite: In some cases you will need regular metal braces to expand the arches and reverse improper facial development and to improve the bite.

Surgery: Surgery should only be used as a last resort after trying multiple other, non-invasive treatments. However, in extreme cases, surgery on the jaw or on the joint may be necessary. This should only be as a last resort after going through all of the treatment options above, experimenting with different combinations of treatments, working closely with your dentist, and getting a second (or even a third) opinion. Surgery on the actual joint has fallen out of favor. Orthognathic surgery, while an extreme option, may be necessary. As with everything, research your options and understand what TMD is and what causes it before committing to any heavy duty treatment. Depending on the severity of your TMD, you might need to go through some trial and error to figure out which treatment or combination of treatments works for you, but that’s where a good dentist, TMD specialist, or ENT doctor should take care of you and be your advocate throughout the process.

TMD is a complicated condition with many possible combinations of causes and symptoms. Do not get discouraged if your symptoms do not go away quickly after trying one treatment option! It often takes some trial and error to figure out what works best for you. But with patience and diligence, your symptoms can either be well-managed or completely healed.

Dr. Mark Burhenne DDS

Read Next: What is TMD and How Do I Know If I Have It?

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Leave a Comment

  1. Linda Fritzer says:

    Dr. Burhenne, I was very pleased to come across your article. I now know I’ve been suffering with TMD for over 10 years. I’ve been shuffled between dentists, oral surgeons, nuerologists, pain specialists and even went through a 9 week pain management program. I’ve been on several medications and even had nerve block injections in my throat just in front of the tonsils. Nothing has ever helped.
    Your article described the symptoms so perfectly, I was amazed that all the specialists I have dealt with didn’t consider this condition.
    I will be trying the exercises you suggest. I have worn a night guard for several years and am actually on my second one.(Broke the first after several years)
    The article also helped me understand why when I was on muscle relaxers for a back injury, it really helped the TMD pain. Not a good permanent solution I guess, but it sure answers a lot of questions I had that no doctor ever had answers for.
    Thank You.

    • Dr. Mark Burhenne says:

      Linda, thank you for the kind words. I’m glad some of that resonated. It just goes to show that TMD/TMJ is such a complex condition that it’s difficult to completely grasp, even for some dentists. I’m sorry to hear of your dental woes, but I think the key in the end in success is keeping at it and seeing many different people. Make sure that your bite has been equilibrated to perfection — this, I find, is probably the most important starting point.

      – Dr. B

  2. Hello Dr. Burhenne
    It’s been 2 1/2 weeks since I had a brutal lower back molar tooth extraction. An old crown fell off and there was nothing to grab to pull it out so my dentist had to take it out in pieces and it was very stubborn. I had to hold my mouth all the way open for a long time. It was the very back rear tooth. Since a couple days after the surgery, both of my ears are plugged and I can barely hear. I have a very good dentist but he said it would not be from the surgery. I want to mention that a week before my surgery I had a cold and I also have seasonal allergies right now. When I wake in the morning I can hear but within several minutes my ears plug. I’m wondering if there is swelling or something holding fluid in my ears?????? I have never had this happen before and I’m worried it will be permanent. I’ve been searching the internet for a week for answers. I hope you can ease my mind. If you think the reason could be my jaw, could you suggest what I can do to get back to normal hearing?
    Thank you
    Linda M.

  3. Anonymous says:

    I ‘recently had crown on back lower molar break off. I had like 4 shots maybe more and now my throat,ears, and jaw hurts. I also can’t open my mouth hardly. I work in a call ‘venter so I suffer a lot at the end of day.

  4. Alisha silbaugh says:

    Consider Botox injections in the massetter muscles too. It helped me greatly, but only lasted about three months.

  5. I’m so glad I found this site 🙂 I’ve had a locked jaw, can barely fit a finger in between my teeth for 2 days now. I have made an appointment with a new dentist and have a fear my wisdom teeth have finally come through and raising hell (i’m 33). I’m worried that if I can’t even open my mouth, how bad the extraction will be. Do you recommend acupuncture before the surgery to remove my wisdom teeth to try and loosen my jaw? Grateful for your suggestions.

    • Chokolate says:

      How did it goes for you .. please im in the same situation !

  6. Shauna D Baker says:

    I’ve suffered since high school with crackling jaw, grinding my teeth, migraines, numbness in my skull, pain n eyes,ears,neck,shoulders, tinnitus, it is causing me to be a extreme insomniac which of course leaves me in a severe state of depression. Sometimes i feel as if I can’t take anymore. I am seeing a great family dr who sent me to a ent and audiologist. I was diagnosed with hearing loss, and tmd. I haven’t seen a dentist yet. Thus far nothing has been prescribed but some excersies that haven’t seemed to relieve anything. Idaho doesn’t do medicinal marjuana or I would try that. I’m not a pot smoker. But would rather do that than Perscription addiction.
    I’m in my 50s and am tired of suffering from this aliment. Thanks for your post. Any advice would be appreciated.
    Grandma in idaho

  7. Dear Dr. B

    I recently was diagnosed with TMD but all the specialist told me to do was take xanax and use heat 3 times a day. I am so glad I came across this. It has gave me some other things to try- As of yet I am still waking up in the night with pain and sometimes in the day time

  8. Joan Mallon says:

    I had an upper back tooth removed 4 months ago. I have trigeminal neuralgia. I thought this was the cause of my pain. I have deep roots, and, the tooth was difficult to remove.
    Gradually, I have lost more and more jaw function.
    Today, I can’t eat at all. I’m seeing a specialist in a week, but, I can’t wait that long.
    I’m in intense pain, worse when I try to eat. I dread waking up, as the pain is horrific then. The TMJ and TN kick in together. I’m reaching, the stage, when I have trouble swallowing medication.
    What can be done. I can’t have surgery. I can’t take ibruprophen. I’m using heat and ice which helps.
    What treatments are available?

  9. I’d like to also add seeing a physical therapist or even a massage therapist that specializes in treating TMJ related disorders to the list of conservative interventions to consider. As Dr. B mentioned, TMJ related disorders are related to an imbalance in muscle strength/activation, but also the flexibility of the muscle and tissues in the head, jaw, and spine, which effect the movement of the tempomandibular joint. Physical therapists can address correcting these issues with exercises as well as various manual techniques, which may include myofacial release (MFR) and/or craniosacral therapy.

  10. Thank You so much Dr B for this article on TMJ. After 6 years of terrible chronic daily pain I was finally diagnosed with TMJ by a head and neck specialist 6 months ago. After having a orthotic made to wear day and night for months, I finally begin to experience less pain. I also find short term relief from NSAID/Aspirin during the really hard flare-ups. I will begin some of the muscle exercises suggested in your article. Have you heard of the Bowen Work Therapy for TMJ relief? I just wonder if this help with pain relief or healing.

  11. I had dental surgery on tuesday of this week. I had 3 wisdom teeth removed and 2 molars removed. My jaw hurts soo bad. I can barely open it, it’s sore, swollen, and tender. Is it due to TMD or TMJ?? I go back to see my dentist on the 2nd of June but I really need to know now. This is the first time I’ve had surgery done on my teeth and I really don’t want this pain to be permanent. Please let me know. Thank you.

  12. This is long but worth reading! I have suffered with TMJ for years – since 2008. I noticed it not long after a dental visit gone wrong where my jaw was cranked open, multiple cavities filled, crown put in, a really painful traumatic visit. Being holistically minded, I tried for years to get everything back to normal without painkillers- saw a TMJ dental specialist, who referred me to a PT for a lot of intensive exercises that actually created neck pain where there wasn’t any before. A costly bruxism nightguard started shifting my teeth around at night which was painful and worrisome so I stopped wearing it. I tried seeing an osteopath, massage therapist, chiropractor, acupuncturist- all to no avail or only very temporary relief. Hot baths, infrared heating pads, TENS units…I tried everything! My TMJ dentist thought it was stress-induced because of my job, but taking time off from work (thanks to my partner) and being very stress free for a long while did not change a thing in regards to my pain levels. To be clear, my symptoms were fairly serious- headaches, constant jaw pains, flare ups, neck pain, poor sleep, night clenching, perhaps even increased anxiety, etc. I was told by a “spine specialist” MD after an MRI that “there is nothing wrong” and perhaps the symptoms were in my head. I could’ve punched that guy. Also tried diet related things although I’m already healthy in that regard. MMJ did help by relaxing my muscles- it’s legal here in CO- but for me I wanted a long-term solution. Also once we started looking into creating a family that was out. I am so happy to report I have finally, almost 10 years later found some relief.

    Recently friend who had suffered for years from migraines after a car accident had been telling about a chiropractor she had seen who had erased her migraines by doing a procedure called Atlas Orthogonal. I was very skeptical after years of nothing helping but I decided to give it a try. I am squeamish about chiro work but this type is different and was actually painless. It involved repositioning your atlas which is an interior bone that cradles the base of your head with a specialized machine. They had to take 4 specific xrays to see if mine was misaligned. When the Dr went over the results with me she was as surprised as I was. You could see how off centered my atlas was. She said people experience discomfort with .5 degree off and I was 6.5 degrees off base. I could see it for myself. Also she showed my how the C-spine of my neck had lost a huge degree of curvature, which is unusual for someone my age. She said these two things would make it feel difficult to hold the weight of my head up at times (so true!) and always leave my head tilted slightly to one side, which we confirmed as I’m standing there. And to have that bone which connects to your head and spine be so out of whack, well, not hard to imagine it can create a lot of pain that muscle massages and such will not truly address.
    I’ve had only 3 treatments and I cannot tell you what a difference it has made. No more severe jaw pain since my first treatment, only mild and only occasionally. I feel like I’m finally getting back to my old self but I will keep going periodically as I feel the need… old body patterns die hard and you need adjustments from time to time to maintain your new equilibrium. One word of caution- in my pre-appointment research online I found there are a lot of atlas “providers” who sprung up recently looking to capitalize on this treatment and many not qualified that were doing actual harm to some. Make sure you see a chiropractor or MD who’s been trained and certified in this procedure. And make sure they are going to do xrays to see EXACTLY where you need the adjustment, otherwise they are just guessing- this is an interior bone- you cannot feel that it’s out of place like they do with everything else. I have no affiliation with this industry just want to help anyone out there that’s suffered needlessly as I did for so long. Hopefully this treatment can help you too!!

    • Colleen Ramirez says:

      Kate, I am also in CO and have been suffering for 14 years with very similar symptoms. I am curious about the provider you are seeing for your treatment.

  13. About 6 weeks ago I had my top right wisdom tooth removed, which was straightforward and had no issues with recovery. Since then I have been back to the dentist multiple times to get a total of 13 fillings (it had been about 17 years since I last went to the dentist), with one of them resulting in me needing a root canal. My last visit to the dentist was just over a week ago, which was when it was discovered that I needed the root canal, which was partially done, but not fully completed, and I’m scheduled to go back in a couple of weeks to get it finished and then prep for a crown (I’m goi g to Thailand for this, as it is ridiculously priced in Australia).
    Anyway, since my last trip to the dentist about a week ago, I have noticed pain in my right jaw and I feels “sticky” when I try to open wide or if I yawn; it’s not unbearable pain, but it’s pain I’ve never had until now. If I clench my teeth I feel a kind of shooting pain up in my teeth where I’ve just had fillings put in, but not sure if the pain is actually in my tooth or up in my jaw – it’s hard to pin-point. This shooting pain really only happens in the evening or at night, and only if I clench or bite food right in that area of my mouth (I don’t clench it all the time, but I know I need to stop doing it).
    Does it sound like I have TMD/TMJ?

  14. Lisa Ouderkirk says:

    20 years ago I had both of my TM joints replaced with artificial ones after trying many other remedies/treatments that didn’t provide any relief. Following the surgery I had surgical pain for about a week followed by 20 years of no issues at all with this disorder. I faithfully wore my mouthpiece for 10 years following surgery, but after some dental work I had to either get fitted for a new mouthpiece or go without; due to financial issues I had to go without. The last three months I have returned to the way I was 20 years ago with extreme headaches, constant jaw pain and clicking, and also ear and neck pain. The last time they said it was due to clenching and grinding of teeth and I know I am doing that again. My dentist went to fit me with a new mouthpiece but I couldn’t open my mouth wide enough to get the mold in so he is having my go to an oral surgeon, who I can’t get into for three months. I am taking ibuprofen and using heat and cold, but is there anything else that might help alleviate some of the pain until I see the oral surgeon? Any suggestions would be greatly appreciated!

  15. I was recently diagnosed with TMD due to extensive dental work, replaced upper right and lower right bridge , double root canal and deep filing procedures. What are your thoughts regarding some of the new TMD treatments such as cold laser therapy, stem cell injections, and Botox?
    How do you select a neuromuscular dentist?

  16. About one month ago, after Dentist did a filling, I had hard time bite normally. The tissue inside the mouth, between upper and bottom jaw hurt. Just 2 weeks ago, my jaw dislocated, only at one side, the same side the filling was done. It was put back by general Dentist, and he prescribed 4mg Methylprednisolone for 6 day. Before I finish the medicine, I feel my tongue is kind of swelling. I went back to the dentist office. He adjusted the jaw. I feel a lot better, but still the tongue looks a little swelling, a little hard to make certain sound. There is scallops mark at both side of tongue. Can dislocation of jaw or the medicine cause the tongue swelling? Can tongue swelling if the jaw was not placed in the perfect position?


  17. Ramon Barragan says:

    I don’t know if I have tmj or not but my left cheek is really sore and its not hurting but its sore and I can’t smile good. I have no clue what it is. Can you please help me?

  18. Thank you Dr. B, your article on TMJ was very informative and I wish it had been something I had found 5 years ago. I have a blunt square jaw so when I first presented the symptoms of TMJ to my dentist. They chalked it to stress from a pregnancy and told me to wait it out. It only progressed. The muscles around my jaw are now pronounced making the sharp edges of my jaw stick out more. I’ve warn out teeth and feelings. The muscles also spasm causing a lock down. It’s progressed to the point I can’t eat a meal without it happening at least once. I’ve had to change how I talk, sleep, and eat. Recently my dentist fitted me for another night guard and prescribed a 3 week soft food diet and treatment of muscle relaxers. I’ve been doing the treatment for a few days and it only seems to be aggravating the condition.the aches have moved down to my neck and I’ve noticed a tension headache start up once the medication takes effect. Is this normal?

  19. I had braces for four years. Before I got braces the right bottom side of my mouth was an underbite. The orthodontist fixed the underbite; however, now when put my bottom and top teeth together I can tell that one side does not line up tooth for tooth. Ever since then I have had severe jaw issues. Clicking, locking, a stick, a cracking noise sometimes, and even lock jaw. I get my wisdom teeth out in two weeks and I am terrified to have my mouth open and yanked around for that long. If you have any suggestions, they would be greatly appreciated. I am beyond scared and have not yet seen a specialist for TMD. Although I know for sure that I have it, because I have every symptom.

  20. I have been suffering for about 9 weeks with ear pain, joint pain , pain under my jaw, in my mastoid and down the side of my neck. Have been on Naproxen for 4 weeks, have done the hot and cold and night splint. Had an Mri done which shows 2 tears in the disk, flattened epicondyle, fluid buildup, arthritis and osteophytes. Would like your opinion on what I should do next.

  21. Levticus Bennett says:

    I never knew that sleep apnea can affect people with TMJ. My sister has been complaining that her jaw is hurting, we thought it was just temporary but she still has pain. We should probably check with a dentist because my sister has trouble sleeping along with her jaw pain.

  22. I have typical symptoms for TMJ for a long time ,I would say classical symptoms but recently I have some serious night and day sweats,impossible to control , and shivers ,and antibiotics seems to help a lot but the moment I stop them my symptoms,sweating ,shivers terrible headache ,dizziness,sinus pain,ear ache .Looks like some kind of infection,is that related to TMJ?

    • Dr. Burhenne says:

      Hi Mark!

      Thanks for being a reader.

      Typical symptoms for TMJ do not include fever, shivers, headache, dizziness, sinus pain or ear ache. It sounds like that’s something on top of the TMJ. There is no connection between the TMJ and all the other symptoms that you listed.

      Go see an ENT or a primary care phisician and find out if this is a sinus infection, as it seems like it is a serious sinus infection. Part of it could feel like TMJ but it is referred pain from the sinuses, perhaps.

      Hope this helps. Good luck!


  23. Alina smith says:

    Nice article its very helpfull thanks for sharing

  24. Hazel Owens says:

    That’s good to know that TMJ could be caused by sleep apnea which is signaled by grinding your teeth at night. My husband told me that his jaw is starting to really hurt and he doesn’t know why, and it seems he has symptoms of TMJ. He does tend to grind his teeth when he sleeps so it might be either due to that or sleep apnea, so we’ll have to set him up an appointment with a doctor to see if he has TMJ and what he can do to treat it and if he has any other underlying issues causing his jaw to hurt.

  25. I’ve been wearing a night guard for almost 30 years. During the last five years, the pain from my grinding has become worse. It is not constant, but I have good times and bad. What I have noticed is that I don’t sleep well and I know I sometimes snore. I’ve recently noticed that my teeth are getting crocked year by year. One of my front teeth overlaps the other and on that same side one tooth is getting pushed back. Could this be caused by my night guard? My dentist says she’s never heard of that. I’m finally going to see a sleep specialist and see what the real issue is. She says I need to consider my TMJ if I get a different device than a CPAP. What are your thoughts?

    • Dr. Burhenne says:

      Hi Linda,

      It’s very possible. I don’t usually do night guards for my patients with sleep apnea. The guard can actually interfere with rhythmic masticatory muscle activity (RMMA) that is trying to open your airway at night. Given your TMJ and poor sleep, I’d get the sleep study as soon as you can. Good luck!


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