Patient information from BMJ

Temporomandibular disorders

Last published:Nov 16, 2023

Your jaw is a complicated joint. It’s fairly common to get problems like a painful or clicking jaw, or even a locking jaw. Doctors call these symptoms temporomandibular disorders. There’s no simple cure for the problem, but the symptoms often improve over time on their own. There are treatments that can help some people. Surgery is usually a last resort for people with severe jaw problems. 

You can talk to your doctor to decide which treatments are best for you.

What are temporomandibular disorders (TMDs)? 

TMD is a condition affecting the jaw. If you have TMD you may get a clicking sound when you move your jaw. You may also get pain in your jaw or face. Some people find they can’t move their jaw properly or open their mouth as wide as they used to. 

What causes TMD?

The exact cause of this condition is unknown. But it has been linked to a few potential factors such as:

• Trauma (to the jaw joint or nearby structures)

• Orthodontic treatment (this is dental treatment focused on teeth straightening)

• Rheumatoid arthritis (a condition that makes your joints swollen and stiff)

• Grinding or clenching your teeth at night.

What are the symptoms?

The main symptoms of TMDs are: 

• Pain in the jaw joint, or in your face from the muscles you use to chew

• Noise, like clicking or popping, from your jaw

• Not being able to move your jaw easily, or finding that your jaw locks.

Some people with TMD also get ear pain, tinnitus (ringing or other sounds in the ears), headaches, backache, or neck pain, and some people feel depressed or anxious. 

Most people won’t need any tests to diagnose their jaw problems, but doctors sometimes order a scan, such as a dental X-ray if they want to examine the structure of the joint.

What treatments work?

A clicking or painful jaw can be very annoying. You might be reassured to know that the problem rarely gets worse. It may even go away on its own given time. There are also several treatments that can help you manage your TMD and reduce the pain you get.

Non-drug treatments 

Resting your jaw might help. This will allow the muscles you use for chewing to relax. You should avoid chewing gum or biting your nails. Eating softer food for a while may also help you rest your jaw.

You should also try to avoid stressful situations, as stress may lead you to clench your jaw or grind your teeth, which can make your jaw problems worse. If you are very stressed or anxious, relaxation techniques like belly breathing or a talking treatment like cognitive behaviour therapy (CBT) might be useful.

Your doctor might recommend that you have physiotherapy. A physiotherapist will show you exercises designed to help your jaw.

Doctors sometimes recommend a splint or bite guard to wear, usually at night (these look a bit like a boxer’s gumshield), if your symptoms don’t improve after two weeks of jaw rest. This may help reduce the pain in your jaw. You’ll need to see a dentist to get a guard fitted.

Some people try acupuncture for a painful or clicking jaw, but there’s no good evidence that it works.

Drug treatments

If resting your jaw doesn’t improve your pain in a couple of weeks, your doctor may suggest drug treatment to help. The treatment you need will depend on what’s causing the pain.

If you have pain because of a misaligned disc or arthritis, your doctor might recommend an anti-inflammatory gel like diclofenac that can be used over the skin of your jaw joint. Painkillers like ibuprofen may be another option.

Surgery

Surgery is an option for people with temporomandibular disorders, although it’s usually a last resort. You might want to think about surgery if you get pain that doesn’t go away with other treatments, or if the clicking in your jaw makes it hard to chew, talk, or get on with your life.  

Surgery isn’t always successful. If you’re considering it, make sure you talk to your surgeon and get a realistic idea of what the outcome is likely to be. You’re likely to get some pain and difficulty moving your jaw while you’re recovering from surgery.

What will happen to me?

Problems with a clicking or painful jaw tend to improve as you get older. People often adapt to the way their jaw moves, and the joint itself may adapt over time. Most people find their symptoms improve even without treatment.

Although there are treatments for a clicking or painful jaw, most aim to help with the symptoms rather than cure the condition. For most people, it’s a case of learning to live with a clicking jaw.