Dra. Cléo Salustiano In this article
SummaryWhat are the symptoms and causes of TMJ disorder?What eases TMJ pain at home, and when should you get an assessment?FAQRead nextTMJ disorder: symptoms, home relief and treatment options
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TMJ disorder involves the jaw joint and the chewing muscles. The most common signs are clicking, jaw pain, pain near the ear, headaches and difficulty opening the mouth or a feeling of locking. The causes usually combine muscle overload, bruxism, stress, habits and changes in the joint itself. At home, a warm compress, a soft diet, avoiding gum and keeping the teeth apart at rest help ease symptoms. Persistent pain, limited opening or locking call for an assessment, and a jaw locked open calls for same-day care. Treatment usually starts with conservative measures such as a custom bite splint, physical therapy and habit changes, and some cases need another professional. Dr. Cléo Salustiano (CRO-SP 170844) sees patients in Mooca, São Paulo, Monday to Sunday, 8 a.m. to 10 p.m., in Portuguese, English and Spanish.
TMJ disorder (temporomandibular disorder, or TMD) is a group of problems affecting the joint that connects the lower jaw to the skull and the chewing muscles around it. The most common symptoms are clicking when you open your mouth, jaw pain, pain near the ear, headaches and, in some cases, a jaw that feels like it locks. In most cases, the first approach is conservative: home care, habit changes and, when indicated, a bite splint and physical therapy.
The TMJ sits just in front of the ear, on both sides of the face, and works all day long: when you talk, chew, swallow and yawn. That is why, when something is off there, the discomfort shows up in places people do not connect with the mouth, such as the ear, the temple or the neck. Many patients arrive at the dental office after seeing an ear, nose and throat doctor for a suspected ear infection, only to learn that the source was muscular or joint-related.
In this article, Dr. Cléo Salustiano (CRO-SP 170844), who provides general dentistry in Mooca, explains the symptoms of TMJ disorder, its most frequent causes, what you can safely do at home, the signs that it is time to get an assessment and which treatments may be recommended. Every case is different, and no article replaces an exam.
This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the general dentistry page to learn how the treatment is done here and book your assessment.
What are the symptoms and causes of TMJ disorder?
The most common symptoms of TMJ disorder are clicking or a grating sound when opening and closing the mouth, pain in the jaw or in front of the ear, tired jaw muscles when chewing, headaches at the temples and difficulty opening the mouth all the way. They can show up on one side or both, and they often change throughout the day and during more stressful periods.
Clicking deserves its own explanation. Inside the joint there is a small disc that works as a cushion. When it slips slightly out of place, the jaw rides over it as it opens, and that produces the click. A click on its own, with no pain and no trouble opening the mouth, is fairly common and often just needs monitoring. It deserves attention when it comes with pain, when the pattern changes or when the jaw starts to lock.
Locking happens in two ways. In the more common one, the mouth will not open fully, as if something were holding the jaw halfway. In the less common one, the mouth opens and cannot close. That second situation needs prompt care, because it requires a maneuver done by a professional and should not be forced at home.
Ear symptoms also confuse many people: a feeling of a blocked ear, pain that radiates into the ear and sometimes ringing (tinnitus). The joint and the chewing muscles are very close to the ear canal, so pain spreads into that area. Even so, an earache with discharge, fever or hearing loss should be seen by a physician, because the cause may be something else.
The causes are usually a combination of factors rather than a single one. In clinical practice, it is common to see muscle overload from clenching or grinding the teeth (bruxism), stress and anxiety, habits such as nail biting, cheek biting, chewing gum or resting the chin on the hand, head and neck posture, a blow to the face, changes in the joint disc and, in some people, wear or inflammation of the joint itself, as in osteoarthritis or rheumatic conditions. The bite can play a part, but today we know it is rarely the only cause.
| Symptom | What it may indicate | What to do |
|---|---|---|
| Clicking without pain | Joint disc slightly out of place, common in the population | Monitor it and mention it at your next visit |
| Clicking with pain | Overload of the joint or the muscles | Home measures and an assessment |
| Jaw pain or tired jaw when chewing | Muscle tension, often linked to clenching | Warm compress, soft diet and an assessment if it persists |
| Pain near the ear or blocked ear | Pain radiating from the joint or muscles | Assessment; with fever, discharge or hearing loss, see a physician |
| Headache at the temples on waking | Clenching or grinding during sleep | Assessment for bruxism and a possible splint |
| Mouth will not open fully | Disc blocking the movement or muscle spasm | Do not force it and get an assessment |
| Jaw locked open | Dislocation of the jaw | Same-day care |
What eases TMJ pain at home, and when should you get an assessment?
At home, what usually helps TMJ disorder most is letting the joint rest: a warm compress on the side of the face for 15 to 20 minutes, a few times a day, a softer diet for a few days, food cut into small pieces and avoiding gum, hard foods and very chewy foods. These are simple, safe measures that help reduce the load on the muscles.
A few everyday habits make a difference. Keep your lips together and your teeth apart when at rest, with your tongue relaxed against the roof of your mouth. Teeth should only touch when you chew and swallow. Avoid opening your mouth very wide: when you yawn, support your chin with your hand. Avoid biting your nails, chewing on pens and resting your face on your hand. Sleep on your back or side without pressing your jaw into the pillow.
Pain medication should only be used with professional guidance, especially if you have other health conditions or already take medication. Do not force your mouth open or closed, do not click your jaw on purpose and do not use ready-made splints bought online: a splint that has not been adjusted can change the way your teeth meet and make things worse.
Get an assessment when pain lasts more than a few days or keeps coming back, when you cannot open your mouth fully, when clicking starts to hurt, when chewing becomes difficult or when headaches come with signs of clenching, such as tooth wear or a tired jaw when you wake up. Seek same-day care if your jaw locks open, if there is swelling with fever or if the pain started after a blow to the face. One important note: pain in the arm, chest or jaw with shortness of breath or cold sweats is a medical emergency, not a dental one.
Treatment options depend on what the exam shows. The most common are a custom-made bite splint (occlusal splint), which reduces the load on the muscles and the joint, physical therapy with exercises and manual therapy, habit changes and stress management. When bruxism is involved, it becomes part of the plan, and you can read more about that in the article on worn-down teeth and oral rehabilitation. Some cases call for another professional, such as a physical therapist, a physician, a rheumatologist, an ear, nose and throat doctor or a dentist focused on TMD and orofacial pain. Irreversible treatments, such as grinding down teeth to change the bite, are not the first step, and surgery is reserved for very specific situations.
Is jaw clicking a sign of a TMJ problem?
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Not always. A click on its own, with no pain and no trouble opening the mouth, is common and often just needs monitoring. It deserves an assessment when it comes with pain, when the pattern changes or when the jaw starts to lock or open less than before.
Can TMJ disorder cause ear pain?
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Yes. The joint and the chewing muscles sit very close to the ear, and pain radiates into that area, sometimes with a blocked-ear feeling or ringing. If there is discharge, fever or hearing loss, see a physician, because the cause may be something else.
Can TMD cause headaches?
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It can, especially at the temples and the back of the head, because of tension in the chewing muscles. It is common in people who clench their teeth at night and wake up with a sore head and jaw. Headaches have many causes, so an exam helps clarify whether the source is muscular.
What should I do if my jaw locks?
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If your mouth will not open fully, do not force it: use a warm compress, eat soft foods and get an assessment. If your jaw is locked open and will not close, seek same-day care, because a professional needs to guide it back. Do not try to reset it yourself.
Hot or cold compress for TMJ pain?
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For muscle pain and stiffness, a warm compress usually helps, for 15 to 20 minutes, a few times a day. A cold compress can be used in the first hours after a blow to the face or when there is swelling. Either way, protect your skin with a cloth and do not apply it directly.
Is chewing gum bad for the TMJ?
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For people with TMJ disorder, chewing gum usually makes things worse, because it keeps the muscles and the joint working for long periods without need. During flare-ups and while symptoms last, it is wise to avoid gum, very hard foods and very chewy foods.
Does a bite splint cure TMJ disorder?
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A splint is not a cure, it is a tool. Custom-made and adjusted by the dentist, it reduces the load on the muscles and the joint and protects the teeth from clenching. The response varies from person to person, and it usually works together with habit changes and, when indicated, physical therapy.
Who treats TMJ disorder: a dentist or a doctor?
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The dentist is often the first to assess it, because the exam covers the joint, the muscles and the bite. Many cases benefit from teamwork with a physical therapist and, when other causes are suspected, with a physician, rheumatologist or ear, nose and throat doctor. More complex cases may be referred to a dentist focused on TMD and orofacial pain.
