Jaw Pain (TMD): What to Try First and Which Costly Treatments to Question

Temporomandibular disorders (TMDs) are more than 30 conditions that cause pain in the jaw joint or the chewing muscles.¹ They affect about 5% of U.S. adults and are twice as common in women.¹ TMD often travels with headaches, back pain, poor sleep, irritable bowel syndrome or fibromyalgia.¹ Many cases are short-lived and go away on their own.¹

First, what’s normal

Clicking or popping without pain is common and normal, and it doesn’t need treatment.¹ Our article on jaw clicking without pain explains this.

Signs of TMD include pain in the jaw or chewing muscles, pain spreading to the face or neck, stiffness, locking, or painful clicking or grating.¹ There’s no single standard test, so diagnosis relies on your history and an exam.¹

Start simple

The National Institute of Dental and Craniofacial Research (NIDCR)¹ says experts recommend conservative care and avoiding treatments that permanently change the jaw, teeth or bite.¹ First steps:¹

• Soft foods for a while
• Heat or cold plus gentle jaw stretching and strengthening exercises
• Over-the-counter pain relievers such as ibuprofen
• Break habits like clenching, gum chewing and nail biting

If that isn’t enough

• Physical therapy, especially hands-on manual therapy, can improve movement and pain.¹
• Cognitive behavioral therapy and biofeedback can help manage TMD.¹
• Mouth guards (splints): evidence for pain relief is limited. If you get one, make sure it doesn’t permanently change your bite, and stop if it causes pain.¹ Our guide to teeth grinding covers night guards.
• Prescription medicines: there’s limited evidence on which work best, and some can be addictive.¹
• Acupuncture and TENS: evidence is limited or comes from small studies.¹

Be cautious about these

• Bite-changing (“occlusal”) treatments, such as grinding down teeth, new crowns or orthodontics to treat TMD. There’s insufficient evidence they work, and they can make the problem worse.¹ A bad bite hasn’t been shown to cause TMD.¹
• Botulinum toxin injections aren’t FDA-approved for TMD, and results are mixed.¹
• Surgery and other procedures: try simpler treatments first, ask detailed questions about risks, and get a second opinion.¹

Questions to ask

1. What type of TMD do I have?
2. Is this treatment reversible?
3. What’s the evidence, and what will it cost?

Try: “My jaw has ached for two months. Before we talk about splints or crowns, can we try exercises and physical therapy?”

Is It My Breath? includes a visit script. Use it to note when your jaw hurts, what you were doing and what you’ve tried.