Is it your tooth, or your jaw?
Tight, tender spots in the chewing muscles, called trigger points, can send pain to the upper and lower back teeth. The pain is real. It is simply coming from somewhere other than the tooth.
Clues the pain may not be dental
- A dull, steady ache that is hard to pin to one tooth
- Worse with chewing, yawning or clenching
- Felt on both sides, or moves from tooth to tooth
- Pressing on the cheek or temple muscles brings it on
- Numbing the tooth does not stop the pain
What is TMD?
Temporomandibular disorders (TMD) are a group of conditions that affect the jaw joints, the chewing muscles, or both. You have two jaw joints, one in front of each ear. Each has a small cushioning disc that lets your jaw glide smoothly when you talk, chew and yawn.
Muscle pain
The most common type. The chewing muscles become sore, tight or tired, often from clenching or grinding.
Joint problems
The disc can slip out of place, causing clicking, catching or locking, or the joint can become inflamed or arthritic.
TMD is common and affects women more often than men. The good news: most people improve with simple, conservative care.
Signs and symptoms
- Pain in front of the ear, in the jaw or at the temples
- An aching face, often worse in the morning or after meals
- Headaches at the temples
- Earache or ear fullness without an ear infection
- Clicking, popping or grating when you open or chew
- Trouble opening wide, or a jaw that catches or locks
- The jaw shifting to one side as you open
- Tooth pain with no dental cause
- Jaw muscles that tire quickly when you chew
What can contribute
Clenching or grinding, day or night; stress, anxiety and poor sleep; a jaw injury or a long dental visit; posture and neck tension; arthritis; and habits like gum chewing or nail biting.
How we find the cause
- Your story: where it hurts, when, and what helps
- Gentle pressure on the jaw muscles and joints
- Measuring your opening and listening for joint sounds
- Testing your teeth to rule out a dental cause
- A 3D CBCT scan or other imaging when needed
- A short questionnaire about sleep, stress and habits
Treatment, step by step
We begin with gentle, reversible care. Most people never need more than the first two steps.
- Self-care. Soft foods, heat or ice, jaw rest and habit awareness.
- Conservative care. A custom night guard (splint), physical therapy, short-term medicine, and support for stress and sleep.
- Targeted treatment. Trigger point or muscle injections, or rinsing the joint (arthrocentesis).
- Surgery. Rarely needed, and only for joint problems that do not respond to other care.
When it helps, we coordinate your care with your dentist, a physical therapist or an orofacial pain specialist.
Caring for your jaw at home
- Choose softer foods and cut food into small pieces
- Skip gum, ice, hard candy and very chewy foods
- Keep your jaw relaxed: lips together, teeth apart
- Use moist heat or a cold pack on sore muscles
- Support your chin when you yawn
- Notice daytime clenching, nail biting and pen chewing
- Avoid sleeping face down with a hand under your jaw
- Protect your sleep and find ways to ease stress
Call 801-278-3636 promptly if your jaw locks open or closed, pain lasts more than two weeks, or pain comes with swelling, fever or numbness.
Download the printable TMD brochure (PDF)
General information only; not a substitute for an exam. Adapted from the DC/TMD diagnostic criteria (2014), the American Academy of Orofacial Pain, and J. P. Okeson, Management of Temporomandibular Disorders and Occlusion.