Temporomandibular disorder (TMD)

Symptoms of TMD

Temporomandibular disorder (TMD) isn't usually serious. The symptoms it can cause usually only last a few months before getting better.

Specialist treatment might be required if they're severe.

Symptoms of TMD include:

• clicking, popping or grating noises as you chew or move your mouth
• muscle pain around the jaw
• pain in front of the ear that may spread to the cheek, ear and temple
• difficulty opening the mouth – the jaw may feel tight, as if it is stuck, making eating difficult
• headache or migraine
• earache or a ’buzzing’ or blocked sensation in the ear
• pain in other areas of the body – such as neckache or backache

These symptoms may lead to related symptoms, such as disturbed sleep.

Causes of TMD

Possible causes of TMD include:

• clenching your jaw or grinding your teeth during sleep (bruxism) – which overworks the jaw muscles and puts pressure on the joint (often caused by stress)
• wear and tear of the inside of the jaw joint – usually caused by osteoarthritis
• injury to the jaw joint – for example, after a blow to the face or surgery
• stress – some people may inherit increased sensitivity to pain or stress
• uneven bite – for example, when new fillings, dental crowns or dentures are fitted
• specific diseases – TMD may be associated with specific diseases such as rheumatoid arthritis, gout or fibromyalgia

Some people may develop TMD without an obvious cause being found.

Treating TMD

If you think you have TMD, see your dentist first for a diagnosis and to discuss how it can be treated.

See your GP if the problem is not being caused by a dental problem.

Generally, non-surgical treatments such as lifestyle changes and self-help physiotherapy-type treatments are tried first.

A small number of people with severe TMD may be referred to a specialist to discuss further treatment options.

Lifestyle changes

There are a number of self-help measures that can help improve TMD, including:

• resting the joint by eating soft food and avoiding chewing gum
• holding a warm or cold flannel to the jaw for 10-20 minutes, several times a day
• doing a few gentle jaw-stretching exercises – your healthcare professional can recommend suitable exercises
• avoiding opening the joint too wide until the pain settles
• avoiding clenching the teeth for long periods of time
• massaging the muscles around the joint
• relaxation techniques to relieve stress
• not resting your chin on your hand

Mouth guards

Mouth guards (plastic devices that fit over your teeth) may be helpful if you grind your teeth.

These cover the teeth at night to reduce jaw clenching and teeth grinding. They can be made to measure by your dentist.

Medication

Painkillers such as paracetamol, ibuprofen or codeine can help relieve the pain associated with TMD. Ask your pharmacist if you need advice.

If these aren't enough to control the pain, your doctor may prescribe alternative medication.

Steroid injections

If TMD is caused by a disease such as arthritis, a steroid injection into the jaw joint may be advised by your doctor. This can help reduce pain and swelling in a joint or the surrounding soft tissue.

Surgery

If you are referred to a specialist, they will discuss options for your treatment.

If your symptoms are caused by the temporomandibular joint – rather than the chewing muscles – surgical treatment may be suggested. 

• Find out more about TMD on the NHS website

More useful links

• How to use your health services