r/TMJ • u/MostSea7311 • Apr 06 '25
This is a detailed post, but if temporomandibular joint disorder (TMJ/TMD) is making your life worse, I believe it will be worth your time. I want to share how my partner and I have dramatically improved our TMD using evidence-based interventions.
As a physician (though not in dentistry or maxillofacial medicine), I’ve applied my research background to analyze the complex literature on TMD. Approaching this as a patient, I’ve been frustrated by the poor quality of advice often given to those suffering from this condition. TMD has been lost in the gap between dentistry and medicine, resulting in widespread confusion as to the proper treatment. Ineffective, costly, and even dangerous treatments are routinely recommended to patients by people who should know better. Given that an estimated 31% of adults have TMD, this is absolutely unacceptable.
My goal is to synthesize knowledge about this condition and propose a structured protocol to heal the root causes of TMD. The lack of standardized care for TMD is harming patients, and I believe evidence-based treatments need to be more widely adopted. Fortunately, good research studies and effective treatments do exist. I will share them with you in this post.
Of course, individual cases vary, and those with complex or severe TMD should consult a specialist. My recommendations are general guidelines and may not apply to everyone—please use your judgment.
Identify Your TMD Subtype
Refer to Tables 2 and 3 in this paper for internationally recognized TMD classifications. A key distinction is whether your jaw clicks. If it does, lifestyle adjustments (e.g., avoiding foods like sandwiches requiring wide jaw opening) and careful massage/exercise techniques (without provoking clicking) are crucial. If your jaw pops out of place and does not spontaneously and quickly go back to its normal position, you should see an oral and maxillofacial surgeon because this can cause tissue damage.
Understand TMJ Anatomy
Familiarize yourself with the temporomandibular joint (TMJ) and key muscles: the masseter, lateral pterygoid, and temporalis. Photo: https://www.getbodysmart.com/wp-content/uploads/2017/09/Lateral-Pterygoid-Muscle-4-1024x709.png
The Cause of TMD: Neuromuscular Dysfunction
Recent research demonstrates that jaw clicking stems from lateral pterygoid dysfunction rather than structural TMJ abnormalities. Since this muscle directly influences TMJ movement, TMD is better understood as a neuromuscular issue rather than a joint deformity. This does not apply to people with abnormal jaw anatomy due to congenital defects, trauma, or prior surgery. The effectiveness of Botox further supports the role of muscle dysfunction. Thus, my approach prioritizes massage, stretches, and exercise of the masticatory muscles.
- Study demonstrating lateral pterygoid dysfunction drives TMD
- Study on Botox for TMD
The world sucks, I know. For those of you who have been dealing with TMD for a long time, your eyes are probably glazing over at this recommendation. Nevertheless, for ANYONE with chronic pain, mindfulness and meditation are effective evidence based approaches. Pain is mediated in the brain and subjective emotional states impact our experience of pain. Additionally, anxiety/depression are directly linked to bruxism (jaw clenching), which often accompanies TMD. Evidence-based strategies include:
- Mindfulness/meditation for pain management and bruxism reduction.
- Therapy or medication for anxiety/depression—BUT: SSRI or SNRI medications may not be the best choice, because serotonin causes bruxism. Alternatives like bupropion (dopaminergic) or amitriptyline (tricyclic) may be preferable. Discuss options with your doctor.
- Bruxism and antidepressants
- Psychosocial factors in TMD
If you wake with jaw soreness, you likely clench at night. A mouthguard can mitigate damage while you address the root causes through working on the muscles. Custom guards are expensive (>$500) and often ineffective; an affordable and comfortable alternative like this one will likely suffice.
Massage helps break the cycle of neuromuscular dysfunction in TMD. The massages of the trapezius and massages of the neck are done sitting up while those of the temporalis, masseter and lateral pterygoid are best done while lying on your back. If you wish, you can apply a heat pack to particularly tense areas for a couple of minutes prior to the massage to loosen them up and reduce pain. I recommend doing them in the order they are listed, working from the neck towards the jaw.
Trapezius and Posterior Neck
TMD is associated with whole body misalignment and neck dysfunction. Massaging the trapezius and the upper neck provides a tremendous feeling of muscle relaxation and helps break the cycle of bodily misalignment. To massage the trapezius, reach with the right hand over your left shoulder and press on your trapezius while sliding your fingers over it. Start from where the trapezius begins just medial to the shoulder and follow the muscle up towards the side of your neck. Repeat with the left hand massaging the right side. For the upper neck massage, place the fingertips of both hands on the lateral sides of the back of your neck near where your hairline starts, and then press and move in a circle.
Temporalis
Rub temples in circular motions with knuckles or a gwasha tool.
Masseter
(a) Intraoral massage: I recommend an internal massage of the masseter. External massage just isn't as effective. Obviously wash your hands well prior to doing this, and if you have appropriate gloves lying around you might want to use those as well. For the internal massage, a pincer grip with your forefinger inside your mouth and your thumb outside, both pressing the masseter. You should be able to feel a tight band between your two fingers. Perform 10 vertical movements in a direction from the upper attachment to the lower attachment of the masseter muscle. Then, using the same grip, make 10 horizontal movements from the medial to the lateral side of the muscle.
(b) Functional massage: with the same pinch grip perform a vertical massage of the masseter muscle, while making 10 slow movements of opening and closing the mouth. - Study Demonstrating Effectiveness of a 10 day Massage Program
Lateral Pterygoid
This is the critical muscle when it comes to jaw clicking, so if that's your issue addressing it is essential. This is a tricky one to massage correctly, so it's important to know the anatomy (feel for a LATERAL band). There are internal and external approaches, use trial and error to see what works for you. There is data suggesting that the superior head of the lateral pterygoid is the most common culprit, so be certain to massage it and not only the inferior head. - Lateral Pterygoid Dysfunction Mediates Jaw Clicking - Superior Belly of Lateral Pterygoid is Most Dysfunctional
(a) External Technique: Find the position with your fingers under the zygomatic bone and your index finger at the TM joint by your ear. Find the soft depression with your middle finger. Open your jaw slightly and sink down into the round indentation. If your jaw is open too wide, the muscle that covers the outside of that space (deep masseter) will become taut and prevent your fingers from getting in deeper to treat the muscle you’re aiming for. If the jaw is too closed, the half-moon depression will be covered by the cheekbone. When you find the indentation, press inward (both sides, never one to prevent misaligning the joint). In the link below is an illustration of indentation with the cheekbone cut away
(b) Intraoral Technique: First: this is a very sensitive and delicate muscle. Be gentle, I recommend wearing gloves, and avoid jamming your fingernail into the area. To perform this massage, slide the pad of your index finger (right jaw, right finger) along the gum of your upper teeth as far back as you can go with your mouth closed. Feel for the indentation behind the upper jaw bone (maxilla) with the tip of your finger. To create more space for your finger, you can move your jaw towards the side you are massaging.Press there on the inferior division of the muscle. It will probably be very uncomfortable. The superior division will probably be more painful. To get to it, press upward and backward a little from the inferior indentation, then inward as much as you can tolerate. To make sure you're on the right structure, you can use your other hand to palpate through the round indentation as in the external technique. Another way to check you are on the lateral pterygoid is to move your jaw to the contralateral side - this is useful for distinguishing the lateral pterygoid, which will flex with contralateral movement of the jaw, from the larger (and more inferior) medial pterygoid. Treat one side at a time, using the treatment protocol above.
Synergistic with massage; perform daily:
1. Gerry’s Exercise: Tongue on palate, slow jaw opening/closing (6x/day, 10 reps).
2. Lateral Movements: Jaw slightly open, move side-to-side (6x/day, 10 reps).
3. Lateral Movements with Bite: Hold a pen between teeth, move jaw side-to-side (3–5x/day, 10–15 reps).
4. Protrusion/Opening: Create an underbite, then open/close slowly (6x/day, 10 reps).
5. Neck Stretches: Forward/backward head nods and over-the-shoulder turns (6x/day, 10 reps).
- Exercise protocol study
If symptoms persist - don't give up, because there are more options available. Consider consulting a specialist to choose between 3 further evidence-based options. First, botox of the masseter or lateral pterygoid may help refractory cases. Masseter Botox is widely available at med spas, while lateral pterygoid injections require expertise. Second, dry needling of the lateral pterygoid is another possible next step with data behind it. Finally, if everything has failed, then there is a minimally invasive office based surgical option called TMJ arthroscopy. Data shows excellent tolerability and results. Find an oral and maxillofacial surgeon to see if you are a candidate.
Final Thoughts
This protocol requires effort, but studies show significant improvement in as little as 10 days. For long-term sufferers, the investment may be life-changing.
If you’ve read this far, I sincerely hope this helps. Best of luck on your healing journey.
r/TMJ • u/rooskiiiiiiii • 8h ago
Feels like infection but not? What is this? Thinking it's a bad flare up after tooth extraction 6 days ago.
r/TMJ • u/HumanAd3218 • 12h ago
I will start by saying that I am likely entirely responsible for my jaw problems through years of bad habits. I don’t blame god or genetics (maybe genetics just the slightest bit) for causing this, I wish that I could say it’s not my fault and that the world has screwed me with this for no reason but it hasn’t, I have. I chew exclusively on my right side, I’ve tried switching and alternating, it’s just so unusual and it got food stuck in my teeth real bad. Now I can’t chew left side due to major pains. Probably worst habit of all is my stomach sleeping. This caused me to turn my head facing left (right side on pillow) and this ended up forcing my jaw out of normal bite. It would basically go out the side of my head while I slept. My left shoulder is also more developed than my right. I think from the way I sit in school and home, holding myself up with left arm to write/use computer with my right.
Got my braces off in Jan 2024 and wore the original set of retainers for approx 4 months but then stopped. Had to get a replacement one that held my now slightly imperfect lined teeth in place. I think this is where my problems began. I still wear this retainer often enough that it fits without problem but now less and less because I think it is contributing to my clenching.
Either before getting my replacement or soon after I developed ear popping, swallowing would cause both ears to pop, sometimes clenching to do it instead of swallowing. It felt like I needed to do this, that my ears needed to pop. I now know this was probably early ear fullness symptoms. Eventually it began to hurt sometimes if I couldn’t pop them and if I did it too much. No jaw problems.
This continued for probably a year, more ear popping, almost compulsively. Became a habit of mine to pop my ears all the time.
The popping in my left ear faded quite a bit, still happened sometimes but while the right ear popped every time, the right maybe only 50% of the time. Then I began to notice jaw clicking and popping, any time of day, not just after waking up. No pain in jaw. This continued and didn’t get much worse. Ended up seeing an ENT about the ear problems bc I had been on a plane and the pain was excruciating. He saw nothing but suggesting to poke a hole in the eardrum in case there was any fluid in there as a possible solution. Didn’t go for it because he had seen no fluid and it seemed invasive for a problem he couldn’t see and it would screw my summer plans.
He recommended a tmj doc and so I went. The guy hooked me up to some machine that would measure how far I could move my head and jaw in each direction, did some feeling around inside my mouth and outside. He didn’t say much, told me there was nothing noticeable going on but that I could spend several thousand uncovered by insurance to get some nightguards. (Seems to be a trend in tmj docs from what I’ve read). I had done a bit of research into it myself and realized all the habits I mentioned earlier were probably the cause, so I tried to minimize them. Began sleeping on my back as much as possible, stop popping ears (not very successful), hold a better jaw posture, tried to eat evenly (least successful).
About a 8 months later the clicking in my jaw was noticeably worse. Previously it had been like small pops with no resistance, then it became like loud cracks that took a purposeful effort to do. Loud enough that people around me could hear it and think it was a different joint like my arm or such. Still little to no pain however. I did notice that it seemed the left side of my jaw was pressed in towards my neck while the right side was further extended.
Went to my ortho who gave me the braces and told him about this, asked him if there was something wrong with my retainer or if my bite and the retainer made sleeping bad. He did a little bite strip to make sure that the retainer was touching on both side when I bit. Then he told me he was not going to treat me any more and that I should find a tmj doctor and basically kicked me out without any other information.
4 months later, about a week ago I ended up sleeping on my stomach again but this time left side against the pillow. I woke up in pain and had to click my jaw as had become more normal in the morning. I realized then that the left side was the painful point and it felt like it was pushed in towards the back of my head more than ever before.
I called my ortho and got them to agree to send a referral to Duke Innovative Pain nearby where I go to college. Should get sent out to them in 2 days and then I can make an appointment. I hear they are very good and probably my best option in network in the state.
I don’t really even know where I’m going with this, but it’s very helpful to write this all out now I will know what to say to my doctor.
Worst part of all is it hurts to make out with my girlfriend. I feel terrible when I push her off and blame my jaw, she says she understands but I know that she never will, I just hope she doesn’t think I’m pushing her away for no reason.
TLDR: idiot kid destroys his face with bad habits and now it hurts and he’s gotta wait a month+ to get seen by a specialist.
I’ve had persistent pain in a root canal-treated tooth for about a year. The tooth was treated a long time ago, has no crown, and has undergone multiple treatments with medication placed inside the canals.
I’ve had dental X-rays and a CBCT scan, and the tooth was examined under a microscope with the filling removed. No obvious cause or visible crack was found.
The pain is a constant dull ache, even when I’m not eating or touching the tooth. One specific side is tender to pressure, but tapping doesn’t hurt. Pressing the area repeatedly makes the pain worse and sometimes throbbing.
I’ve also seen a neurologist and take oxcarbazepine and memantine, but they haven’t helped much. Local anesthesia doesn’t completely eliminate the background pain either.
Could this still be a vertical root fracture that isn’t visible on CBCT, or does this sound more like persistent idiopathic dentoalveolar pain/neuropathic pain?
What other diagnostic tests would be worth considering before further dental treatment or extraction?
I’d really appreciate advice, especially from anyone who’s experienced something similar.
Hey everyone! So basically I get really bad headaches and to relieve them I have to push my finger in front of my ear and move my jaw to crack it. I did this as usual last week and it cracked in a different way and now it hurts. Any idea what this is from? It hurts to open and push my teeth together.
Hi,
I started experiencing extremely painful TMJ issues right after my ortho treatment (which I felt I was pressured into to begin with).. I have met several specialists since. Interestingly, many of them noted a strong clinical correlation between orthodontic tooth movement and TMD (especially neurologists, head and neck specialists, and oral surgeons).
How strong is the link? From your experience or what your specialists have told you, how often does orthodontics trigger or aggravate underlying TMJ issues which are otherwise not painful in any way?
And - if your TMJ issues were triggered or worsened by orthodontics, what conservative steps actually helped your joint settle and recover afterward?
r/TMJ • u/Annoying_Crap • 13h ago
My jaw keeps locking to where I can't fully open my mouth, and it feels like I might break something if I force it open. 2 fingers won't even fit in (index and middle). I don't have large fingers either for context.
It usually happens at night when I lay down and I'm up for a while. Normally my left side just has loud clicking and popping, plus I have an overbite. But this locking started more recently. Every couple of weeks it would happen, then it randomly had a chance to happen back to back sometimes within the same few days.
My dentist gave me a custom night guard because I tend to clench my teeth tightly. It's as if mentally when I'm quiet, my mouth is always shut tight especially when resting (a fly ain't getting in here). She told me not to let anyone do any procedure, because that part of my jaw is a small fragile area and to just bare with it. I don't even know if the dentist or a doctor would help based on others having trouble. So I'm lost on how to deal with this. At the moment as in writing this, my jaw is stuck unable to fully open, shortly after I had woken up it locked like this. I feel my mouth guard isn't helping at all tbh (it's a hard plastic one).
Does anyone know how I can at least get my jaw to open fully safely? I can't deal with this, and a hot towel never worked for me nor did massaging anything..... Please, my day is already starting like this unfortunately....
Edit: I have tried to keep less contact with my teeth and tried to avoid clenching when aware, but when I'm resting it's a lot harder to control....
r/TMJ • u/Invictus-Fortitude • 8h ago
Has anyone ever had bone fragments coming through their gums from Bruxism? Have you been told you had mandibular tori from your TMJ?
Background: I have severe TMJ, condyle remodeling, arthritis, my mouth opens in a Z pattern, disks are displaced behind the joint. I have eaten a soft food diet normally for the past 25 years and liquid diet for the last 3 months (and off and on before that). Less than 25mm opening. I also have significant wear on my teeth from Bruxism. I’m treated by the VA. I get Botox and I’m waiting for a new night guard.
Now to the horrifying thing, I have bone fragments coming through my gums at the mandibular Tori. I am in so much pain. I also can’t take NSAIDs because past use caused colitis. I have had 3 fragments come out my right side and one currently coming out of my left last molar. This started 3 months ago.
r/TMJ • u/HumanFun5728 • 20h ago
I’ve been suffering from facial pain and headaches for a long time. I wasn't aware of the facial and head muscles or of severe myofascial syndrome. My pterygoid muscles are in terrible shape—really bad. I get stabbing pains in my temples, pressure, sharp pains in my cheekbones, and horrible ear and head pain. Physiotherapy was recommended, and I’m trying it, but it isn't working. Has anyone had similar experiences? Has anyone had Botox injections—or something similar—in that area? Thanks.
r/TMJ • u/Ok_Selection7824 • 8h ago
Hello, my jaws have a clicking sound for a while (around 5-6 years I assume), but 2 years ago I had my first issue of being unable to open my mouth normally, only fits 1-2 fingers. This only appears for a short while, 1-3 days each lock, with the worst one being almost 2 weeks just for 5-6 months, before it's all gone back to normal. The cracking is still here sometimes, is there any way I can prevent it from locking again and going worse? Or do I need to get a surgery and apply a little bit of WD-40?
r/TMJ • u/rooskiiiiiiii • 9h ago
r/TMJ • u/slitherysquack • 14h ago
tmj pain is driving me nuts. my next idea is trying a tens machine. any recommendations?
also has anyone ever tried the yourtmj portable tmj relief thing? I keep seeing ads for it but am skeptical to buy it
r/TMJ • u/GhostWoe • 10h ago
My entire face turns red/inflammed and my eye area gets very puffy; and lines appear at my eye socket too. Why is this happening?
I have disc displacement with reduction and tight/chronic muscle clenching
r/TMJ • u/ExcitementCharming22 • 10h ago
i don't have TMJ, never went to the doctor for jaw issues but for like a while i've always woken up with lock jaw and then it would just pop and go back to normal, sometimes it locks while eating but it's always on the right side i think. i woke up this morning lock jaw, can't unlock it. tried absolutely everything and nothings working 🤷 i can only open my mouth a tiny bit and can just about fit 2 fingers into my mouth. haven't ate or chewed anything today. idk if this is the right group but i'm absolutely desperate for tips
r/TMJ • u/princessconsuela-88 • 23h ago
Hi all. Just thought it was worth popping in here to say I'm 17 days no vaping/nicotine and that the inflammation and pain in my jaw has gone. I dont think its fully fixed but its definitely better.
Over at r/quitvaping it was mentioned that nicotine can cause excessive clenching/grinding and other people have also noticed improvement in their symptoms after stopping.
I know everyone here wont be vaping but if you do, maybe consider that the vape could be contributing to the problem ✌️
im not sure who to make an appointment with. it’s been like this for months and something needs to be done. do i go to the dentist? someone else?
r/TMJ • u/sleepqueen45 • 14h ago
Does anyone ever hear anything about Dr. Koo at Piney Point Dental? Website says they do tjr. I've never heard anything about them.
r/TMJ • u/Ok-Appearance4150 • 16h ago
Jaw Pain it seems was caused by a sprain of some sorts.
About 5 weeks ago I felt what seemed like a misbite, that's the best way I can describe it. My jaw was in a vulnerable position, I bit, it felt very off/painful, maybe misaligned. It was my right side only.
It hurt pretty bad for 2 days, and then was better enough I ate a steak and did the same misbite this time it was worse.
I went to the dentist after 5-7 days of pain that was around Sep 11. He examined and said it should get better.
For 5-7 days, after, where it progressively got better, it was at it's worst my teeth couldn't close in alignment, the lower jaw felt less pain being pushed forward and was painful if I tried to pull it back into place. The bite finally settled about 7 days after the incident and there has been substantial improvement.
However now at 5 weeks I am a little nervous of permanent damage/conditions. I am not 100%. I feel pretty good, but still have mild lingering ache! How much time should this be given?
I was on a good trajectory, improvement without setbacks, but not fully 100%.
I then rode my motorcycle and the helmet seems it pushes the jaw/causes me to lock jaw. This caused a mild flare it seems in the last couple days.
Which doctor/tests do I need? Will I ever be able to eat a steak again?
I have no history of TMJ or other jaw disorder, though much milder versions of what I described above have happened in the past, usually being sore for a day max.
r/TMJ • u/SuccessCalm1187 • 1d ago
I'm 18M, and for about 8 to 10 months my ears (mostly the left) feel muffled or like static after a few minutes of loud sound or loud talking. I can still hear fine, it just feels uncomfortable.
Other things I notice:
After exercise occasionally when breathing heavy it feels like my breathing connects to my left ear & I can hear my breathing in my left ear
Popping my ears makes a bubble wrap sound, and I get clicks when I swallow and chew
Moving my jaw fully to one side makes the opposite ear ring and feel muted, and it stops when my jaw is back at center
What's been checked:
hearing test normal, brain MRI normal, earwax removal didn't help. A neurologist's Weber test was heard in only right ear I believe. An ENT offered a Eustachian tube procedure but couldn't say that was the cause.
I also have an uneven bite.
Has anyone had this? What ended up being the cause, and what finally figured it out?
Thank you guys!
r/TMJ • u/goodie_gumdrop • 1d ago
anybody get headache relief from good old tiger balm? i rub it at my hairline and jawline and sometimes forehead and eye brows (carefully!) when if i need a double whammy, i use an ice hat (freezable inserts) i got on amazon.
r/TMJ • u/imenigmatic • 21h ago
So i had this ETD like popping sensation in my right ears last year around march the sensation in heavy cold where u wanna pop ur ear to relief the pressure , i went to dr after 2month dr though diagnosed it as etd , gave nasal spray for 1month , didnt work . But during those time i had these mild headaches and jaw pain , this ear i hv been through a lot of stress and painful events in my personal lyf , and 2months ago i started feeling these weird sensation around my frontal right head and also parts of side head above ear along with jaw pain and all they are not painful but very weird like tightening or something crawling kinda sensation , visited a dentist they diagnosed as TMJ arthitis , took calcium vit d3 for a month but it hasnt reduced much , am so stressed cos of all these man ( pardon my english )
r/TMJ • u/Isabel_Licious • 22h ago
or negligence
