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TMJ (Jaw Joint & Jaw Pain)

Pain, clicking or locking in the jaw joint and chewing muscles. Most cases settle with simple self-care, exercises and stress relief, and experts advise against treatments that permanently change your teeth or bite — but a locked jaw, or jaw pain with chest pain or stroke signs, is an emergency.

Call 911 right away if jaw, face or ear pain comes with any of these:

  • Possible heart attack: chest pain or heaviness, shortness of breath, heavy sweating for no reason, nausea or sudden dizziness. Pain in the jaw can be a heart attack symptom. Call 911 even if you are not sure, and don’t drive yourself (NHLBI). See our Heart guide.
  • Possible stroke: a drooping face, an arm that drifts down, slurred or confused speech, sudden numbness or weakness on one side, sudden trouble seeing or walking, or a sudden severe headache (CDC). See our Stroke guide.
  • Trouble breathing, speaking or swallowing, a lot of swelling in the mouth, or a swollen, painful eye or sudden eyesight problems alongside a swollen jaw or face (NHS).

Go to the emergency room or urgent dental care the same day if:

  • Your jaw is stuck wide open. A dislocated jaw joint needs prompt medical attention (emergency nursing review, 2016), and emergency doctors can often move it back into place (emergency medicine review, 2008).
  • Your jaw is locked shut, you can’t open your mouth fully, or you can’t eat or drink. The NHS lists jaw locking and being unable to eat or drink among reasons to ask for an urgent appointment (NHS).
  • You have a fever and a swollen face or jaw. That can mean a dental abscess (a pocket of infected pus), which needs urgent treatment by a dentist and will not go away on its own (NHS).
  • New jaw pain while eating or talking comes with tenderness at your temples or scalp, frequent severe headaches, or vision problems. Those can be signs of temporal (giant cell) arteritis, a serious condition that needs urgent treatment because it can lead to stroke and blindness (NHS).
  • You were just hit in the face or jaw. Fractures and dislocations are jaw problems of their own, separate from TMD (MedlinePlus). See our Head Trauma guide.

TMJ or TMD: what’s the difference?

People say “TMJ” for the whole problem, but the two terms mean different things. The TMJ is the temporomandibular joint itself — you have two, one on each side of the jaw, and you can feel them by placing your fingers in front of your ears and opening your mouth. TMDs (temporomandibular disorders) are the group of more than 30 conditions that cause pain and trouble in the jaw joint and the muscles that move the jaw (NIDCR; MedlinePlus). This guide uses “TMD” for the problems and “TMJ” for the joint.

There are three broad groups: disorders of the joint itself (including problems with the cushioning disc), disorders of the chewing muscles, and headaches linked to a TMD. A person can have more than one at the same time (NIDCR).

How common is it, and what does it feel like?

NIDCR says TMD affects about 5% of adults in the U.S., twice as often in women as in men, especially women between 35 and 44 (NIDCR). A 2023 guideline puts it at 6% to 9% of adults worldwide (BMJ guideline, 2023). The most common symptom is pain in the chewing muscles or jaw joint. Others include pain that spreads to the face or neck, jaw stiffness, limited movement or locking, painful clicking, popping or grating, ringing in the ears, hearing loss or dizziness, and a change in how the teeth fit together (NIDCR). The NHS adds a headache around the temples and pain that is worse when chewing or stressed (NHS).

Here is some reassurance: clicking or popping without pain is common, is considered normal, and does not need treatment (NIDCR). TMD often travels with headaches, back pain, sleep problems, irritable bowel syndrome and fibromyalgia (NIDCR); see our Headaches, Migraines, Neck and Fibromyalgia guides, and our Tinnitus guide for ringing in the ears.

What causes it?

An injury to the joint can lead to some TMDs, but in most cases the exact cause is not clear. Research suggests a mix of genes, psychological and life stressors, and how a person senses pain may help explain why a TMD starts and whether it becomes long-lasting (NIDCR). The NHS lists teeth grinding, wear and tear of the joint, a blow to the head or face, stress and an uneven bite as possible causes (NHS).

One long-held idea is not supported: research does not support the belief that a bad bite or orthodontic treatment such as braces causes TMDs (NIDCR). Teeth grinding and clenching (bruxism) are linked, though; see the bruxism section below.

When jaw pain is something else

Pain in the mouth, jaw or face may or may not be related to a TMD, and a doctor or dentist may need to rule out other conditions first (NIDCR). Other possibilities include:

  • A tooth or gum infection. A dental abscess brings intense toothache or gum pain, a swollen face or jaw and a high temperature, and needs a dentist urgently (NHS). Our Teeth guide is planned.
  • Trigeminal neuralgia, sudden, severe, electric-shock-like facial pain that comes in short attacks, often set off by washing, eating or brushing the teeth (NHS). See our Trigeminal Neuralgia guide.
  • Temporal arteritis, described in the warning box above (NHS).
  • Heart, ear or sinus problems. Jaw pain can be a heart attack symptom (NHLBI); for pain around the ear or face, see our Ear and Sinus guides.

How it’s diagnosed, and what usually happens

There is no widely accepted standard test for TMD, so diagnosis can be hard. A doctor or dentist will ask where and when the pain occurs and what helps or worsens it, examine your head, neck, face and jaw, and may recommend an x-ray, MRI or CT scan (NIDCR). Many TMDs last only a short time and go away on their own, although some become chronic (NIDCR). Because the evidence behind many treatments is limited, experts recommend conservative treatments and avoiding ones that permanently change the jaw joints, teeth or bite, or that involve surgery (NIDCR). Keep that principle in mind as you read on.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Diagnosis by a dentist or doctor, simple self-care, jaw exercises and physical therapy, cognitive behavioral therapy, medicines for pain, and sometimes a bite splint. Injections and surgery are for stubborn cases. Non-surgical TMJ care (splints, medicines, imaging) often about $500–$2,000. A dentist-made night guard about $300–$700 or more; store-bought $15–$100. Jaw-focused physical therapy about $50–$200 a session. Medicare covers medically necessary outpatient physical therapy (20% after the deductible) but most dental services not at all. Procedure costs in the guide. Many people improve with simple steps, exercise and stress relief. Splints, medicines and injections have thin or mixed evidence. Experts caution against irreversible treatments.
Chiropractic Joint mobilization or manipulation of the jaw and upper neck, soft-tissue work and exercise advice from a chiropractor trained in jaw care. Without insurance, about $90–$200 for a first visit and $55–$100 for follow-ups. Reviews of hands-on therapy for TMD (done by several professions, including chiropractors) report short-term pain relief and easier jaw opening, but the certainty is low. Neck manipulation carries a rare risk of artery tears and stroke.
Acupuncture Fine needles, sometimes with laser or electrical stimulation, aimed at easing jaw and facial muscle pain. About $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. NIDCR says evidence is limited; a 2023 guideline conditionally favored it for chronic TMD pain, and reviews report short-term benefit with low-quality evidence. Safe when done with sterile needles.
Herbal medicine Supplements and plant products are marketed for jaw pain and clenching, but little research has tested them for TMD. Cost estimate being researched. We found little research. One short trial of a multi-ingredient product reported benefit, and evidence for glucosamine is very low. No herb is proven for TMD. Supplements can interact with medicines.
Massage therapy Massage of the jaw, face, neck and shoulder muscles, including focused trigger-point work, plus relaxation. At one national chain, about $125–$160 for a 60-minute massage for non-members and $65–$90 for members; memberships about $70–$90 a month. A 2023 guideline strongly favored manual trigger-point therapy for chronic TMD pain, and a review found massage of the chewing muscles beat control treatment. Quality of the studies is low to moderate.
MBHA Wellness Coach Habit changes: catching clenching, soft-food and heat/cold routines, relaxation, sleep, tracking triggers, and preparing for dental and medical visits. MBHA coaching cost estimate being researched. Practical help with the self-management steps that NIDCR and the NHS recommend first, alongside your care team — never in place of a diagnosis.

Approach 1 of 6

Conventional medicine (AMA)

For most people with TMD, conventional care means a dentist or doctor confirming the diagnosis and then starting with the simplest, reversible steps. If you can, ask for a referral to an orofacial pain specialist, especially before anything irreversible; NIDCR suggests seeking one for a second opinion (NIDCR). A 2023 international guideline for chronic TMD pain (lasting 3 months or longer) and a linked analysis of 153 trials with 8,713 people found that treatments that promote coping and movement were the most effective when the evidence was of moderate or high certainty (network meta-analysis, 2023; BMJ guideline, 2023). A 2022 review of 62 reviews and nine guidelines also found moderate evidence for starting with a multi-modal conservative approach (rapid review, 2022).

1. First steps you can start today

NIDCR says your doctor or dentist may suggest soft foods, heat or cold on the face with gentle jaw stretching and strengthening exercises, over-the-counter anti-inflammatory pain medicine, and cutting back habits such as jaw clenching, gum chewing and nail biting (NIDCR). The NHS adds an ice or heat pack wrapped in a towel, whichever feels better (a wrapped pack of frozen peas for no more than 5 minutes at a time, or a wrapped hot water bottle twice a day for 15 to 20 minutes), gently massaging the painful muscles, and finding ways to relax. It also says not to bite food with your front teeth, yawn too wide or clench your teeth — apart from when eating, your teeth should be apart (NHS).

2. Physical therapy and jaw exercises

NIDCR says research suggests hands-on manual therapy, in which a therapist stretches the soft tissues and muscles around the joint, can improve function and relieve pain (NIDCR). The 2023 guideline made strong recommendations for therapist-assisted jaw mobilization, manual trigger-point therapy, supervised posture exercise, and supervised jaw exercise and stretching, compared with placebo or sham treatment (BMJ guideline, 2023). A 2023 review of 16 studies (812 people) found exercise therapy reduced pain and improved mouth opening (meta-analysis, 2023). Be aware of the limits: a 2016 review of 48 trials rated the overall evidence low, calling manual therapy “promising” rather than proven (systematic review, 2016), and Cochrane’s review of exercise for TMD has so far been published only as a plan (Cochrane protocol, 2026).

3. Cognitive behavioral therapy and biofeedback

Cognitive behavioral therapy (CBT) helps you spot unhelpful thought patterns and gives coping skills; biofeedback uses a sensor on the jaw so you can notice and release muscle tightening (NIDCR). The 2023 guideline strongly favored CBT, with or without biofeedback or relaxation therapy, for chronic TMD pain (BMJ guideline, 2023). Cochrane is more cautious: across 22 trials (2,001 people), CBT may reduce pain more than other treatments or no treatment when measured at the longest follow-up, but not right at the end of treatment, and the evidence was low certainty (Cochrane review, 2022).

4. Bite splints (night guards)

An intraoral appliance fits over the teeth to protect them and may help you stop clenching. NIDCR says there is not much evidence on whether splints improve TMD pain, and advises making sure yours is not designed to permanently change your bite, and stopping and calling your dentist if it causes pain (NIDCR). The research agrees: a 2024 Cochrane review of 57 studies (2,846 people) found the results inconclusive and the evidence very uncertain (Cochrane review, 2024), and a 2020 UK analysis of 52 trials found no evidence that splints reduced pain compared with no splint or minimal treatment, while adverse events seemed infrequent (health technology assessment, 2020). The 2023 guideline conditionally recommends against reversible splints and strongly against irreversible ones (BMJ guideline, 2023). A dentist may still suggest a night guard if you grind your teeth, to protect them (NHS).

5. Medicines, injections and procedures

See “Medicines by class,” “Injections, joint washouts and surgery” and “Cautions about irreversible dental treatments” below.

What it costs

One price guide says non-surgical TMJ care such as splints, medicines and basic imaging often runs about $500–$2,000, and that jaw and neck physical therapy commonly costs $50–$200 per session (The Pricer). Night guards run about $15–$100 at retail, $150–$200 from a mail-order lab and $300–$700 or more through a dentist (The Pricer). Medicare Part B covers medically necessary outpatient physical therapy, with you paying 20% after the deductible (Medicare.gov), but in most cases Medicare does not cover dental services (Medicare.gov), so ask whether a night guard will be paid for. Costs of procedures are in the injections section.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic is a licensed profession whose treatment often includes spinal manipulation and other hands-on therapy. Most spinal manipulation is done by chiropractors, though physical therapists and osteopathic physicians also use it (NCCIH). For the jaw, the research is about hands-on therapy in general, not chiropractic alone.

Treat this as promising, not proven. Whoever treats you, NIDCR cautions against treatments that permanently change the teeth, bite or jaw joints, so ask any provider whether a plan would do that (NIDCR).

Safety: be cautious about neck manipulation. Mild soreness, stiffness or headache often follow spinal manipulation and mostly pass within 24 hours. Serious problems are very rare, but manipulation of the neck has been linked to small tears in neck arteries that can lead to a stroke (NCCIH). Tell the chiropractor your health history and medicines, and ask about education and licensure (NCCIH). Sudden stroke signs mean 911; see our Stroke guide and Neck guide.

What it costs

Without insurance, about $90–$200 for a first visit and $55–$100 for follow-ups; a course of several weeks can come to $500–$1,000 (The Pricer).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

NIDCR says there is limited evidence that acupuncture helps TMDs (NIDCR). The picture from reviews is mildly positive but weak:

If you try it, use acupuncture along with your dental or medical care, not instead of it.

Safety and cost

Few complications have been reported, but problems have come from non-sterile needles and poor technique; needles must be sterile and single-use, and most states license acupuncturists (NCCIH). Sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. Medicare Part B covers acupuncture only for qualifying chronic low-back pain, not TMD (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

We found little research on herbal medicines for TMD, and none of it proves a plant remedy works. Please be wary of products that promise to relax your jaw or end teeth grinding.

  • A combination product. One 40-day randomized trial gave people with TMD a supplement containing Boswellia extract, magnesium, tryptophan and vitamins B2 and D. Groups taking it improved more than their comparison groups on most measures, and the authors called it a short-term support to usual care. Because the product mixes several ingredients and the trial was short, we cannot say which ingredient mattered, or whether benefits last (randomized trial, 2024).
  • Glucosamine. For arthritis of the jaw joint, a review found very low evidence; in two of three trials it was about as effective as ibuprofen, but in a six-week trial it was not better than placebo (systematic review, 2018). The 2023 guideline conditionally advises against cartilage supplements (BMJ guideline, 2023).
  • Topical products. The same panel conditionally recommended against topical capsaicin for chronic TMD pain (BMJ guideline, 2023).

Talk to your doctor or pharmacist before trying a supplement. Supplements may interact with your medicines or pose risks if you have certain medical problems or are having surgery, and the FDA does not review them for safety before they are sold (NCCIH). We don’t list doses here. Our Medication Safety guide has more.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage of the jaw, face, neck and shoulder muscles is a gentle, popular self-care and professional option. The NHS suggests massaging the painful jaw muscles as part of home care (NHS).

Be realistic: the broader 2016 review of manual therapy rated the overall evidence low (systematic review, 2016). Not every massage therapist does focused jaw work, so ask about training, and tell the therapist about your TMD.

The risk of harm from massage appears low, but there have been rare reports of serious side effects, some with vigorous deep-tissue massage or in older adults (NCCIH).

What it costs

At one national chain, franchise price lists show about $125–$160 for a 60-minute massage for non-members and $65–$90 for members, whose memberships run about $70–$90 a month (The Pricer). Tips are extra.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you turn your care team’s advice into daily habits — always alongside your dentist or doctor, never instead.

Start with self-management

NIDCR’s self-management list is a good template for coaching: learn all you can about your specific type of TMD, become aware of and reduce habits like clenching, gum chewing and nail biting, practice meditation and relaxation, set specific goals for managing the condition, and stay involved in activities that are meaningful to you (NIDCR). A coach can help you build reminders to check for clenching and a soft-food plan for flare-ups.

Keep a trigger diary

A simple log of pain, jaw habits, foods, stress and sleep can help you and your clinician see patterns; the NHS notes the pain may be worse when chewing and when you feel stressed (NHS).

Sleep and stress

A 2021 analysis found poor subjective sleep quality was linked with TMD in every diagnostic group, and concluded sleep quality should be considered in management; this shows an association, not that poor sleep causes TMD (systematic review, 2021). The NHS suggests a GP can offer relaxation techniques and ways to improve sleep, and may suggest a psychologist if stress and anxiety are worsening your pain (NHS). See our Sleep Problems and Anxiety guides.

Prepare for visits and protect your choices

A coach can help you write down your symptoms, questions and medicines before appointments, and remind you of NIDCR’s advice: start with simple treatments, ask about risks in detail, get second opinions before irreversible treatments (NIDCR). MBHA coaching cost estimate being researched.

Another approach

Medicines by class

Evidence on which medicines work best for TMD pain is limited (NIDCR). We don’t list doses; your prescriber or pharmacist will.

  • Over-the-counter anti-inflammatory pain relievers (NSAIDs, such as ibuprofen). NIDCR lists these among the first steps, and the NHS suggests paracetamol (acetaminophen) or ibuprofen (NIDCR; NHS). Ibuprofen may not suit people with stomach ulcers, asthma or allergies, or who are pregnant (NHS). The 2023 guideline conditionally recommended CBT combined with NSAIDs for chronic pain, but conditionally recommended against acetaminophen, with or without muscle relaxants or NSAIDs (BMJ guideline, 2023).
  • Prescription medicines. NIDCR lists antianxiety medicines, antidepressants, antiseizure medicines and opioids, and warns that some can lead to addiction or have other serious side effects (NIDCR). The guideline conditionally advised against gabapentin, benzodiazepines and beta blockers, and strongly against combining NSAIDs with opioids (BMJ guideline, 2023).
  • Muscle relaxants. A 2024 analysis of 40 trials found evidence for muscle relaxants in muscle-type TMD, and for NSAIDs and steroid medicines in joint-type TMD with inflammation, and urged finding each person’s individual causes first (network meta-analysis, 2024).
  • What Cochrane found. An older review of 11 trials (496 people) said there was insufficient evidence to support or reject the drugs tested for chronic TMD pain; four trials showed pain relief but three were of poor quality (Cochrane review, 2010).

The guideline covers chronic pain of 3 months or more and does not apply to short-term TMD pain (BMJ guideline, 2023). Always tell your prescriber what else you take; our Medication Safety guide explains why.

Another approach

Injections, joint washouts and surgery

These steps involve going into the muscles or joint with a needle or instrument. NIDCR advises asking about simpler treatments first, asking the doctor to explain risks in detail, and getting second opinions from qualified specialists (NIDCR).

Botulinum toxin

Botulinum toxin type A relaxes muscles. The FDA has approved it for some conditions (like migraine) but not for TMDs, and results in studies have been mixed (NIDCR). Reviews disagree:

Steroid and other joint injections

The 2023 guideline conditionally recommended against corticosteroid injection, hyaluronic acid injection and trigger-point injection for chronic TMD pain (BMJ guideline, 2023). A 2024 analysis of 20 trials (810 people) found some steroid injections into the joint reduced pain more than a joint washout alone in the first months (moderate certainty), but nothing convincingly improved jaw movement or quality of life, and one of the steroids may have been more harmful (network meta-analysis, 2024). An older Cochrane review of jaw-joint arthritis found hyaluronate and corticosteroid injections not dissimilar in effect (Cochrane review, 2012), and a 2026 analysis called the benefits of drug treatments for painful joint-type TMD limited and inconsistent (network meta-analysis, 2026). NIDCR says prolotherapy (injecting an irritating solution) has shown promise for some joint problems, but only in a few small studies (NIDCR).

Arthrocentesis and arthroscopy

In arthrocentesis, a needle flushes liquid through the joint to loosen adhesions and wash out inflammatory substances. NIDCR says it has helped pain and mouth opening when the disc is out of place, though results are inconsistent (NIDCR); a 2021 review of 30 trials likewise suggested benefit, with multiple sessions better than one, but called the findings inconsistent (systematic review, 2021). A 2022 rapid review found moderate evidence for arthrocentesis or arthroscopy for joint-type TMD not helped enough by conservative care (rapid review, 2022). In arthroscopy a tiny camera goes into the joint; NIDCR says it works moderately well (NIDCR), though a Cochrane review of seven trials found all had high or unclear risk of bias (Cochrane review, 2011). The 2023 guideline conditionally advised against arthrocentesis for chronic TMD pain (BMJ guideline, 2023).

Open surgery and joint implants

Open surgery makes permanent changes to the joint, and NIDCR says there are no long-term studies of its safety or how well it works. It should be considered only for joint destruction that other procedures can’t fix, or severe symptoms despite other treatments. Two jaw implants are currently FDA-approved; some earlier implants caused serious complications and left the market (NIDCR). The 2023 guideline strongly advised against discectomy (removing the disc) for chronic TMD pain (BMJ guideline, 2023).

What these cost

One price guide lists self-pay ranges of about $300–$1,500 for arthrocentesis (up to $3,000–$8,000 with anesthesia and facility fees), $5,000–$10,000 for arthroscopy and $20,000–$50,000 or more for open joint surgery (The Pricer). One New York dermatology practice’s cosmetic pricing for jaw botulinum toxin reaches $1,000–$1,400, which is not a medical TMD price (The Pricer). Insurance often treats TMJ care as dental or medical inconsistently, so get written estimates and ask about prior authorization (The Pricer).

Another approach

Teeth grinding and clenching (bruxism)

Teeth grinding can happen awake or asleep. Symptoms include a painful jaw, which can lead to TMD, worn or broken teeth, headaches, earache and disturbed sleep. Stress and anxiety are the most common cause; other links include sleep problems such as snoring and sleep apnea, medicines for sleep problems, depression or anxiety, smoking, and lots of alcohol or caffeine (NHS). A 2023 meta-analysis of 20 studies found that people with bruxism had about twice the odds of TMD, both for awake and for sleep bruxism; that is an association, which does not prove that grinding causes TMD (meta-analysis, 2023).

The NHS says treatment is not always needed. It suggests relaxation, a regular bedtime, pain relievers and a wrapped ice pack if the jaw hurts, no gum or hard foods, and a visit to a dentist if you have tooth damage or pain in the jaw, face or ear (NHS).

The evidence for fixes is thin. Cochrane found not enough evidence that splints help sleep bruxism, although they may help with tooth wear (Cochrane review, 2007), and not enough evidence for drug treatment, with frequent side effects from some of the drugs tested (Cochrane review, 2014). For snoring and sleep apnea, see our Sleep Apnea guide; see also our Snoring guide.

Another approach

Cautions about irreversible dental treatments

This is the most important caution in the guide. Occlusal treatments change the teeth and bite, for example by placing crowns, grinding down teeth, or using orthodontic treatment to move some or all teeth. NIDCR says there is insufficient evidence that they work to treat TMDs, and in some cases they make the problem worse (NIDCR). Current evidence does not support a strong link between misaligned teeth and TMDs (NIDCR).

The Cochrane review of bite interventions (splints and adjustments) reached the same overall verdict: insufficient evidence to reach conclusions (Cochrane review, 2024), and the 2023 guideline made a strong recommendation against irreversible oral splints (BMJ guideline, 2023).

Before any procedure that cannot be undone, NIDCR suggests discussing benefits, risks and alternatives and, if possible, getting a second opinion from an orofacial pain specialist (NIDCR). That applies to dentists, orthodontists and surgeons alike.

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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