CONDITION / JAWS, MOUTH AND NECK

Jaw joint dysfunction.

Temporomandibular joint dysfunction (TMJ) — pain in the jaw and in front of the ear, clicking and limited opening of the mouth. Usually it is not serious and often passes by itself; it is primarily treated without surgery, and surgery is resorted to only when other methods have not helped.

Discuss your case How it is treated in the clinic ↓

CONCEPTUAL VISUALIZATION

OVERVIEW

What it is: Disorders of the jaw joint and masticatory muscles: pain, clicking, limited opening of the mouth.
How common: According to the BMJ guideline, 6–9% of adults in the world; the second most common cause of chronic muscle and joint pain after low back pain.
run over: It is usually not serious and often goes away on its own.
How we treat: First without surgery: exercises, manual therapy, prescribed medication; surgery is considered when this has not helped.

01 / WHAT IS IT

What is
joint dysfunction.

The temporomandibular joints connect the lower jaw to the skull just in front of the ears; between the bones in each lies a cartilaginous disc. Dysfunction is a collective name for several conditions: the chewing muscles or the joint itself hurt, the jaw clicks, the mouth does not open completely.

Some of the problems are related to the muscles, some are related to the joint itself, such as a displaced disc. It depends on what will help, so the doctor first finds out what exactly hurts.

The dysfunction is usually mild and often goes away on its own. A herniated disc that clicks is usually a stable condition that is painless and lasts a lifetime. Only in a small number of people does the disc stop coming into place, and only rarely is this accompanied by pain and limited opening of the mouth; these symptoms tend to diminish and often resolve within a few months.

This is general information. The doctor will tell you what will suit you after the examination.

02 / SIGNS

How
dysfunction presents.

In a meta-analysis of 27 studies, among the signs, muscle pain (37.2%) and clicking (29.8%) occurred more often than others, pain in the joint itself (16.8%) was less common, and limited opening or jamming (8.1%) was the least common. The pain may increase during chewing and under stress.

pain

Pain around the jaw, near the ear and in the temple, worse when chewing.

Clicking

Clicking, crunching or creaking in the joint when you move your jaw.

The mouth does not open

Inability to open the mouth fully, or the jaw jams when opening.

Headache

Pain in the temples that can interfere with sleep.

The mouth does not close

If the jaw jumped forward and the mouth froze open, it is already a dislocation.

Dislocation of the jaw

03 / REASONS

Why does it occur?
dysfunction

In a meta-analysis of 27 studies, women had significantly more joint dysfunction than men. Among the reasons, the NHS cites the following.

Grinding teeth

The habit of clenching or grinding the teeth.

Wear and tear of the joint

Wear and tear of joint cartilage and bones.

Destruction of the joint head

hit

A blow to the head or face.

Fracture of the condylar process

Stress

Pain can be aggravated by stress, and anxiety can make it worse.

Uneven bite

The teeth close unevenly.

Asymmetry of the face and jaws

04 / SEEK MEDICAL ADVICE

When to seek medical advice?

Joint dysfunction is usually not serious and does not require emergency care. But pain radiating to the jaw can be a sign of other dangerous conditions - a heart attack or inflammation of the arteries of the temple.

103 immediately if:

pain in the chest, as if it were squeezed or squeezed;
pain in the chest radiates to the arm, neck or jaw;
it is very difficult to breathe - a person gasps for air, suffocates, cannot utter a word;
lips or skin are pale, blue, or gray;
the person is unconscious and does not react as usual.

Other levels of urgency:

Immediately, in the reception: the jaw popped out and the mouth does not close - see dislocation of the jaw. On the same day - to the doctor: cannot eat or drink; the jaw suddenly jammed or the mouth stopped opening completely; frequent severe headache appeared; aching or painful to the touch of the temple or scalp - these can be signs of inflammation of the arteries of the temple, which, without prompt treatment, can lead to stroke or blindness. If your eyes are double or your vision has worsened, see an ophthalmologist the same day. In the coming days: new pain near the jaw, ear, or temple or clicking pain that does not go away despite household activities or interferes with chewing and sleeping. Planned: long-standing pain, clicking or limited opening of the mouth that has been bothering you for months, as well as clicking that does not hurt or bother you - make an appointment for a consultation.

05 / DIAGNOSTICS

As defined,
what exactly hurts

Questioning
Where and when it hurts, when it clicks, does the jaw jam, do you clench your teeth, how do you sleep, or is there stress.
Review by criteria
The international diagnostic criteria for DC/TMD help distinguish muscle pain from joint pain; these include short questionnaires about pain, jaw movements, mood and habits.
Jaw movements
The doctor measures how much the mouth opens, listens and feels the joints and chewing muscles.
Teeth and bite
If teeth grinding is possible, see a dentist.
MRI or CT if necessary
If a disc displacement, wear or damage to the bones of the joint is suspected or an intervention is planned.

06 / TREATMENT

How we treat
joint dysfunction.

Usually the dysfunction goes away without treatment or with simple methods. The BMJ guideline for chronic pain (from 3 months) advises to start with strongly recommended methods and decide with your doctor, based on what you have already tried.

What can you do yourself?

Home measures advised by the NHS.

food: Soft food - pasta, omelet, soups; do not bite food with your front teeth, do not chew gum or handles.
Analgesia: Paracetamol or ibuprofen according to the instructions.
Cold or warm: A bag of frozen peas wrapped in a towel - no longer than 5 minutes at a time, or a heating pad in a towel twice a day for 15-20 minutes; which helps better.
Habits: Massage sore muscles, find ways to relax, don't yawn too wide, don't bite your nails; outside of food, the teeth should be open.

Without surgery

The main treatment, in particular for chronic pain.

Exercises: Therapeutic exercises and stretching for the jaw: In a meta-analysis of 16 studies (812 participants), they reduced pain and increased mouth opening. The BMJ guideline advises exercise under the supervision of a specialist.
Manual therapy: Joint mobilisation, working on sore muscle points, postural exercises are a strong BMJ recommendation; manipulations and acupuncture are conditional.
Psychotherapy: Cognitive behavioral therapy has a strong BMJ recommendation. If stress and anxiety make the pain worse, the NHS advises to see a psychologist.
Tire (cap): Data are contradictory. The 2023 Japanese guideline advises a stabilizing splint as first-line treatment, although the level of evidence is very low; the BMJ guidelines for chronic pain conditionally do not recommend removable splints and categorically do not recommend splints that irreversibly change the bite. In a meta-analysis of 18 studies, splints did not provide better pain relief than other nonsurgical methods, but they did reduce clicking.
Medicines: The doctor prescribes stronger painkillers. For chronic pain, the BMJ strongly advises against combining anti-inflammatories with opioids and conditionally advises against gabapentin, benzodiazepines, injections of botulinum toxin, hyaluronic acid or corticosteroids.
Laser and current: Low-intensity laser is conditionally recommended by the Japanese guideline, BMJ guideline is conditionally not recommended, as well as electrical stimulation (TENS).

Surgical treatment

If pain and limited opening do not go away despite treatment without surgery.

Arthrocentesis: The joint is washed with liquid through thin needles. In a meta-analysis of 9 randomized trials (545 patients), pain was reduced more significantly than after treatment without surgery, and the increase in mouth opening was too small to be clinically significant. In another meta-analysis of 7 studies (448 patients), the difference at 6 months was probably not clinically significant.
Arthroscopy: Examination and washing of the joint through a thin camera. In terms of pain and complications, it did not differ from arthrocentesis; the quality of research is low.
Open operations: Disc surgery should not be the first choice: the evidence for their benefit is unclear. The BMJ guidelines categorically do not recommend disc removal (discectomy) for chronic pain.
Displaced disc: Active treatment is only necessary when the disc is not in place and this causes pain or limited opening of the mouth; they start here without surgery.
A broken joint: Destruction of the joint head and fusion of the joint (ankylosis) are separate conditions with different treatment, see pages destruction of the head and ankylosis.

07 / AT THE VALIKHNOVSKYI INSTITUTE

How
we treat it.

TMJ dysfunction is usually treated without surgery — with exercises, manual therapy, and medication; part of this treatment is conducted by a dentist, physiotherapist or psychologist. A surgeon from the "New Face" department at the Dr. Valikhnovskyi Institute of Surgery evaluates whether non-surgical methods are sufficient and performs jaw and joint surgeries when they are needed.

CLINIC SERVICE A new face Form, symmetry, facial expressions and functions after injuries, wounds, burns, removal of tumors and congenital changes. View service

What we do for this condition

Consultation of a surgeon — examination of joints, muscles and bite; whether surgical treatment is necessary or non-surgical methods are sufficient.
CT and 3D planning — if it comes to surgery, it is planned on a three-dimensional model built according to CT.
Exercises for opening the mouth — exercises with a device for developing the jaw within the framework of facial rehabilitation.
Operations on the lower jaw and joint — in particular, a joint implant, if the own joint is destroyed.

Rostislav Valikhnovskyi

Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.

About the doctor ORCID

How treatment works with us

Pictures onlineSend an MRI or CT if you have one and describe what hurts, clicks, or jams and when.
ConsultationExamination of joints and muscles, measurement of mouth opening; if necessary — CT or MRI.
PlanWhat to do without surgery and who leads this part; whether there are indications for intervention on the joint.
TreatmentExercises and other methods without surgery; interventions on the joint - only if they did not help.
Follow-upControl of pain and mouth opening; after the operation - soft food for a while.

Discuss your case Call

08 / QUESTIONS AND ANSWERS

Common
questions

Short answers. What is right for you, the doctor will tell you during the consultation.

Does TMJ dysfunction go away by itself?

Often yes: usually it is not serious and goes away without treatment. Soft food, cold or heat, massage and giving up the habit of clenching your teeth help to relieve the condition.

Is surgery necessary?

Mostly no. Surgery is not the first choice; arthrocentesis or other interventions are discussed if pain and limited opening of the mouth do not go away despite treatment without surgery.

The jaw clicks, but it does not hurt. Is it necessary to treat?

Usually not. A herniated disc that clicks is usually a stable condition that is painless and lasts a lifetime. Treatment is required if pain or limited mouth opening occurs.

Will a mouthguard help?

The data are contradictory: the Japanese guideline recommends a stabilizing splint, while the BMJ guideline for chronic pain conditionally does not recommend removable splints. Tires that irreversibly change the bite are strongly discouraged by the BMJ.

What exercises help?

Stretching and mouth-opening exercises reduced pain and increased opening in a meta-analysis of 16 studies. They should be selected with a physiotherapist.

Can pain in the jaw not be from the joint?

Yes. Chest pain radiating to the jaw is a reason to call 103. Pain in the jaw while eating or talking along with headache and temple soreness is a reason to see a doctor the same day.

Will botox injections help?

For chronic pain, the BMJ guideline conditionally does not recommend injections of botulinum toxin, hyaluronic acid, and corticosteroids. The decision is made together with the doctor.

09 / SOURCES

Sources

14 sources · reviews, guidelines and researchshowCollapse

Management of chronic pain associated with temporomandibular disorders: a clinical practice guidelineBMJ, 2023doi:10.1136/bmj-2023-076227 ↗
Clinical practice guidelines in primary treatment for temporomandibular disorders: The Japanese Society for the Temporomandibular Joint, 2023 editionJournal of Prosthodontic Research, 2025doi:10.2186/jpr.JPR_D_24_00168 ↗
Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research ApplicationsJournal of Oral & Facial Pain and Headache, 2014doi:10.11607/jop.1151 ↗
Global prevalence of temporomandibular disorders: a systematic review and meta-analysisJournal of Oral & Facial Pain and Headache, 2025doi:10.22514/jofph.2025.025 ↗
Disc displacement within the human temporomandibular joint: a systematic review of a ‘noisy annoyance’Journal of Oral Rehabilitation, 2013doi:10.1111/joor.12016 ↗
The efficacy of treatments for temporomandibular disorders with occlusal splints versus other conservative therapies: a meta-analysis of randomized controlled trialsOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2025doi:10.1016/j.oooo.2024.11.089 ↗
Exercise therapy improves pain and mouth opening in temporomandibular disorders: A systematic review with meta-analysisClinical Rehabilitation, 2023doi:10.1177/02692155221133523 ↗
Arthrocentesis versus conservative treatments for temporomandibular joint disorders: A systematic review with meta-analyses and trial sequential analysesJournal of Cranio-Maxillofacial Surgery, 2025doi:10.1016/j.jcms.2024.12.006 ↗
A systematic review and meta-analysis of randomized controlled trials comparing arthrocentesis with conservative management for painful temporomandibular joint disorderInternational Journal of Oral and Maxillofacial Surgery, 2023doi:10.1016/j.ijom.2022.12.005 ↗
Arthroscopy versus arthrocentesis and versus conservative treatments for temporomandibular joint disorders: a systematic review with meta-analysis and trial sequential analysisInternational Journal of Oral and Maxillofacial Surgery, 2024doi:10.1016/j.ijom.2024.01.006 ↗
Invasive surgical procedures for the management of internal derangement of the temporomandibular joint: a systematic review and meta-analysis regarding the effects on pain and jaw mobilityClinical Oral Investigations, 2022doi:10.1007/s00784-022-04428-7 ↗
Temporomandibular disorder (TMD)NHS, 2023nhs.uk/conditions/temporomandibular-disorder-tmd ↗
Temporal arteritisNHS, 2023nhs.uk/conditions/temporal-arteritis ↗
Heart attackNHS, 2026nhs.uk/conditions/heart-attack ↗

The figures on the page are from these sources.

VALIKHNOVSKI SURGERY PARTNERS

It hurts or clicks
jaw?

Describe what bothers you and when, and send pictures if you have them. The doctor will tell you where to start; usually start with treatment without surgery.

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