Temporomandibular joint and muscle disorders (TMJ/TMD)



The cause of TMD is often not clear. It may be due to:

  • An injury of the jaw or face
  • Too much tension in the jaw muscles
  • Displacement or poor position of the jaw joint or cartilage disc inside it
  • The upper and lower teeth not being in line
  • Disturbed movement of the jaw joint
  • Arthritis or a swelling in the joint
  • Too much or not enough motion of the joint

Risk Factors

TMD is more common in women. People from 20 to 40 years old are most at risk. Other things that may raise the risk are:

  • An injury of the jaw and neck
  • Clenching or grinding of teeth
  • Poorly fitting dentures or crowns
  • Stress
  • Fingernail biting
  • Playing a wind instrument
  • Smoking



TMD may cause:

  • Pain in the jaw or face
  • Pain that may be worse with chewing, yawning, or opening and closing the mouth
  • Clicking, popping, or grating sounds with movement of the jaw
  • A feeling of the jaw catching or locking briefly while attempting to open or close the mouth, or while chewing
  • Headache
  • Earache
  • Neck or shoulder pain


The doctor or dentist will ask about symptoms and past health. A physical exam will be done. It will focus on the jaw, teeth, face, and head. This is often enough to make the diagnosis.

Pictures can help confirm the diagnosis. They may be done with:

  • X-rays
  • CT scan
  • MRI scan
  • Ultrasound



The goal of treatment is to manage symptoms. Options are:

  • Lifestyle changes, such as ice or heat packs and avoiding gum chewing
  • Counseling to learn how to manage stress
  • Physical therapy to stretch and strengthen the jaw
  • Dental devices to relax the jaw muscles and prevent the teeth from clenching and grinding
  • Medicine, such as:
    • Pain relievers like ibuprofen
    • Muscle relaxants
    • Antidepressants to ease pain
    • Cortisone injections to ease swelling and pain
    • Botulinum toxin (Botox) injections to ease tension in the jaw
    • Certain antidepressants—to treat long-term TMD

Some people may need surgery when other methods are not helpful. This is not common.


To lower the risk of TMD, avoid:

  • Jaw clenching
  • Nail biting
  • Teeth grinding
  • Excessive chewing of hard foods, gum, or the lip

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.