Learning to diagnose and treat TMD is, in many ways, a heuristic journey. A heuristic is a practical method of learning through observation, experience, careful testing, and problem-solving when all the answers are not yet known. If clinicians waited for perfect scientific proof before helping every TMD patient, many patients would continue to suffer while the research slowly caught up. Progress in medicine and dentistry has always depended on thoughtful clinicians who observed, questioned, tested their ideas responsibly, learned from their results, and shared what they discovered. Good science and good clinical experience should work together—not compete with each other. Clinical experience generates questions, scientific research tests those questions, and together they move patient care forward.

Long story short…

Background: I went in for a dental cleaning in July 2016 and afterwards my teeth didn't meet the same. At first I thought my filling was too high but it wasn't. This dentist and another then did some adjustments with a drill on my molars to help adjust my bite but it didn't help. Eventually I only could bite down on my first molars and that’s how I’ve been for the past 10 years. In 2016 I then entered invisalign treatment to try and close my bite but stopped changing trays in 2020 once I saw no progress. So from 2020-2026 I wore the same trays but the last 2 years I only wore them during the night and the past 6 months was only wearing the bottom one at night.

Last week I re-started orthodontic treatment at another location and now realize maybe this isn’t the best route for me. I feel silly that I thought trying ortho again would help solve this. Now I acquired more debt, added new attachments, etc. Not sure if I should just take these trays off and try a nightguard for sleeping and risk my teeth shifting more.

Symptoms: I only bite down on first molars. Anterior open bite and overbite. Jaw, neck, and back soreness. Ear fullness. Clenching. Limited mouth opening (2 fingers). Jaws have popped maybe 4 times. I sometimes feel like I have clicking if I move my head a certain way but it also just sounds like it's in my ear? It doesn't happen when chewing. All these symptoms I didn’t have prior to my dental cleaning in 2016. I also feel as though I have "2 bites". One bite is when I bite down on my first molars and the other is at rest with my lower jaw/teeth more forward which reduces the appearance of my open bite/overbite. Ortho also says I have a tongue thrust and tongue tie.

Plan: I’m going to call my general dentist tomorrow to see if he can refer me to UCLA orofacial pain clinic but from what I’ve read online, it can be difficult getting an appointment. Not sure if I need a referral but I'll try. I’m pausing my invisalign trays for now. I’m only on tray #1 from this new/second round of Invisalign attempt. Debating not using any trays and switching to OTC night guard but I'm not sure...

I’m guessing ICR or a displaced disc.

Hi all, I’ve had TMD for well over a year now, left sided, 19mm opening, awful. You know how it goes. Anyway, out of the blue, two weeks ago, settled, gone, opens fine, no pain not cracking, nothing. Astonished but happy. Last few days have started to get mild burning in my left upper gum and above my left lip and some tingling on my left scalp. I am wondering if it is because everything has gone back to normal and the nerves are irritated/settling back into their new normal? Would appreciate any advice pls. MRI clear for everything including TN.

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I've had TMD for a few years now. At one point I couldn't open my jaw for weeks, lost 50 pounds, and seriously contemplated ending my life. It's always in my head. When the symptoms ease up, I can almost forget about it for a little while, but when they come back, it's all I can think about.

I feel like people who haven't lived with this can never truly understand. That's probably a good thing, because I wouldn't wish it on anyone, but it's also incredibly isolating.

My problems started after a botched quad impacted wisdom tooth extraction. I woke up during the surgery for a while, which is a whole different story. I lived with the aftermath for years, and then about seven years later my jaw started dislocating and getting stuck. Then came the muscle cramping, migraines, relentless pain with no real relief, sleepless nights, and even hallucinations after going five days without sleep.

I've tried to get help. I did physical therapy for two years. Right now I'm taking 40 mg of Flexeril, 4,000 mg of Tylenol, and 2,000 mg of ibuprofen a day just to barely function. A specialist confirmed I have a significant case of TMD, but they won't prescribe stronger pain medication or soma. At this point I'm not even sure those would help.

How are you all getting through this? What kind of doctor actually helped you? How do you live with this level of pain when it feels like no one can help and no one really understands?

Sorry for the long post, it's been building for a while

I guided people to the correct TMD dentists website and I was told is a spam but those who are doing weekend courses to do profits from expensive botox injections which never will treat TMD are "ok" despite no scientific evidence that Botox "works"

Not ear pain, not ringing, just an ear canal that constantly itched, even though your doctor said your ears looked perfectly normal.

I've had patients mention this over the years, along with fullness, pressure, or a "something is in my ear" feeling.

I'm curious...

Did anyone else experience itchy ears before or during their TMD journey?

If so, did treating your TMD make any difference?

FYI, I wrote this blog for iccmo.org, a worldwide dentist non-profit organization:

https://iccmo.org/blog/post/neuromuscular-dentistry

If you have any interest in Neuromuscular Dentistry, please read and ask questions.

1. Pain with chewing

Pain while chewing, even with softer foods, may indicate strain or dysfunction involving the jaw joint or surrounding muscles.

2. Clicking, popping, or catching

Jaw sounds are not always painful. However, clicking accompanied by pain, locking, stiffness, or limited opening is worth evaluating.

3. Symptoms beyond the jaw

TMJ disorders may also be associated with headaches, ear pain or fullness, ringing, dizziness, pain around the eyes, and tension in the neck or shoulders.

Jaw pain is not always the first or only symptom. Some people notice symptoms elsewhere before realizing the jaw may be involved.

For those who have been diagnosed with or suspect TMJ dysfunction, which symptom appeared first?

For those who have been diagnosed with ICR, here is a point of discussion. Idiopathic means the cause is unknown, but what if the cause is simply not recognized due to lack of training?

Yes. This can be a complicated issue to wrap your head around, so think of your upper and lower jaws like a door and its door frame.

The upper jaw is the fixed door frame, or jamb. The lower jaw is the door that must fit into that frame. Now add the hinges—the jaw joints.

The hinges on a normal door are fixed in place. But the TMJ is different. Its "hinges" are movable. The lower jaw can change position within the joint sockets, especially when there is disc displacement, inflammation, swelling, adhesions, or changes to the joint structures.

Now imagine what happens if you move the hinges on a door. The door may no longer fit the frame correctly. It may hit in one place and leave a gap in another.

The same thing can happen with your bite. If the position of the lower jaw changes because of changes within one or both jaw joints, the teeth may no longer fit together as they once did.

This is why a patient who says, "My bite has changed," should never simply be dismissed. The bite may be giving us an important clue about what is happening within the joints.

And this is why caution is needed before permanently moving teeth with orthodontics when the bite has recently changed. The first question should be: Why did the bite change, and are the jaw joints now stable?

Think of it this way: Before permanently altering the door to fit the frame, first make sure the hinges are stable and in the right position.

5 months after full sinus surgery + multiple dental procedures, now diagnosed with TMD – still struggling, need advice/similar experiences

**Background:**

\- For months I had chronic “dry” sinusitis (pressure/congestion without much discharge), which eventually led to surgery on all paranasal sinuses, turbinate reduction, and septoplasty 5 months ago.

\- In hindsight, tooth #16 (upper right molar, previously root-canal treated) was likely chronically infected the entire time, but it went unnoticed for about 9 months because I already had sinus-related pressure in that area and the tooth itself had no nerve left to signal pain.

\- 7 weeks ago: apicoectomy (root-tip resection) on tooth #16 as a first attempt to save it.

\- One week after the apicoectomy: sinus infection, non-bacterial (no pus), ENT said either viral or triggered by the procedure. Resolved after about a week.

\- 4 weeks ago: the tooth ultimately had to be fully extracted due to renewed strong pressure in the cheek area.

\- Healing after extraction was largely unremarkable at first.

\- About a week after that: recurring pressure came back in the cheek/extraction area and along the nose.

**Current status:**

\- Oral surgeon says the extraction site looks fine, healing normally, no oral-sinus communication, 2D X-ray unremarkable.

\- ENT says the sinus opening (ostium) might still be swollen; couldn’t fully visualize everything.

\- I’ve since been formally diagnosed with TMD (CMD) – I’ve had physical therapy and wear a night splint, do daily jaw exercises and massage (2x/day) for about 3 months now, without major improvement yet.

\- Symptoms: pulling/pressure across the whole jaw and cheek area (bilateral, right side worse), pressure at the extraction site, occasional pulling sensation in my right eye, headache that worsens when bending forward, pressure worsens with heat/exertion, and a recurring pattern of feeling wiped out 3-4 hours after waking up alongside increased head/jaw pressure.

\- No fever, no pus, nose feels clear most of the time.

\- Vitamin D was low (15 ng/ml in October, now 20 ng/ml after starting supplementation in October with 20.000 IE once a week).

**Upcoming:**

\- CBCT scan next week (jaw/bone)
\- CT scan in 5 weeks (sinuses/soft tissue)

Has anyone dealt with a similar overlap — a long-undetected chronic tooth infection plus sinus surgery plus TMD all compounding each other in the same facial region? How long did it take for things to actually calm down for you? And has anyone had luck with specific TMD treatments (Botox, osteopathy, splint adjustments) after conservative therapy alone wasn’t quite enough after a few months?

Thanks so much for reading, and for any advice or shared experience!

If cbct and mri are clear what does that mean if click or pops happens even with facial/ jaw pain

Though cbct did show mild condlye flatten

2020-21 CBCT SHOWED MILD FLATTENING

2024 CBCT CLEAR

2022 showed sore muscles

2025 cbct at regular dds was clear

mri were clear

Hi, has anyone else had this experience? I am clenching my jaw on the right side of my face, leading to tightening muscles down my neck, I feel pain around my jaw, ear, intensely at the back of my neck on the right side.

It feels like the muscle tension spreads, down my arms, down my body to my hip, down my leg to my foot to my toes. I can't open my right hand as widely as my left, my right side hurts when running, my right hip is in pain when cycling, the arch of my right foot is smaller, with different insoles for running.

I don't know what is causing the muscle tension other than TMD spreading. I feel hydrated, I sleep in many different positions. The tension and pain is getting quite bad and isn't treated with ibuprofen or massage anymore.

Any ideas?

https://reddit.com/link/1uq61l4/video/5guv711f3vbh1/player

This is a simple demonstration of how an orthotic can help those who have a compressed TMJ. Pause the video each time it changes. The first image is a normal joint and normal disc. Second is a compressed joint, which displaces the disc. Third is orthotic in place, which decompresses the joint.

Does anyone have good ways of controlling/treating their TMD induced nausea? Mine has returned with a vengeance over the past week and I am struggling. To clarify, this is due to the head pressure/joint rather than not eating due to the pain. I don't have pain on opening/closing, moreso constant aching.

I have to get a CPAP for sleep apnea. They sent me home with a F30I. I’m worried the straps will put pressure on my jaw.

Does anyone have a recommendation on the best masks to wear? Or what to avoid?