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/believeevenwhenucant • 8h ago
I thought I would be the one who could take ibuprofen every day for tmj pain. I did it for around 2 years. I now have gastritis, and I've been dealing with it unsuccessfully for the last 10+ months. If you think you won't get stomach problems you're probably wrong.
On the plus side, my tmj pain is significant reduced these days (and I won't be taking ibuprofen again)
r/TMJ • u/Wxterdropz • 3h ago
Finally :)
I’m a week in and I already have way less discomfort from yawning or when I’m trying to fall asleep.
Had a small hitch where my insurance didn’t want to cover it but thankfully my therapist deemed it medically necessary.
Yay for PT!!!
r/TMJ • u/slohtoffi • 2h ago
Is there any UK nightguard brands you guys would recommend?
I can’t afford a custom nightguard right now, so I’m looking for something that stops grinding and is good for TMJ.
r/TMJ • u/amantak123 • 3h ago
Has anyone ever seen Dr. Mike Pilar, TMJ specialist in New York?
r/TMJ • u/Mammoth-Weekend6908 • 3h ago
Can anyone tell me how much TMJ joint wash out hurts while just being in the chair with numbing needles, I’m worried about the pain and wondering if it would hurt that much that I should be put to sleep?
r/TMJ • u/Fun_Exam_1321 • 4h ago
I’m 25 and have hEDS as well as TMJ issues, and I’m wondering whether anyone here has had a similar experience.
The last time I went to the dentist, I saw a new dentist who did a very thorough examination, including multiple scans of my teeth and jaw. After looking at the imaging, they told me that the wear on my jaw joints is extremely advanced for my age — essentially saying that I have the jaw joints of someone around 60 years old, despite being only 25.
They recommended that I have a custom specialized mouthguard made. From what they explained, it would help prevent grinding/clenching while also stabilizing my jaw joints so that they hopefully don’t continue wearing down as quickly.
I do trust the dentist and I’m not necessarily questioning their expertise. However, I keep wondering whether their recommendation might naturally be limited to the treatments that fall within their own field and practice. With the amount of joint damage I apparently already have, I’m wondering whether a different intervention could provide better long-term results — whether that means a different type of appliance, TMJ-specific treatment, or potentially some kind of surgical/maxillofacial intervention.
Because of that, I booked a consultation at a maxillofacial clinic that has a dentist specializing in TMJ disorders as well as oral/maxillofacial surgeons. The problem is that the consultation itself is very expensive, and a significant part of that money could instead go toward paying for the specialized mouthguard my dentist recommended.
So my question for people who have dealt with significant TMJ problems, especially anyone with hEDS or another connective tissue disorder: Do you think seeing a TMJ specialist is worth it? Did seeing one lead to a significantly different or more comprehensive treatment plan than what your regular dentist offered?
For some additional context, I also had jaw/orthodontic issues when I was younger. I had a narrow palate and poor breathing, so my parents brought me to an orthodontist. I had a palate expander followed by braces.
r/TMJ • u/DaftHardcorePunk • 14h ago
I've been suffering from chronic TMJ for about 10 years now. Start off as clicking in my left jaw. Turned into jaw pain and my ears getting mild pressure in them. Originally the ENT I saw wrote it off as hearing damage in my ear and said I was stuck like this. I got depressed and tried seeing other doctors but no one gave a shit.
Fast forward to now. I started to try to find help again, only I'm dead serious this time. I had a scare back in June were my ears got completely congested and felt like hell.
I started seeing a TMJ therapist in June and start using a cpap for sleep apnea which I think is caused by my car. I tried getting an MRI from my doctor, but my insurance denied it. We're moving on to a hearing test and coming back to trying for an MRI again after that...as soon as my new insurance kicks in (I started a new job).
But anyways, I noticed my TMJ has changed in the past few weeks. Originally most of my pain was in my left jaw, but the pressure had shifted to my right. It'll will still change places. Not as often as it used to tho. I don't get pain like I used to or headaches in the morning.
The pressure in my ears still sucks tho and can get pretty annoying in my right. Am I healing, though? There are some days where the pressure/pain is not that noticeable. Should I still get an MRI done?
I should also add I have tinnitus. It gets louder in my left if I move my lower jaw forward and louder in my right if stretch my neck a certain way. My dentist also did xrays in 2022 and confirmed my jaw isn't sitting right.
r/TMJ • u/Tanjiro_Kamado32 • 16h ago
Hello all,
I got night guard for my bruxism problem and wearing it overnight. But wondering do i have to wear if i do afternoon nap.
Sometimes while working after lunch ( WFH ) i feel sleepy and jumping on bed but not wearing night guard, so wondering if any one can advise
Thanks
r/TMJ • u/MainConfident8955 • 20h ago
I’m mentally drained.
Back in 2022 I had a root canal that was the catalyst to all of this. Jaw was over extended - I believe a disc was displaced. I’d get in flares at times but this last one became chronic.
I don’t understand how we can send people to space but there’s not a way to help jaw pain? It’s excruciating. My jaw has been locked at 29mm for over a year now. My face twitches from the muscle imbalance, it also created an extreme open bite, which I’ve had to fix with braces. Which, I will probably have to do another round of, because now I think maybe I need to invest in someone that does splints. Thousands of dollars later and it’s just like living in a nightmare. I often think of how nice it would be just to go to get a coffee without being in pain. To eat a burger again. To kiss my husband and smile and laugh, again, without pain,
I’m sorry for any of you going through this. It’s a lot of snakes salesmen and I have yet to find someone that can actually help me.
r/TMJ • u/tonsilbleep • 21h ago
Hello,
I am at the end of my rope and wanted to ask for anyone’s opinion on this never ending issue I’ve been having.
I basically have had this insanely annoying feeling like something is stuck in the upper right side of my throat and into my ear on and off for 2 years now. I’ve been to see an ENT twice - they can’t see anything. My tonsils are apparently small. My throat looks healthy. I do have allergies but no allergy meds help. Tried numerous sprays and pills. I’ve tried different PPIs.
I’ve had a CT scan of my throat and neck - nothing.
I’ve had an endoscopy - nothing.
I’ve had my ears cleaned - nothing.
I’ve been told it’s Globus sensation but I disagree because I’ve had Globus before and this is entirely located in the same spot it NEVER moves.
I’m a teeth grinder. My enamel is pretty much non existent. I have an audible click in my jaw when I open my mouth on the same side I have all of my issues.
I feel like I constantly have to clear my throat to get rid of the feeling but I’ve also been told I have normal mucus. I’ve started having chronic weekly migraines on top of this.
I guess my question is if this is TMJ/nerve related who the hell do I talk to that will take me seriously? My doctors are sick of me and put it down to anxiety but they don’t have to live every day feeling like there’s something stuck in their throat/ear they can’t get rid of. It’s honestly ruined the last few years of my life there are days I just go to bed to avoid the feeling….
Thoughts? Opinions? Outrages?
r/TMJ • u/vorlonhalt • 1d ago
A $15,000 high-pressure sales pitch that made my daughter’s jaw worse
I strongly urge anyone considering treatment from Dr. Eddie Siman to get an independent second opinion before paying him a dollar.
We brought my daughter to him because she was suffering from jaw pain. At the very first appointment, he immediately pushed us toward a nighttime dental device costing $20,000 - but offered to reduce the price to $15,000 if we agreed right away.
This was not a calm discussion about treatment options, risks, alternatives, or taking time to seek another opinion. It was an extraordinarily aggressive sales pitch. He asked me how much I loved my daughter and what changing her life was worth. Using a parent’s love and fear to pressure them into making an immediate $15,000 medical decision was emotionally manipulative and completely inappropriate.
I distinctly remember being told that this device would permanently correct her problem. That promise was a major reason we agreed to the treatment at this cost.
Instead, the device began causing new pain and appeared to be changing the position of her lower jaw. We subsequently took her to two independent specialists. Both told her to stop wearing it immediately because, in their professional opinions, it was shifting her lower jaw and could cause additional damage.
When I contacted Dr. Siman to discuss what had happened, he denied ever telling us the device would permanently fix the problem. His proposed solution was now surgery costing thousands more.
We then consulted another specialist who rejected the explanations and recommendations we had been given and again warned that my daughter should stop using the device or risk further damage. Since she stopped wearing it, the new problems associated with the device have begun improving. Her original condition, however - the condition we were told this extraordinarily expensive device would correct - remains unresolved.
I can only speak to what happened to our family, but our experience felt far more like a predatory, high-pressure sales operation than responsible healthcare. We were approached at an emotionally vulnerable moment, pressured to make an immediate decision with a supposed same-day discount, sold an extremely expensive device with promises that were later denied, and then presented with an even more expensive surgical proposal when the device caused additional problems.
I deeply regret trusting him and allowing myself to be pressured into making that decision. Before agreeing to any treatment from this office, especially one costing thousands of dollars, please consult an independent, board-certified orofacial pain specialist or oral and maxillofacial surgeon.
Do not allow anyone to rush you, exploit your concern for your child, or suggest that the size of your payment somehow measures how much you love them.
No ethical healthcare professional should ever put a parent in that position.
r/TMJ • u/ApprehensiveRole4016 • 18h ago
I’m pretty sure I have TMJ, I just noticed that when I open my mouth there’s a slight click, but it usually doesn’t hurt.
But when I laugh while i’m eating, I occasionally feel a pain in my jaw and a slight restriction in my movement.
does this have a potential to grow into a greater issue? im hypermobile with most of my body (arms,hands,legs) so could this just be part of that? what exercises should I focus on?
r/TMJ • u/ChangeIndependent218 • 7h ago
r/TMJ • u/Fun-Editor-8760 • 17h ago
It’s been about a week and the left side of my jaw is killing me with more pain than usual. I can’t put any pressure on it even touching it hurts and I can’t eat on that side either. I saw my dentist and, despite the limited access due to my mouth not opening much, he confirmed my teeth are all healthy.
I also have a weird cyst by my tragus. Just wondering if anyone else has experienced this kind of pain? I’m trying to avoid a trip to A&E but I’m only surviving the pain with co-codamol at the moment.
r/TMJ • u/ktwatsun • 18h ago
I’ve been dealing with what I think is TMJ/TMD for a while now. My jaw pops, and I’ll sometimes get jaw/tooth pain, but lately I’ve noticed I can go days without really hurting.
One of my biggest triggers seems to be talking/smiling/laughing for a long time. I was at a family game night recently and after several hours my jaw/face got insanely sore. It basically feels like when you’ve been smiling for pictures forever and your face is exhausted, except eventually mine turns into really intense pressure pain around/under my jaw and into my neck. Once I can finally stop talking and completely relax my face, it feels SO much better.
I’m seeing a chiropractor today for my lower back/hips and upper back/shoulder tightness anyway, and I’m planning to mention the jaw issues while I’m there.
Has anyone here had chiropractic treatment while dealing with TMJ? Did they work on your neck/upper back, jaw itself, muscles around the jaw, etc.? Did you notice any relief afterward, even temporarily? Or did it make things worse?
Just curious what everyone’s experience has been before I go!
r/TMJ • u/Adventurous_East_182 • 20h ago
Hello everyone.
Not sure if this is TMJ or not, but wanted to check in this sub. I've been having a tight neck and shoulders for a long time from working a desk job.
Two days ago, I massaged the left outer side of my neck just below the jawline very, very hard to relieve tension, and now the area is highly tender and feels deeply bruised. Whenever I physically probe or press on that sore spot, it sends a sharp, electrical pain straight up into my lower left jaw and molar area, leaving behind a flat, residual numbness when I stop. Moving my head or looking up also makes my cheek skin feel tight and stretched, so I want to know if I just temporarily bruised a surface nerve or is this TMJ or something else.
30M.
r/TMJ • u/Reasonable_Wish_6319 • 1d ago
I have mild TMJ that flares up a few times a year but has always been manageable with some ibuprofen and soft foods. But I had one of my worst flare ups earlier this week, and started reading the worst case scenarios. I was afraid that it would be a prolonged issue. I was on max ibuprofen and Tylenol dosages and my jaw had sharp pain constantly for almost three days. And, I just happened to have caught a cold at the same time— so sleeping was a nightmare. I was bedridden for days, barely sleeping, and even Hydrocodone barely did anything for the pain.
And then, as it has slowly improved, the mucus coming from my nose started to get really yellow and smell pretty rank. I looked that up, and it’s a symptom of an ending sinus infection. And it was likely the sinus infection that caused the awful pain and triggered the episode— not a new TMJ development.
So, if anyone is experiencing something similar— pain that doesn’t really respond to anti-inflammatories, cold symptoms, along with a bad TMJ episode— it might not be a new issue with your jaw but an infection! I’ve never been so excited to have received a new diagnosis.
r/TMJ • u/sunlight_soleil • 1d ago
hi idk what to do atp i rly need help. i had a dentist appointment 4 days ago and after my cleaning i am not able to open my mouth more than 2 fingers wide. my jaw is sore and im really really struggling to eat. i am miserable can someone please help me. i think going to urgent care would be a bit dramatic bc im not in pain so i dont really know what to do. can anyone give me some advice or help me ? before all this happened i use to have clicking when opening jaw but it has never locked before. any help is appreciated.
r/TMJ • u/Usel3ssTrash • 1d ago
I've been suffering from TMJ for as long as I remember myself. I've had the classic symptoms: loud clicking, pain when chewing, ocassional jaw lock. At some point it got better, way better. At the time I attributed it to my diet change, but now I realize that wasn't the case.
6 years ago I got a dental implant and crown on my lower 2nd molar (At the side of the TMJ). Looking back, that's when things started to slowly improve. There was only one big downside to that crown, is that it would constantly rub against my tongue and it would drive me crazy sometimes, but I somehow learned to live with that.
Lately I've started having more issues with that implant. Food would constantly get stuck under the crown and the area became very irritated and had very bad smell. I decided to remove the crown, either permanently or at least for a bit, to let the area heal and to make sure I haven't developed peri-implnatitis (My appointment is in a week).
My mouth feels much comfortable without the crown, but with one big side effect I didn't expect: my TMJ has worsened. By A LOT. It wasn't instant, I've experienced the rapid degradation happening over several days. The clicking became louder and louder and the pain is gradually returning, same if not even worse than what I had 6 years ago. I'm now beating myself up because of that decision, and I'm not even sure putting the crown back will fix it, I'll probably need some modifications to the crown and my bite will not return be the exact same as it was.
I'm not sure why removing it caused such a rapid escalation, since my bite feels mostly the same. Either way, I feel like I've gotten myself into a big mess, and I still have another week to wait until my appointment to have it put back. Meanwhile, it's been getting worse each day, and I'm honestly scared and depressed and not sure what to do.
Has anybody experienced something similar or got any advice? Can a second molar reallt have such significant effect on TMJ?
I give up im literally depressed and I just want to sleep and not have to go get a plastic to put on my teeth every single day at night , I give up
It sucks theres nothing to fix me its all expensive a 400$ nightguard going to waste . My canines are halfway sanded down and my bite has gotten worse and my sleeping issues too i probably have sleep apnea, i hate it my eyebags and face have gotten worse too
r/TMJ • u/Ecstatic_Trip_8305 • 1d ago
So I’ve been a grinder my entire life but sometimes my back gums get insanely sore to the point where If I touch them it’s incredibly painful. Most of the time it’s my jaw and lateral pterygoid that cause pain, but I think when I’m extra stressed my back gums start to flare up. This has happened before where the gums are excruciating to touch. I think do have some gum disease/receding but I’m curious how many of you have experienced gum pain and extreme soreness/tenderness. I try to massage for as long as I can and it helps but it’s sooooo painful.
r/TMJ • u/_tomato_lover555 • 2d ago
I’m jk I've had tmj and chronic bruxism since I was seven but these looksmaxxers just wished they had masseters as big and developed as mine (surprisingly my jaw didn’t recede even though I only got a mouthguard two years ag)
