Why does my jaw hurt? Causes and diagnosis
Jaw pain can come from the chewing muscles, the joint, a tooth or surrounding tissues. Here I explain how these situations differ and which observations help identify the source of pain.
Temporomandibular disorders (TMD) is the collective name for conditions affecting the jaw joints and chewing muscles. Treatment depends on the condition found and how it affects you. The videos below illustrate joint movement and grinding; I also use them to explain these processes during appointments.
Where and when it hurts: the starting point
Before your appointment, think about how the pain behaves as well as its location. Does it occur with the first movement in the morning, after a long conversation or while chewing? Does one tooth hurt, or the area in front of the ear, or the whole cheek? Was there a sudden loss of opening? Each observation helps guide the examination.
The place where pain is felt is not always its source. I therefore examine teeth and surrounding tissues, palpate the muscles and joints, assess movement and ask whether this reproduces your familiar pain.
The joint and disc: pain, clicking and restricted movement
Opening the mouth involves a combination of movements in both joints, coordinated by the muscles. A disc sits between the joint surfaces. A change in how these structures move together may be accompanied by sounds or difficulty opening, but the sound cannot tell you the position of the disc.
I ask whether movement is painful, whether the jaw has locked and how opening has changed. MRI may be considered when soft-tissue assessment is needed, while CBCT can help assess bone when indicated. Condylography has a different purpose: recording movement for functional analysis.
Chewing muscles: pain and tension with bruxism
The chewing muscles work during eating, speech and jaw movement. Sustained clenching adds to their workload. Patients may describe tired cheeks, aching temples or morning tension. During examination, I check whether movement and muscle palpation reproduce the familiar pain.
Bruxism occurs during sleep and wakefulness. The assessment distinguishes muscle tenderness, the condition of the joint and tooth damage. These needs may coexist: one patient may need help with daytime clenching, while another needs tooth protection and a separate plan for pain.
Clicking and locking need different assessments
Movement matters as well as sound. Painless clicking with normal opening is different from painful locking. If your opening has become restricted, I ask whether it happened suddenly, how long it has lasted and what preceded it.
Describe an episode in your own words: could you eat, could you close your mouth, and did it hurt? These details help guide the investigation. Do not attempt to manipulate or reposition your jaw using an educational video as instructions.
Injury and joint disease
A blow, fall or other injury is an important part of the history. Inflammatory or degenerative joint changes may also require assessment. I ask about other medical conditions and existing diagnoses so that care can be coordinated with another specialist when needed.
After an injury, tell me whether opening has become difficult or your teeth meet differently. CBCT is used to assess bone changes, while MRI shows the disc and soft tissues. The choice depends on which structures need examination.
Why I examine the teeth and bite
The condition of your teeth matters for chewing and dental planning. I look for missing teeth, assess wear and existing restorations, and check how your teeth meet. If you noticed a change after a crown or orthodontic treatment, we need to understand what changed and how it relates to the symptoms.
Research does not support treating an uneven bite as a universal cause of TMD. Permanent changes to teeth or the bite should not be based on pain alone. When a damaged tooth needs restoring or there is an orthodontic problem to address, I explain that need separately and take joint and muscle function into account in the wider plan.
Sleep, stress and persistent pain
Symptoms are influenced by more than anatomy. Poor sleep, tension and clenching may accompany the problem and affect how it feels. With persistent pain, it is also important to understand the effect on everyday life rather than expecting one measurement to explain everything.
Questions about sleep and daily demands are part of a thorough assessment. If another specialist could help, I explain the purpose of the referral.
When pain comes from somewhere else
When pain is felt in one tooth and changes with hot or cold food or biting, the tooth and surrounding tissues need examination. Pain in front of the ear during jaw movement directs attention to the joint and muscles. These observations guide the starting point of the assessment; examination determines the next steps.
Pain felt around the jaw may arise from teeth, surrounding tissues or another condition. Ear symptoms, headaches and neck pain also have other possible explanations. The examination therefore starts more broadly than checking a single joint.
Significant swelling, an injury, inability to eat or drink, or rapidly worsening symptoms need urgent in-person assessment. Difficulty breathing or swallowing requires emergency care.
From assessment to treatment
After the assessment, I explain the findings, the likely cause of your symptoms and whether further investigations are needed. My practice focuses on non-surgical treatment. I select splint therapy and other treatments according to the diagnosis, explain how to reduce strain on your jaw and review your progress. If teeth need restoring, we discuss that separately.
Bring any scans, reports and splint you already have. Note the symptoms that trouble you most and how they have changed. This helps us begin with your situation rather than automatically repeating previous investigations.