Temporomandibular Joint (TMJ) Disorders

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Pain in your jaw, in the muscles that you use to chew, and around your ear, as well as difficulty opening and closing your mouth (jaw locking), jaw clicking, jaw popping, and some types of headaches could indicate a temporomandibular joint disorder, also called TMJ or TMJD. Symptoms can range from mild to debilitating and significantly interfere with eating, speaking, and other aspects of daily living. Duke’s orofacial pain specialists (dentists who diagnose and treat TMJ disorders and other types of pain in the mouth and face), physical therapists, and psychologists offer evidence-based treatments for TMJ disorders. Together, our goal is to identify what may be causing your TMJ disorder and improve your quality of life.

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About TMJ Disorders

Temporomandibular joints connect your jawbone to your skull on either side of your face. These joints allow your jaw to open and close. A variety of factors can cause TMJ disorders and jaw and face pain, including:

  • Arthritis
  • Genetic predisposition
  • Jaw joint injury or trauma to the face
  • Oral habits (chewing gum, biting nails and lips, leaning on your chin, and daytime or nighttime clenching or grinding)
  • Psychosocial factors (anxiety, depression, stress, and other issues)
  • Rheumatologic disorders
Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Diagnosing TMJ Disorders

Comprehensive Exam

The first step toward diagnosing a TMJ disorder is thoroughly discussing your symptoms and medical history with your doctor. This will help identify any underlying causes for your symptoms and sources of pain. Your doctor may ask:

  • When did your pain start?
  • What is its location, quality, intensity, duration, and frequency?
  • What makes your pain better or worse?
  • Do you have any other symptoms with your pain, like nausea or light sensitivity?
  • Do you have pain elsewhere? Are you experiencing facial pain, ear pain, headaches (including migraines), neck pain, or shoulder pain.
  • Do you have a sleep-related disorder?

Your doctor will also perform a physical exam, inspecting your jaw joint, surrounding structures, nearby muscles, and your mouth and teeth.

Imaging

X-ray, CT, or MRI imaging can help your doctors see your bones, tissue, and muscles in greater detail and identify conditions that could be contributing to your TMJ.

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Nonsurgical Treatments for TMJ Disorders

Our TMJ specialists offer a wide range of evidence-based treatment options to manage TMJ disorders.

Medications
Several types of medications can help reduce inflammation and manage pain.

Oral Appliances 
A custom-made, removable mouth guard, called an orthotic appliance, can help relieve pain by stabilizing your jaw and protecting your teeth from clenching or grinding. 

Physical Therapy
Physical therapists assess how your jaw functions and teach you exercises to stretch and strengthen jaw muscles, adjust jaw posture, and improve jaw function. They can offer practical guidance on improving oral habits and other factors contributing to your symptoms.

Injections
Injections can help treat TMJ disorders. Your provider will recommend certain injections based on your condition. 

  • Trigger point injections help reduce myofascial pain, a common muscle condition in people with TMJ disorders that can cause referred pain (when you feel pain somewhere besides where it originates) and headaches.  
  • Steroid injections help control pain in the temporomandibular joint.
  • Botulinum toxin A (Botox) injections treat chronic migraines, muscle spasms, and involuntary jaw movements. 
  • Hyaluronic acid injections in the temporomandibular joint help lubricate the joint and reduce inflammation. 
  • Platelet-rich plasma (PRP) is produced using your own blood. Specialized centrifuge devices isolate platelets and growth factors in your blood, which can help stimulate the healing process. 

Complementary Medicine 
Your doctor may recommend complementary therapies like massage or acupuncture to help relieve pain and other TMJ symptoms.

Cognitive Behavioral Therapy
Our psychologists offer techniques to reduce distress, tension, and negative thoughts that exacerbate TMJ symptoms. We also help you learn to cope with pain to lessen its impact on your life.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

Why Choose Duke

Team Approach to Care
Our board-certified dentists work closely with other specialists -- including physical therapists, rheumatologists, health psychologists, neurologists, pulmonologists, and primary care providers -- to ensure you receive thorough, comprehensive care.

This page was medically reviewed on 10/23/2023 by