TMJ & Jaw Pain

What's actually causing it

The guard is doing what it was built to do. It keeps the teeth from wearing each other down. You can still clench on it. The masseter and the temporalis stay on, and the lateral pterygoid, tucked behind the upper teeth, can stay irritated. So the dentist is happy with the teeth, and you are still waking up sore.

I am not telling you to throw the guard out. Wear it if your dentist gave it to you. It has a job. Releasing the muscles is a different job, and the guard does not do that one.

What I find, after 23 years of seeing this, is a jaw that has been asked to stabilize a neck that isn't doing its share, or a clench that never got the signal to stop. The pain in the cheek, the temple, or in front of the ear is those muscles referring. It is not a bone that needs to be shoved back into place.

How I treat it

I don't adjust the jaw. I don't pull it, and I don't crack it. No popping. No high-velocity adjustments. The work inside the mouth is on a muscle.

From the outside, I do myofascial work on the temporalis and the masseter. The temporalis sits at the temple. It is a strong muscle, and it is thin. I still can't get over that. You can feel the whole sheet of it under the skin, and it is pulling hard for something that thin. The masseter is the bulge in the cheek when you clench. When those two lock down, they are often guarding for a neck that is out of whack, so I work the neck too.

The lateral pterygoid is the one I cannot reach from the outside. To get to it I wear a glove. After I explain it and you agree, a gloved index finger goes beside and behind the last upper molars, onto that muscle. That is a lateral pterygoid release. It is pressure on the muscle, the same idea as trigger point therapy anywhere else, and the same family of work as myofascial release. It is not a joint adjustment. The finger does not go down your throat, and it does not crank the jaw open.

It aches. Most people describe a deep ache in the cheek, up toward the ear, the way a tight muscle aches when you press it. I stay in contact with you the whole time. Raise a hand and I am out. If you do not want a finger in your mouth, say so before we start and we stay on the outside. The outside work is the masseter, the temporalis, and the neck.

The neck, the jaw, and the headache

These three travel together. Clenching loads the masseter and the temporalis, and those refer into the temple and behind the eye. The muscles at the base of the skull refer into the head. When the neck is stiff, the jaw often clenches to hold you steady, and when the jaw is clenched, the neck stays guarded. I work the jaw and the neck on the same visit. Treating the cheek and ignoring the neck is how this comes back.

If headaches or a stiff neck are the bigger problem for you, I've written more about headaches and neck pain.

What a first visit looks like

The visit is 30 minutes, and it is you and me. I don't hand this off.

I ask where it hurts, whether it clicks, whether it has ever locked, whether you have a night guard, and whether the headache or the neck showed up with it. Then I work the masseter, the temporalis, and the neck from the outside. You are treated that same visit, and I tell you what I am finding while I am finding it.

Intraoral work does not happen by surprise. I tell you which muscle I am going after, I put a glove on, and I wait until you say yes. You can stop it at any point. Nothing about it is a crack. Most of the external work feels like a deep stretch. The spot inside the cheek feels like a deep ache, and I back off if you need me to.

You leave with a short home routine, not a program. No referral. Book a visit or call (913) 451-7500.

What it costs

Sessions are $100 for a full 30 minutes, including the first visit. No packages. I don't bill insurance.

The office is at 8600 W 110th St STE 211, Overland Park, KS 66210. Monday through Thursday, 8am to 6pm.

How long it takes

Many people notice a change within a few visits. A jaw that has been clenched for years usually takes longer than one that flared last month. I don't promise the click disappears. I will tell you at the first visit what I think is realistic, and I would rather say so than sell you a package.

A jaw release you can do at home

This is the routine I actually send home. It takes a few minutes. Once a day is enough. Stop if the pain spikes.

Rest the jaw first. Tongue on the roof of the mouth, teeth slightly apart, lips together. That is where the jaw should sit when you are not eating. A lot of clenching is teeth together all day, and you don't feel it until someone points it out.

Then heat. A warm washcloth on the masseter, the bulge in the cheek you feel when you clench, and on the temple, for a few minutes.

Then a press, not a hard rub. Find the masseter by clenching once, relax, and press a fingertip into the muscle for about ten seconds. Move a finger-width and repeat, both sides. Do the same on the temporalis, above the ear and toward the forehead. Pressure you can breathe through. If you are wincing, that is too much.

Then open slowly, tongue still on the roof, only as far as it stays comfortable, and close. A few times. Don't chase a click, and don't force a wide stretch.

Leave the inside of the mouth to me. The gloved finger beside and behind the last upper molars is an office technique, where I can see what I am pressing. Don't try to do that part yourself.

When I send you to a dentist or an oral surgeon

Muscle work is the wrong first stop for some jaws. I will tell you that in the office if it is what I find, and I would rather you hear it before you book.

A jaw that is locked open, or locked shut, needs a dentist or an oral surgeon, not a week of muscle visits. So does pain that started with a hit, a fall, or a car accident, until someone has ruled out a fracture or a real joint injury. A bite that suddenly shifted to one side belongs in that same conversation.

Swelling, a fever, or a tooth that hurts when you bite is a dental problem. Numbness in the face is not a muscle I am going to chase. If a dentist or an oral surgeon has already told you the joint is damaged, or the disc is out of place, I can still work on the muscles around that joint if they want the muscles calmed down. The joint itself is their decision. I don't treat a damaged joint by pressing on it, and I don't adjust it.