This information is taken from a BMJ patient information leaflet published in May 2020.

Temporomandibular joint syndrome (clicking jaw)

Your jaw is a complicated joint.

It’s fairly common to get problems like a painful or clicking jaw, or even a locking jaw. Doctors call these symptoms temporomandibular joint syndrome.

There’s no simple cure for the problem, but there are treatments that can help, and the symptoms often improve over time.

Surgery is usually a last resort for people with severe jaw problems. 

We've brought together the research about temporomandibular joint syndrome (clicking jaw) and talked to experts about how to treat it. You can use our information to talk to your doctor and decide which treatments are best for you.

What is temporomandibular joint syndrome?

If you have temporomandibular joint syndrome you may get a clicking sound when you move your jaw. You may also get pain in your jaw or face. Some people find they can’t move their jaw properly or can’t open their mouth as wide as they used to.

There are three main types of temporomandibular joint syndrome:

• Pain that comes from the muscles you use to chew.
• Misalignment of a disc in your jaw. Normally, a disc sits between your skull and your jaw, and helps the jaw to slide properly. This disc can move out of position, causing a clicking jaw or pain.
• Arthritis of the joint, where the smooth cartilage that should protect the joint breaks down.

Temporomandibular joint syndrome gets its name from the bones at either side of your skull (the temporal bones) and your jawbone (the mandible). The joint between your skull and your jaw is called the temporomandibular joint.

What are the symptoms?

The main symptoms of temporomandibular joint syndrome are:

• Pain in the jaw joint, or in your face
• Noise, like clicking or popping, from your jaw
• Not being able to move your jaw easily, or finding that your jaw locks.

Some people with temporomandibular joint syndrome also get headaches, backache, or neck pain, and some people feel depressed or anxious.
Most people won’t need any tests to diagnose their jaw problems, but doctors sometimes order an X-ray if they want to examine the structure of the joint.

What treatments work?

A clicking or painful jaw can be very annoying. You might be reassured to know that the problem rarely gets worse. It may even go away on its own given time.

There are also several treatments that can help you adapt to the problem with your jaw and reduce the pain you get.

First-line treatments - Resting your jaw might help. This will allow the muscles you use for chewing to relax. You should avoid chewing gum or biting your nails. Eating softer food for a while may also help you rest your jaw. You should also try to avoid stressful situations, as stress may lead you to clench your jaw or grind your teeth, which can make your jaw problems worse.

If you are very stressed or anxious, a talking treatment like cognitive behaviour therapy (CBT) might be useful. 

Your doctor might recommend that you have physiotherapy. A physiotherapist will show you exercises designed to help your jaw. These might involve opening and closing your mouth in a particular way: for example, trying to keep your jaw movement in a straight line, and keeping
your tongue touching the roof of your mouth.

Doctors sometimes recommend a splint or guard to wear, usually at night (these look a bit like a boxer’s gumshield). If you clench your jaw or grind your teeth, a splint or guard can help you stop, which may reduce the pain in your jaw. You’ll need to see a dentist to get a guard
fitted.

Some people try acupuncture for a painful or clicking jaw, but there’s no good evidence that it works.

Drug treatments - If resting your jaw doesn’t improve your pain in a couple of weeks, your doctor may suggest drug treatment to help. The treatment you need will depend on what’s causing the pain. If you have pain because of a misaligned disc or arthritis, your doctor might recommend an anti-inflammatory painkiller like ibuprofen.

If you’re getting pain in the muscles in your face, your doctor may recommend a drug that relaxes your muscles, such as diazepam. You’ll probably take it for around 10 days. Diazepam can make you drowsy, and if you take it for too long you can become dependent on
it. This means you get withdrawal symptoms when you stop taking it.

Surgery - Surgery is an option for people with temporomandibular joint syndrome, although it’s usually a last resort. You might want to think about surgery if you get pain that doesn’t go away with other treatments, or if the clicking in your jaw makes it hard to chew, talk, or get on with your life.

Surgical procedures include:
• washing out the joint with sterile fluid to encourage the disc to move back to the correct
position (this is called arthrocentesis)
• realigning the joint (this is called condylotomy or osteotomy)
• replacing the joint itself with an artificial joint (called a total TMJ replacement).

Surgery isn’t always successful. If you’re considering it, make sure you talk to your surgeon and get a realistic idea of what the outcome is likely to be. You’re likely to get some pain and difficulty moving your jaw while you’re recovering from surgery.

What will happen to me?

Problems with a clicking or painful jaw tend to improve as you get older. People often adapt to the way their jaw moves, and the joint itself may adapt over time. Most people find their symptoms improve even without treatment.

Although there are treatments for a clicking or painful jaw, most aim to help with the symptoms rather than cure the condition. For most people, it’s a case of learning to live with a clicking jaw.