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DEAR MAYO CLINIC: Does temporomandibular joint pain that’s caused by grinding teeth ever go away on its own, or is treatment always required?
ANSWER: Teeth grinding or clenching can lead to discomfort around the temporomandibular joint, or TMJ. The causes of these behaviors are complex and likely triggered by multiple factors. In most cases, the pain is a result of muscle soreness — not damage to the joint itself. This pain often can be relieved with self-care. If pain continues, however, consider having the condition evaluated. You may need to take steps to reduce teeth grinding. You also may benefit from exploring other treatment options for the pain, such as prescription medication or physical therapy. If the joint becomes damaged, surgery could be necessary, but that’s rare.
Your temporomandibular joints connect your jawbone to your skull. They act like sliding hinges that enable you to move your jaw up and down, and side to side, so you can talk, chew and yawn. These joints and the powerful muscles that surround them can become sore or damaged due to a number of disorders, including teeth grinding — a condition also known as bruxism.
People often unconsciously clench their teeth when they are awake, or they clench or grind their teeth together when they’re asleep. Over time, teeth grinding can lead to pain in the muscles of the jaw. If teeth grinding is severe, or if it lasts for a long time, teeth grinding can cause ongoing joint pain, inflammation and degenerative changes in the joint itself.
For some people, teeth grinding fades away over time, or it may lessen to the point that it no longer causes pain or discomfort. In the meantime, you can often ease temporomandibular joint muscle pain with over-the-counter pain relievers, such as acetaminophen or ibuprofen. Applying ice or warm, moist heat to the side of your face may reduce pain, too.
If these steps aren’t enough to relieve the pain, or if teeth grinding or clenching gets worse, make an appointment to see your health care provider. He or she can evaluate your condition and recommend treatment.
For example, in some cases, changes in behavior, such as relaxing or repositioning your mouth and jaw, may ease teeth grinding. Life stressors often are associated with daytime grinding or clenching, but it is important to separate the habit from stress. Habit reversal techniques, such as setting regular reminders or alarms to remind you to relax your jaw and separate your teeth, can be effective. Another means of habit reversal involves setting up visual cues around your home or workplace to help you remember to relax your jaw and separate your teeth. During normal function, the only time your teeth should be in contact is when you swallow.
If your health care provider suspects that nighttime teeth grinding could be associated with a sleep disorder, it may be helpful for you to consult with a sleep medicine specialist. A splint or mouth guard may help prevent damage to teeth caused by nighttime teeth grinding.
For temporomandibular joint pain that persists despite using over-the-counter pain relievers, stronger prescription pain medications and anti-inflammatories may help. Your health care provider also may recommend a muscle relaxant to ease the discomfort. In some cases, physical therapy can be useful for reducing pain by strengthening and stretching jaw muscles.
If temporomandibular joint pain still won’t go away, your health care provider may recommend other approaches, such as a corticosteroid injection into the joint. If damage to the bones or disc within the joint develops due to teeth grinding, a surgical procedure may be needed to treat that damage. Surgery is uncommon, though, and typically isn’t necessary since temporomandibular joint pain often can be relieved with less-invasive treatment options. — Dr. Jonathan Fillmore, Oral and Maxillofacial Surgery, Mayo Clinic, Rochester, Minnesota