TMJ Pain and Symptoms Guide

If there is no pain, locking, or functional limitation even when making a sound upon opening the mouth, the course can be observed. Conversely, if the mouth does not open well even with a low volume of sound, or if it hurts when chewing or the jaw is locked, an evaluation is necessary.

We do not definitively determine the cause of temporomandibular joint pain based solely on facial asymmetry or dental occlusion; instead, we verify the actual range of mouth opening and chewing function.

• Pain in the front of the jaw when opening the mouth
• A crunching or sand-like sound
• The mouth does not open well, or is deviated to one side.
• The mouth remains open after being opened and cannot close, or the jaw gets locked.
• Fatigue and pain when chewing tough food
• Tension around the temples, cheeks, and neck
• In the morning, I feel my jaw is stiff and have a sensation of clenching my teeth.

We assess not only pain and sound, but also how much eating, yawning, and speaking functions are restricted.

If you cannot close your mouth after trauma, if your bite suddenly changes, or if severe swelling occurs, a fracture or dislocation must be ruled out. If you have high fever or facial swelling, or if tooth pain is suspected to be due to infection, we recommend prompt dental or medical evaluation for accurate assessment of the condition.

If sudden facial paralysis, difficulty speaking, and severe headache occur together, do not attribute it solely to temporomandibular joint (TMJ) problems; instead, undergo a prompt neurological evaluation.

We ask when the pain began and check for trauma, tooth-clenching and sleep habits, and previous dental treatment. We examine how wide the mouth opens, which direction the jaw moves when opening, and whether there is sound or locking.

We examine the tension in the chewing muscles, temples, and neck muscles along with neck movement; if dental or gum disease is suspected, we will guide you to a dental evaluation.

If there are no warning signs and it is necessary to manage movement of the temporomandibular joint and neck/upper cervical spine, as well as masticatory muscle tension and function together, Chuna manual therapy may be considered.

We do not describe this as a treatment that forcefully presses the jaw or corrects facial asymmetry in one session. Acupuncture and pharmacopuncture can be selected to examine pain in the masticatory muscles and around the neck, and after treatment, the range of mouth opening and chewing function are checked.

Reduce habits such as chewing tough and hard foods when pain is severe, yawning widely, and chewing only on one side. Check whether the upper and lower teeth are continuously in contact during daily activities and adjust the habit of resting your chin on your hand.

Whether a temporomandibular joint device is needed must be evaluated separately based on the condition of the teeth and occlusion, symptoms, and scope of treatment.

We do not simply compare whether the mouth opens by about two or three finger widths; we also examine whether the jaw deviates to one side while opening, whether sounds occur or movement is hindered in specific ranges, and where pain is located. It can also be checked whether the timing of sound production differs between opening and closing the mouth.

If there is only sound and no pain or functional limitation, treatment is not necessarily required. Whether there is locking and pain, as well as dietary restrictions, is more important.

Chewing hard and tough foods, chewing on one side, the habit of clenching teeth, and bruxism during sleep can tense the muscles around the jaw. We simultaneously check for tension and tenderness in the temples, cheeks, and muscles below the jaw, along with headaches and discomfort around the ears.

Dental occlusion and restorations may affect symptoms; therefore, dental evaluation and collaboration are considered when necessary.

If the mouth cannot open or close after hitting the jaw, if the jaw shape changes, or if there is bleeding or tooth damage, fracture and dislocation must be checked first. High fever, rapid facial swelling, and difficulty swallowing or breathing also require prompt medical attention.

In this condition, do not perform self-exercises that force the jaw to be pushed in or opened widely.

After evaluating the temporomandibular joint, chewing muscles, and movement of the neck and upper back, we may consider gentle techniques appropriate for the patient's condition. After treatment, we check the range of mouth opening and whether chewing, yawning, and speaking have become easier.

We may consider a direction that helps alleviate symptoms associated with tension in the nervous system and pain, stiffness, headaches, and dizziness by balancing the temporomandibular joint, but we do not assert that all symptoms originate from the temporomandibular joint alone.

During acute pain, you can practice the habit of avoiding tough foods and yawning widely, and chewing gently on both sides. Even with your mouth closed, you can help by not continuously clenching your teeth and relaxing the jaw.

Whether device therapy is needed is determined separately based on the condition of the teeth and temporomandibular joint, symptoms, and treatment goals; not all jaw sounds require the use of a device.

Record how wide the mouth opens, whether the jaw deviates to one side or subluxates, and the timing when sound or pain occurs. Please also report on hard foods, teeth grinding, chewing on one side, recent dental treatments, and headaches or discomfort around the ears.

Avoid actions such as repeatedly opening your mouth wide to hear sounds from the jaw or pushing the jaw with your hand to align it left and right, if you believe there is sound coming from the jaw. During periods of severe pain, reduce intake of tough foods and large portions, take smaller bites, and frequently check whether you are clenching your teeth. In your usual state, you can practice lightly closing your lips and keeping your upper and lower teeth in a relaxed, separated position.

After treatment, we check not only whether the jaw sounds have decreased but also how eating time, mouth opening, yawning/speaking, and headaches have changed. If the jaw suddenly dislocates and cannot close, if occlusion changes after trauma, or if there is swelling or fever, prompt dental or emergency evaluation is recommended.

If symptoms begin after a new prosthesis, orthodontic treatment, or dental procedures involving prolonged mouth opening, the timing of treatment and changes in occlusion must be reported. A Korean medicine clinic can assess jaw, neck and chewing-muscle function, but tooth fractures, bite problems and infection require dental evaluation. By dividing the roles of the two physicians and collaborating, unnecessary stimulation can be reduced.

Recording jaw symptoms together with the point at which sound occurs, the direction in which the mouth closes, the number of times this happens, the size of food that can be eaten, and accompanying headaches or discomfort around the ear will be helpful. After treatment, we check whether jaw sounds have decreased and whether opening the mouth, chewing, and speaking have become easier; if dental or occlusion problems are suspected, we coordinate evaluation with a dentist.

Treatment of the temporomandibular joint does not aim to perfectly align the left and right shapes of the face. We check whether mouth opening, chewing, speaking, clenching during sleep, and neck symptoms and headaches actually change; if appliance treatment is needed, the teeth and bite are assessed separately.