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Pain Management

TMJ and Jaw Pain Treatment in Montville, NJ

Jaw pain, clicking, facial tension and headaches from temporomandibular joint disorder — treated without surgery.

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Does this sound like you?

  • Pain in the jaw, in front of the ear, or across the temples
  • Clicking, popping or grating when you open your mouth
  • Jaw that locks, catches, or will not open fully
  • Headaches at the temples, often on waking
  • Aching teeth with no dental cause found
  • Facial tightness, or waking with a clenched jaw

You do not need all of these, and having them does not confirm the diagnosis — that is what an examination is for. But if several look familiar, it is worth being seen.

The joint, and what usually goes wrong at it

The temporomandibular joint sits just in front of each ear and does something no other joint does: it hinges and slides, and it does so a couple of thousand times a day. A small disc inside it keeps the two surfaces apart.

Most TMJ pain is not the joint failing. It is the muscles that drive it — masseter, temporalis, the pterygoids — working far harder than they should, usually from clenching or grinding, and often at night when you have no idea it is happening. Those muscles are notorious referrers: masseter refers into the teeth and the ear, temporalis refers into the temple and behind the eye. Which is why people with TMJ pain so often present to a dentist with a toothache for which no cause can be found.

What the appointment covers

Examination of the joint — how far the jaw opens, whether it deviates to one side, what clicks and when. Palpation of each of the muscles involved, which usually reproduces the patient’s pain and is often the moment the problem makes sense to them.

Then the neck, because the upper cervical spine refers into the face and jaw, and because the two problems commonly travel together. And the picture around it: stress, sleep, daytime clenching habits, gum, nail-biting, a side you always sleep on.

Treatment

Trigger point injections into the masseter and temporalis where those muscles are in spasm. This is often the intervention that breaks the cycle, because a muscle that is clenching because it hurts and hurting because it clenches will not talk itself out of that.

Botox into the same muscles in selected cases, reducing the force available for clenching over a period of months. Used where the problem is clearly muscular and simpler measures have not held.

Treatment of the neck where it is contributing.

The practical layer, which matters more than it sounds: a dental guard where grinding is confirmed, awareness training for daytime clenching, jaw rest, soft diet through a flare, and stopping the habits that keep loading the joint.

Surgery is rarely the answer for TMJ pain and is not performed here. Where a dental or maxillofacial opinion is needed, you will be told.

Treatment

How tmj / jaw pain is treated here

Which of these applies to you is decided by your examination, not by a price list. Each page says what the treatment involves and what it does not do.

Trigger Point Injections

A fine needle into a muscle locked in spasm, to break the cycle and make rehabilitation possible. Minutes to do, and often the step that unblocks everything else.

What it involves →

Botox for Migraine

A series of small injections given every twelve weeks to reduce how many headache days you have. Preventive, FDA-approved for chronic migraine, and covered by many plans.

What it involves →

Questions patients ask

Is TMJ pain a dental problem?

Often it is not, though the dentist is usually the first person to hear about it, and dental assessment is genuinely worth having. Most TMJ pain is muscular — the masseter, temporalis and pterygoid muscles overworking, frequently from clenching or grinding — rather than a structural problem with the joint. Those muscles refer pain into the teeth, the ear and the temple, which is why teeth get investigated first and found to be fine.

Should I be worried about the clicking?

Painless clicking on its own is very common and generally does not need treatment. Clicking with pain, or a jaw that locks or catches, is worth assessing. The click tells you the disc inside the joint is moving in a way it should not; whether that matters depends on the symptoms it comes with.

What treatments are there short of surgery?

A good deal. Injections into the overworked muscles to break the cycle of clenching and spasm. Treatment of the neck, which contributes to jaw pain more often than people expect. Practical changes to the habits keeping the joint loaded — daytime clenching, chewing gum, sleeping position — and a mouth guard where grinding is the driver. Surgery for TMJ is uncommon and is a long way down the list.

Can Botox help TMJ?

Injected into the masseter and temporalis muscles it reduces the force of clenching, which can break a cycle of spasm and pain in people whose problem is muscular. It is used for jaw pain and clenching rather than for the joint itself, and it is not a first step — habits, the neck and simpler measures are addressed first. Dr. D’Alessio will explain what is and is not covered by insurance for this use.

Related conditions

Neck Pain

Persistent neck pain and stiffness, including pain that refers into the shoulder, arm or head. Assessed properly before anything is injected.

Chronic Migraines

Frequent, disabling headaches — including chronic migraine treated preventively with Botox, and headaches that are actually coming from the neck.

Tell us what’s going on

A consultation is a conversation and an examination, not a sales appointment. Dr. D’Alessio will tell you what she thinks is causing it, what can be done about it, and — when that is the honest answer — that you do not need a procedure.

Request an appointmentor call (973) 397-5304