Jaw Pain That Will Not Go Away: When It Is TMJ and When It Is Grinding

You wake up with a sore jaw. Some days there is a headache at your temples. Sometimes there is a click when you open wide.

You have probably been told it is stress, and you have probably been told to get a night guard. Both of those can be right.

But grinding and a jaw joint problem are two different things. They need different treatment, and a night guard only helps one of them properly.

What is the difference, in plain terms?

Grinding and clenching is a muscle habit. Your jaw muscles work when they should be resting, usually at night, sometimes during the day when you are concentrating.

The damage shows up on the teeth and in the muscles.

TMJ trouble is a joint problem. The temporomandibular joint is the hinge just in front of each ear, and it has a small disc inside it.

When that disc or the joint is not moving smoothly, you get clicking, catching, and sometimes a jaw that will not open all the way.

They overlap constantly. Long term grinding puts load through the joint, and a sore joint changes how you position your jaw, which makes you clench.

That is why two people can give you two different explanations and both sound right.

How do I tell which one I have?

The pattern of the symptoms tells you more than the pain does.

Points toward grinding. The ache is worst first thing in the morning and eases through the day. Your teeth look flat across the tips or the edges.

Teeth are sensitive to cold with no cavity to explain it. A partner has heard it. Your cheek muscles feel tight or tired.

Points toward the joint. A click or a pop when you open or close. The jaw catching, locking, or shifting to one side as it opens.

Pain right in front of the ear instead of across the cheek. Trouble opening wide enough for an apple. Ear ache with nothing wrong in the ear.

Points toward both, which is common. Morning ache plus clicking, headaches at the temples, and neck or shoulder tightness on the same side.

Does a night guard fix it?

It protects your teeth from grinding. That is its job and it does it well.

What a night guard does not do is stop you grinding. The habit is there, the muscles work all night, and the guard takes the wear instead of your enamel.

That is a win, because enamel does not grow back. But a guard is protection, not a cure.

For a joint problem, a guard can help by changing how the jaw rests at night. It can also do little, depending on what is happening inside the joint.

That is the reason to work out which problem you have before you buy a solution.

One thing worth saying plainly. The soft boil and bite guards from a pharmacy make clenching worse for some people, because a soft surface is something to chew on.

A custom guard is made to a hard or dual layer surface for that reason, and it is fitted to your bite.

What else causes jaw pain?

Worth ruling out before anyone treats you for grinding.

A cracked tooth can feel like jaw pain, especially on biting. An infected tooth can send pain along the jaw and up toward the ear.

Wisdom teeth pushing against a neighbor cause an ache at the back that people put down to the joint. Sinus trouble shows up as pain in the upper back teeth.

All of those are found with an exam and an x-ray, and all of them get treated differently.

What helps in the meantime?

None of this replaces getting it looked at. All of it is safe to try tonight.

Soft food for a few days. Rest the joint the way you would rest any other sore joint. Cut things up instead of biting into them, and give the gum a break.

Warmth on the muscles, cold on the joint. A warm compress on the cheek helps tired muscles. If the pain is at the joint in front of the ear, cold usually suits it better.

Notice your daytime jaw. Most people who clench at night also rest their teeth together during the day without knowing.

Lips together, teeth apart, is where your jaw should be at rest.

Ease off the wide yawns and the chewy foods for a while if the jaw has been catching.

When should I get it looked at?

Sooner than most people do.

Go now if the jaw locks open or locked shut, or if the pain is getting worse instead of settling. Go now if you cannot open wide enough to eat, or if there is swelling.

Book soon if the ache has gone on for weeks, if you are waking with headaches, or if your teeth are changing shape.

The reason to move on it: grinding is progressive. Worn enamel does not come back, and teeth flattened over years need more work than teeth caught early.

What we would do

Look at the teeth for wear patterns, check how the joint moves and where it clicks, and feel the muscles. Then take an x-ray to rule out a cracked or infected tooth.

That usually separates the two within one appointment.

Then we treat what is there. If it is grinding, a custom night guard made to your bite. If the joint is the problem, our page on TMJ treatment in Chicago covers what we do about it.

Often it is some of both.

If your jaw has been sore for weeks, come in and let us find out which one it is. (312) 602-0036.