Pillar three
Jaw pain, and the headaches nobody connected to your bite.
You have been to a GP, possibly an ENT, maybe a physiotherapist. The scans came back clear. The pain is still there every morning. There is a reasonable chance the answer is the joint your teeth hang off.
The symptoms
Things patients never think to mention to a dentist.
If three or more of these are familiar, the temporomandibular joint is worth examining properly.
- Clicking or popping when you open
- The jaw catching or locking
- Aching just in front of the ear
- Worse in the morning than at night
- Headaches around the temples
- Ear pressure with a clear ear examination
- Being told you grind in your sleep
- Front teeth wearing flat
- Tightness down the side of the neck
- Chewing on one side only
- Teeth that feel like they do not meet properly
- A dull ache after a long meeting or a long flight
Why it gets missed
The symptom and the source are in different places.
The muscles that close your jaw run up through the temples. When your bite is unbalanced, those muscles work harder than they were built to, all day and often all night. The ache shows up in the head, and nobody thinks about teeth.
A GP examines the head. An ENT examines the ear. A physiotherapist examines the neck. All three can be thorough and all three can still miss a joint that sits between them, because the bite is not part of any of those examinations.
That is not a criticism of any of them. It is simply why jaw problems take years to land in the right chair.
For referring doctors
If you see these patients, we would like to hear from you.
ENT surgeons with a normal otoscopy and persistent ear pressure. Physiotherapists with cervical pain that keeps returning. Neurologists with tension-type headache that does not respond as expected. Gynaecologists seeing gum change in pregnancy.
Dr. Amaey A. Parekh will assess the joint and the bite and send you back a written note. There is no obligation attached to the referral and the patient returns to you.
How it is assessed
Measured, not guessed at.
The history, in detail
When it started, what makes it worse, how you sleep, what you chew, how much stress the last year has held. Most of the diagnosis is in this conversation.
The joint examined directly
Opening range measured, the path the jaw takes on opening watched, joint sounds palpated, and the closing muscles pressed to find which ones are tender.
The bite recorded
How the teeth actually meet, where the first contact lands, and which surfaces are wearing. Wear facets tell you what has been happening at night.
A plan you can live with
Usually a splint made from your own impressions, habit change, and sometimes physiotherapy alongside. Irreversible adjustment of teeth is a last resort, not a first move.
On night guards from a chemist
A shop-bought guard cushions the tooth surface a little. It is not made to your bite and a poorly fitting one can load the joint in a way that makes things worse rather than better. A splint made from your own impressions is designed to hold the jaw in a specific position, which is a different job entirely.
TMJ questions
What people ask once they suspect the jaw.
What are the signs of a TMJ problem?
Clicking or popping on opening, the jaw catching or locking, aching in front of the ear, pain that is worse in the morning, headaches around the temples, ear pressure with a clear ear examination, and front teeth wearing flat.
Why did my doctor or ENT not find anything?
Because the symptom appears somewhere other than the source. Headache, ear pressure and neck tightness are all things a jaw joint can produce, and the joint and the bite are not usually part of a general or ENT examination.
Do I need surgery?
Very rarely. Most cases settle with a properly made splint, habit change and physiotherapy alongside. Surgery is the exception and it is not where treatment starts.
How long does treatment take?
Many patients notice a change within a few weeks of wearing a correctly made splint, but joints settle at their own pace. We review at intervals rather than promising a date.
Can my bite really cause headaches?
It can. The muscles that close the jaw pass through the temples, so when the bite is unbalanced they overwork and ache. This is the connection most patients are never told about.
I grind at night because of stress. Is a dentist the right person?
Both things are true at once. Stress drives the grinding and the grinding damages the teeth and joint. A dentist protects the structures while you deal with the cause, and the two work better together than either alone.
When teeth have already worn down
Rebuilding a collapsed bite is prosthodontic work, planned as one case.
See implants and rehabWhen the bite needs moving
Some jaw pain is an alignment problem rather than a joint problem.
See alignersWho does the assessment
Dr. Amaey A. Parekh, MDS Prosthodontist and Implantologist.
Meet Dr. AmaeyTalk to us first
Send us your problem before you send us a booking.
Tell us what is bothering you on WhatsApp. If you already have an X-ray or an OPG, send a photo of it. You will get an honest answer from a dentist, not a call centre, and you will know what you are walking into before you sit in the chair.