Can TMJ Cause Tooth Pain? How to Tell the Difference
Patients often come to me with a toothache, and sometimes when I look at the tooth, I can’t find anything wrong with it. No decay, no crack, nothing going on at the gum. So where is the pain coming from?
Sometimes the answer is the jaw.
Your jaw joints and chewing muscles can refer pain (send it somewhere other than where it starts), and that pain can feel a lot like a sore tooth. But tooth pain has plenty of other causes too, like decay, a cracked tooth, gum problems or an infection. So if you’ve had pain that won’t settle, it’s worth getting it checked properly rather than guessing.
What is TMJ?
TMJ is short for temporomandibular joint. That’s your jaw joint, and you have one on each side, just in front of your ears.
It’s a very unusual joint. Most joints just pivot, but when you open really wide, your jaw joint actually slides forward out of its socket and then back in again. It can move side to side as well. That flexibility is what lets you chew, talk and yawn, and it’s also why things can go out of balance.
When people say they “have TMJ”, they usually mean temporomandibular disorder, or TMD. That’s the umbrella term for problems with the jaw joints, the chewing muscles, or both.
Symptoms vary a lot from person to person. The ones I see most often include:
- Jaw or facial pain
- Sore, tender muscles around the jaw or temples
- Pain when chewing
- Clicking or popping that hurts
- Trouble opening your mouth fully
- A jaw that locks
- Headaches around the temples
- Ear discomfort or a blocked feeling in the ears
And for some people, pain that feels like it’s coming from their teeth.
Why can jaw problems feel like a toothache?
Your teeth, jaw joints and chewing muscles all sit close together and share nerve pathways. When a muscle is overworked, your brain doesn’t always pinpoint exactly where the pain is coming from.
Two muscles are common culprits. The masseter (the big chewing muscle at the angle of your jaw) and the temporalis (the fan-shaped muscle at your temple). When they’re tight and tender, the ache can be felt in the upper or lower back teeth, even when those teeth are healthy.
Could clenching or grinding be the cause?
A lot of my patients grind their teeth at night and have no idea they’re doing it. Others clench during the day, often while they’re concentrating at the computer or sitting in traffic. The dental term for this is bruxism.
All that pressure adds up on your teeth and on the muscles that move your jaw. Signs to look out for:
- Waking up with a tired or sore jaw
- Teeth that feel sensitive
- Flattened or worn edges on your teeth
- Chips or cracks that keep happening
- Headaches at the temples in the morning
- Notches in the teeth near the gum line
Clenching doesn’t automatically mean you have TMD, but the two often turn up together.
I also look closely at how your teeth meet. Where your teeth fit together decides where your jaw joints and muscles have to sit. In my experience, when the bite holds the jaw in a strained position, the muscles can end up working much harder than they should.
Toothache or TMJ: what’s the difference?
Honestly, you can’t always tell from symptoms alone. They overlap a lot.
Pain from a particular tooth is more likely to come with sensitivity to hot or cold, pain when you bite on that one tooth, throbbing that won’t go away, or swollen and tender gums nearby. A visible crack, decay or a broken filling points that way too.
Jaw-related pain is more likely to show up alongside tender jaw muscles, stiffness, soreness after a long chew, clenching or grinding, painful clicking, limited jaw movement, or headaches and facial aches.
A dental examination is the only way to work out whether the pain is starting in the tooth, the muscles, the joints or somewhere else.
Does jaw clicking mean something is wrong?
Not necessarily. Plenty of people have a jaw that clicks now and then with no pain at all.
Inside the joint there’s a small disc of cartilage that works like a cushion, keeping the movement smooth. If that disc sits a little out of place, it can act a bit like a doorstop. The click is the jaw popping over it as you open.
A click on its own, with no pain and no locking, often doesn’t need treatment. It’s worth having it looked at if it comes with pain, locking, difficulty opening or chewing, or ongoing tenderness in your face or jaw.
How I assess jaw and tooth pain
When you come in with unexplained tooth or jaw pain, I don’t only look at the sore tooth. Depending on your symptoms, I’ll check:
- Your teeth and gums, including for decay and cracks
- Signs of wear from grinding
- Your existing fillings and crowns
- How your jaw opens, closes and moves side to side
- Your jaw joints and chewing muscles
- How your teeth come together when you bite
- X-rays, when they’re clinically needed
Where it’s appropriate, I may also use EMG scans (which measure how active your jaw muscles are) and jaw tracking (which records the path your jaw moves along). These give me a clearer picture of how your muscles and your bite are working together.
The aim is to find the likely source before we talk about treatment.
How is TMJ-related pain managed?
It really depends on what’s causing it and how severe it is.
For some people, small changes make a difference, like becoming aware of daytime clenching and giving the jaw a rest from heavy chewing. Other options may include an occlusal splint (a thin plastic guard that protects the teeth at night), a custom orthotic made using neuromuscular dentistry to support the jaw in a more relaxed position, physiotherapy, dental treatment, or a referral to another health practitioner.
Muscle-relaxant injections can ease tight jaw muscles for a while, but the effect wears off and they usually need repeating every three to six months. Where I can, I’d rather find what’s driving the pain than keep treating it over and over.
There’s no single treatment that suits everyone with jaw pain.
When should you see a dentist about jaw or tooth pain?
It’s worth booking an assessment if you have:
- Tooth pain that keeps coming back without an obvious cause
- Jaw pain that recurs
- Pain when you chew
- A stiff jaw in the mornings
- Frequent clenching or grinding
- Clicking that hurts
- Trouble opening your mouth, or a jaw that locks
- Teeth that are wearing down or chipping
Jaw and TMJ Assessment in Mosman Park, Perth
If you’ve got tooth pain that doesn’t add up, a sore jaw, or you suspect you’re clenching, come in and have a chat. At Smile Design Studio in Mosman Park, I’ll look at your teeth, your bite and how your jaw moves, then we’ll talk through the options that make sense for you.
Complimentary initial consultation
Your first consultation with me is free of charge. It’s a chance to talk through your symptoms, have a look at your teeth and jaw, and discuss whether further assessment could help. It doesn’t include X-rays, EMG scans, jaw tracking or any treatment. If further assessment or treatment is recommended, I’ll explain the costs to you before anything goes ahead.
Call (08) 9385 2000 or book online at smiledesignstudio.com.au/complimentary-consult
Book Your Complimentary Consultation
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
Dr Vicky Ho, General Dentist, Registered Dental Practitioner (DEN0001536037)
Frequently Asked Questions
Can TMJ make your teeth hurt?
It can. Problems with the jaw joints and chewing muscles can cause referred pain that feels like it’s coming from the teeth. Dental problems like decay or a cracked tooth can feel very similar, though, so ongoing tooth pain should always be examined.
How do I know if my tooth pain is from TMJ?
It’s hard to know without an examination. Jaw-related pain often comes with clenching, tender jaw muscles, headaches or painful jaw movement. Pain from decay or a crack is more likely to sit in one specific tooth.
Can clenching cause tooth pain?
Yes, it can. Repeated clenching puts pressure on the teeth and the muscles around them, and may lead to tenderness, sensitivity and wear over time.
Can TMJ cause pain on only one side?
Jaw and facial pain can show up on one side or both. Where the pain sits doesn’t tell you what’s causing it on its own.
Does a splint help with TMJ pain?
For some people, a splint or orthotic can reduce clenching pressure and ease muscle tension. The right type depends on what’s causing your symptoms, which is why an assessment comes first.
Should I see a dentist for TMJ pain in Perth?
A dental assessment is a good starting point when jaw pain comes with tooth pain, clenching, grinding, painful clicking or changes in how your jaw moves. Depending on what we find, a referral to another practitioner may also be recommended.
