The temporomandibular joints sit just in front of each ear and move every time you speak, chew or swallow. When they or the muscles that drive them are strained, the result is jaw pain, clicking, headaches, earache and limited opening, collectively called temporomandibular disorder (TMD). Facial pain also has other causes, including trigeminal neuralgia, a sharp, electric-shock pain along the nerve of the face that is often misdiagnosed as a dental problem and leads to unnecessary extractions. Both of our surgeons have published research on the drug treatment of trigeminal neuralgia.
Is this treatment for you?
Consider a consultation about TMJ disorders & facial pain if you have:
- Clicking, popping or grinding in the jaw joint
- Jaw locking open or closed
- Pain in front of the ear, temple or cheek
- Morning jaw stiffness or headaches from night grinding
- Worn, chipped teeth from bruxism
- Sharp shooting facial pain triggered by touch, chewing or cold
- Jaw dislocation
Conservative treatment comes first
The great majority of TMD improves without surgery. Treatment begins with an accurate diagnosis, then jaw rest and a soft diet during flare-ups, anti-inflammatory medication, muscle relaxants, physiotherapy exercises, heat, and a custom-made occlusal splint (night guard) to unload the joint and protect the teeth from grinding. Stress and sleep quality are addressed because clenching is often the driver.
Injections and minimally invasive procedures
For joints that do not settle, arthrocentesis (washing out the joint with sterile fluid under local anaesthesia) relieves pain and improves opening in locked joints. Corticosteroid or hyaluronic acid injection into the joint and botulinum toxin injection into overactive chewing muscles are further options.
Joint surgery
A small number of patients with disc displacement, degenerative disease, ankylosis (a fused joint) or recurrent dislocation need surgery, from arthroscopy and disc repositioning to joint reconstruction. These are performed in hospital under general anaesthesia and are the province of maxillofacial surgeons.
Trigeminal neuralgia and neuropathic pain
Diagnosis is clinical and the first-line treatment is medication such as carbamazepine or oxcarbazepine, carefully titrated and monitored. Where a dental cause has been excluded we coordinate with neurology and, where necessary, neurosurgery. Getting this diagnosis right saves patients from losing healthy teeth.
What happens, step by step
- 1
Diagnosis
Detailed history, joint and muscle examination, OPG; CBCT or MRI of the joint if needed.
- 2
Conservative phase
Splint, medication, exercises and habit management for 6 to 12 weeks.
- 3
Procedures if required
Arthrocentesis or injections in clinic; surgery in hospital for the few who need it.
- 4
Maintenance
Splint reviews and adjustment; coordination with your dentist for any bite work.
Recovery and aftercare
Conservative treatment has no downtime. After arthrocentesis, expect mild soreness for a day or two and an early improvement in opening. Joint surgery involves a short hospital stay and several weeks of physiotherapy exercises.
Common questions
Will my clicking jaw get worse?
Painless clicking is common and often needs nothing more than reassurance and avoiding wide yawns and hard foods. Clicking with pain or locking should be assessed.
Is a night guard from a chemist good enough?
Boil-and-bite guards are bulky and can worsen clenching. A thin, hard, custom-fitted splint made from impressions of your teeth is more comfortable and clinically effective.
My dentist extracted a tooth but the pain is still there. Why?
This is a classic presentation of trigeminal neuralgia or another neuropathic pain, where the nerve rather than the tooth is the source. Please see us before any further extraction.
What this costs
Fees depend on the complexity of your case, the materials used and whether preparatory work such as grafting is needed. You receive a written, itemised estimate after your examination, before any treatment begins.
Medically reviewed by Dr Syed Muhammad Zaki Mehdi, BDS, FCPS (OMFS), CHPE, C-Implantology, Consultant Oral & Maxillofacial Surgeon. Last reviewed 16 September 2026. This page is general information and does not replace an examination.