TMD assessment
We examine the range of movement, palpate the joints and muscles, listen for sounds, check the bite and screen for red flags. Imaging is arranged only where the findings warrant it.
About this treatmentDental condition · Wimpole Street, Marylebone
TMJ pain: understanding jaw joint disorders and the conservative route to relief
The temporomandibular joints sit just in front of each ear, where the lower jaw hinges and glides against the base of the skull. They are used thousands of times a day for speaking, chewing and swallowing, and a small disc of cartilage cushions each one. When the joint, its disc or the muscles that drive it become painful, the result is grouped under temporomandibular disorder, or TMD. Pain may sit directly over the joint, radiate to the ear, temple or cheek, or appear as a headache that no scan explains. The jaw may click, grate, catch or refuse to open fully. It is common, affecting perhaps one in ten adults at some point, and in most people it is a muscular and joint strain problem rather than structural damage, which is why the large majority settle with conservative measures. Our Wimpole Street dentists assess the joint, the muscles, the bite and the habits feeding into them, and treat in a stepwise fashion, starting with the least invasive options.
Recognising it
How it usually feels
Dull ache in front of the ear, worse with chewing or in the morning
Joint inflammation or overworked muscles; morning pain points to night-time clenching.
Clicking or popping on opening or closing
The disc slipping on and off the condyle; harmless in isolation.
Grating or crunching sound
Bone surfaces in contact, often with wear in the joint; assessed but frequently stable.
Restricted opening, or the jaw deviating to one side
Muscle guarding or a disc that has stopped repositioning.
Ear pain, fullness or ringing with a normal ear examination
The joint and the ear share nerve supply, so pain is often felt in the wrong place.
Temple or side-of-head headache
The temporalis muscle in spasm; frequently mistaken for tension headache or migraine.
Behind the symptoms
What's going on
- 01
Muscle overuse
Clenching by day, grinding at night, gum chewing, nail biting and prolonged wide opening at a long dental appointment all fatigue the chewing muscles. Tired muscles ache, develop trigger points and hold the jaw in a protective, tight posture that perpetuates the pain.
- 02
Disc displacement
The cartilage disc can slip forward of its normal position. It clicks as it pops back into place on opening. If it stops reducing, the jaw may lock with limited opening for a period. Most displacements adapt over months and become painless even if a click remains.
- 03
Joint inflammation and arthritis
The joint capsule can become inflamed after strain or minor injury. Osteoarthritis produces wear of the joint surfaces and a grating sound, more common with age. Rheumatoid and other inflammatory arthritides can affect the TMJ and are managed jointly with a rheumatologist.
- 04
Stress and central sensitisation
Anxiety, poor sleep and low mood lower the pain threshold and increase muscle tension. Long-standing TMD is often part of a wider picture with neck pain, headaches or fibromyalgia, and treating the jaw alone without addressing sleep and stress gives partial relief.
- 05
Trauma and bite changes
A blow to the chin, whiplash, or a sudden change in the bite from a high filling or a lost molar can precipitate symptoms. Bite discrepancies are rarely the sole cause but can be a contributory factor and are corrected where clearly relevant.
Before your appointment
What you can do today
- Eat soft food for two weeks, cut things small, and avoid chewing gum, crusty bread and anything requiring a wide bite.
- Apply a warm compress to the side of the face for ten minutes, twice daily, followed by gentle massage of the cheek and temple muscles.
- Keep teeth apart during the day: rest the tongue on the palate and let the jaw hang slightly open.
- Avoid yawning wide, resting your chin on your hand and sleeping face down with the jaw pushed sideways.
- Take ibuprofen for a short period if you can, following pack directions, to reduce inflammation in the joint.
- Practise slow, straight opening in front of a mirror, a few repetitions several times a day, stopping short of pain.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
In the chair
How we treat it at Wimpole Street
Conservative TMJ treatment
Reassurance, exercises, habit change and short-term anti-inflammatories form the first tier, and around three-quarters of patients improve on these alone within two to three months.
About this treatmentStabilisation splint
A hard acrylic appliance worn at night unloads the joints, relaxes the muscles and protects the teeth from clenching. Custom made from a scan and adjusted so the bite is even; indicative fee £795.
About this treatmentBruxism management
Where clenching or grinding drives the pain, we address triggers, daytime habits and, in selected cases, muscle-relaxing injections to the masseter.
About this treatmentPhysiotherapy and medical referral
Specialist jaw physiotherapy, and referral to oral surgery or a facial pain clinic for persistent locking, suspected arthritis or pain that has not responded to first-line care.
Bite correction where indicated
A high restoration is adjusted, or a missing molar replaced, when it is clearly contributing. Extensive bite reconstruction for TMD is rarely justified and not offered as a first step.
About this treatmentFees
Costs to expect
A TMD consultation at Wimpole Street, with joint and muscle examination and any X-rays, is expected to be £95. Advice, exercises and a self-care programme are part of that visit. A stabilisation splint is indicative at £795 including the scan, fitting and a review adjustment.
If clenching has cracked or worn teeth, repairs are quoted separately: bonding from £395, a crown or onlay at £995. Referral to physiotherapy or a specialist clinic is arranged through your GP or privately, and we write with our findings. Fees are confirmed in writing before appliances are made.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Don't wait if
When to see a dentist
- Jaw or ear-area pain has lasted more than two weeks or keeps returning.
- Your jaw locks, catches or will not open as wide as it used to.
- You wake with a stiff jaw or temple headache most mornings.
- Clicking has become painful or is accompanied by swelling.
- Pain began after a blow to the jaw or a whiplash injury.
- You have been told your ears are normal but the ear pain continues.
FAQ
Common questions
A click on its own, without pain or locking, is very common and does not need treatment. It reflects the disc moving slightly out of position and back. We treat the pain and function, not the noise. If the click becomes painful, or the jaw starts catching, that is the point to be assessed.
For many patients it reduces pain substantially, particularly when night-time clenching is the driver, but it works alongside exercises and habit change rather than instead of them. It is not a lifelong fix in itself; some people wear it long term for comfort, others need it only through a difficult period.
Very rarely. Surgery is reserved for joints with structural damage that has not responded to everything else, or for persistent locking that cannot be released. Well over nine in ten patients are managed without any surgical procedure.
Yes, and it is one of the most consistent findings. Stress increases muscle tension, disrupts sleep and lowers the threshold at which pain is felt. Patients often notice symptoms flare during exams, bereavement or work pressure and ease afterwards. Addressing sleep and stress is therefore a legitimate part of jaw treatment.
Most acute episodes settle within weeks to a few months with rest and simple measures. A proportion of people have a fluctuating course with flares over years. Early advice and a splint where appropriate reduce the length and severity of episodes.
Not as a primary treatment. Research has not shown that reshaping the bite reliably relieves TMD, and it is irreversible. We adjust a single obviously high spot if there is one, and otherwise manage the condition conservatively.
Marylebone, W1
Wimpole Street opens 1 October 2026
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
Until we open
Need an appointment before 1 October 2026?
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
South Kensington
- 20 Old Brompton Road, London SW7 3DL
- Open seven days a week
- 020 7183 2362
St Paul's, City of London
- 5 Ave Maria Lane, London EC4M 7AQ
- Open Monday to Friday
- 020 7183 3709
