Self-care programme
Written exercises, heat, diet modification and habit awareness. Free, and the first step for every patient; many need nothing more.
Part of assessment
Bite and jaw · Wimpole Street, Marylebone
TMJ treatment in Marylebone: settling an aching, clicking or locking jaw joint
The temporomandibular joints sit just in front of each ear and work harder than almost any other joint in the body, opening, closing, sliding and grinding thousands of times a day. When the joint, its cartilage disc or the muscles that drive it become strained, the result is a cluster of symptoms called temporomandibular disorder: aching around the ear and temple, clicking or grating on opening, a jaw that locks or deviates, headaches and sometimes ear fullness or neck pain. Most cases are muscular, most are linked to clenching, stress or posture, and most improve with conservative measures over weeks to months. At Wimpole Street the assessment will be £95, or £30 for new patients, and treatment ranges from advice and exercises that cost nothing to a laboratory-made stabilisation splint at £795 and small bite adjustments from £200. Surgery is almost never the answer and is not something we do.
- Assessment £95 (£30 new patients)
- Stabilisation splint £795
- Mostly conservative
Suitability
Is it right for you?
A good fit when
- A dull ache in front of the ear or in the cheek muscles, worse in the morning or after a long day of talking.
- Clicking or popping on opening or chewing, particularly if it has become painful or the jaw catches.
- A jaw that occasionally locks open or will not open fully.
- Headaches centred on the temples that dentists and doctors have not otherwise explained.
- Ear pain or fullness with a normal ear examination.
- Symptoms that started or worsened with a period of stress, a new medication or after dental work that changed the bite.
Think twice, or choose another route, when
- Sudden, severe pain with swelling or fever, which may be infection rather than joint strain and needs urgent assessment.
- A jaw that has locked and cannot be closed, which is a dislocation and needs same-visit reduction, usually in an emergency setting.
- Suspected inflammatory arthritis of the joint, which is managed with your GP or rheumatologist alongside dental measures.
- Painless clicking with no functional problem, which is common and generally better left alone.
- Anyone expecting a bite adjustment or surgery to resolve a muscular problem; the evidence does not support either as a first step.
The process
How it works at Wimpole Street
- 01
History
When the pain started, what makes it worse, whether the jaw clicks or locks, sleep quality, stress, clenching habits, posture and any recent dental work. The pattern usually points to muscle, joint or both.
- 02
Examination
Range and path of opening are measured, the joints are felt and listened to for clicks and grating, the chewing and neck muscles are palpated for tender points, and the teeth are checked for wear that betrays clenching.
- 03
Imaging, where justified
Most muscular cases need none. A panoramic radiograph screens the bony joint; MRI or CT are arranged through a specialist where disc displacement, arthritis or locking make them worthwhile.
- 04
Conservative care first
A soft diet for a fortnight, avoiding wide yawns and chewing gum, heat on the muscles, gentle stretching exercises, awareness of daytime clenching and short courses of anti-inflammatories are the foundation and help most people.
- 05
Splint therapy
Where symptoms persist or night clenching is clear, a hard full-coverage stabilisation splint is made from scans of both arches and adjusted so the jaw rests in a relaxed, even position. It is worn at night and reviewed after a month.
- 06
Review and onward referral
Improvement is measured against the baseline. Cases that do not respond, or where imaging shows joint pathology, are referred to a physiotherapist with jaw expertise or to an oral and maxillofacial team.
Choices
Options & materials
Stabilisation splint
Hard acrylic covering all the teeth of one arch, adjusted to give even contact and a relaxed jaw position. Worn at night for muscular and disc-related pain.
£795
Soft night guard
A quicker, cheaper interim appliance for mild clenching where a full splint is not yet justified.
From £185
Bite adjustment
Very small reshaping of high spots where a recent filling or crown has clearly changed how the teeth meet. Used sparingly and only for an identifiable cause.
From £200
Physiotherapy referral
Manual therapy, posture correction and a structured exercise programme with a physiotherapist experienced in jaw disorders.
Referral; physiotherapist’s own fees
Fees
What it costs
| Item | Fee |
|---|---|
TMJ assessment £30 for new patients. Panoramic radiograph £20 where indicated. | £95 |
Stabilisation splint Laboratory-made, fitted and adjusted; includes one review. | £795 |
Soft night guard Interim or mild cases. | From £185 |
Bite adjustment Only for an identifiable high spot. | From £200 |
Masseter muscle injections For persistent muscular pain alongside a splint. | From £450 |
Indicative Wimpole Street fees, the same as at South Kensington and St Paul's. A written plan with the exact figure is agreed before anything is started.
Outcomes
What the result looks like
Most temporomandibular disorders are self-limiting or respond to conservative care within a few weeks to a few months: pain eases, opening improves and the morning stiffness fades. Clicking often persists even when pain resolves, and a painless click is not something that needs treating. Splints help many patients, particularly those whose symptoms are worst on waking, though individual responses vary and the evidence for splints is stronger for pain relief than for stopping clicks.
A minority of cases involve real joint changes, disc displacement without reduction or arthritis, and these follow a longer course with specialist input. Surgery has a very small role, reserved for the few with structural problems that fail everything else; we would refer for that opinion rather than offer it.
Afterwards
Looking after the result
- Keep to softer food and avoid wide opening, gum and biting into hard fruit while symptoms are acute.
- Do the stretching and relaxation exercises twice daily; they work only if done regularly.
- Apply warmth to the cheek muscles for ten minutes before bed if they are tender.
- Notice daytime clenching: lips together, teeth apart, tongue resting lightly on the palate.
- Wear the splint nightly if one is made, and bring it to every review so wear patterns can be read.
- Address sleep and stress where you can; both feed jaw muscle tension.
Informed consent
Risks and honest limitations
Every treatment has trade-offs. These are the ones we discuss at the consultation so that a decision is made with full information rather than after the fact.
- Symptoms may recur during stressful periods even after a good response, and long-term management is often intermittent rather than a single course.
- Splints can feel bulky initially and, if poorly designed or worn only on some teeth, can alter the bite; full-coverage designs and regular review avoid this.
- Bite adjustment is irreversible and, done for the wrong reasons, can worsen symptoms; it is offered only for a clear mechanical cause.
- Anti-inflammatory medication has its own side effects and is used short term.
- Imaging can reveal joint changes that are incidental and not the cause of pain, which needs careful interpretation.
- A small number of patients have persistent pain that no dental measure fully resolves and benefit from a chronic pain approach.
FAQ
Questions patients ask
Usually overworked chewing muscles from clenching or grinding, often linked to stress, poor sleep or posture. Less often the cartilage disc in the joint has shifted, or the joint itself is inflamed or arthritic. Many patients have a mixture.
Not on its own. A painless click that does not catch or lock is very common and does not need treatment. It becomes worth assessing when it hurts, the jaw sticks, or opening is restricted.
It helps many patients with pain and morning stiffness, particularly where night clenching is the driver. It is less reliable for stopping clicks and does nothing for the underlying stress or posture, which is why it is combined with self-care.
Rarely. Grinding teeth down to treat jaw pain has a poor evidence base and cannot be undone. We reserve it for a clear high spot from recent dental work.
Almost certainly not. Surgery is for the very small number with structural joint problems that have failed every conservative measure, and it is carried out by hospital maxillofacial teams to whom we would refer.
Yes, at South Kensington or St Paul’s now at the same fees, with splint reviews in Marylebone from 1 October 2026.
Keep reading
Related treatments and guides
Marylebone, W1
TMJ treatment at Wimpole Street from 1 October 2026
Register your interest and we will contact you as soon as the Marylebone diary is live. If you would rather start sooner, the same clinicians already see patients in South Kensington and at St Paul’s.
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
