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TMJ and Ear Pain - Causes, Symptoms, Treatment

May 21, 2023

One of the leading symptoms of temporomandibular joint (TMJ) disorders is ear pain. In fact, it is one of the more commonly reported symptoms. Your temporomandibular joint is connected to many of the muscles found in the maxillofacial region and as a result, a problem with your TMJ can cause pain across your face. Fortunately, experts like Dr. Katherine Phillips can provide TMJ disorder treatment, thus providing lasting relief.

What is TMJ?

The TMJ are the joints that connect your jaw to your skull on each side of your head just below your ears. Acting as a sliding hinge, moving side to side, up and down, and back and forth, they enable you to chew, talk, yawn, and more. Due to overuse, when injured, or when certain medical conditions affect your TMJ, TMD-related inflammation, pain, and swelling can wreak havoc on your quality of life. The pain and discomfort of TMD is not surprising when you consider how often you use these complex joints.

What are the symptoms of ear pain from TMJ?

The maxillofacial region, which includes the TMJs, is immensely complex and closely interconnected. Just think about the many different facial expressions you can make and the many ways you can move your jaw and mouth. The intricate system of muscles, joints, and other tissues of the maxillofacial region make all this possible. You can click here to learn about the basics of your TMJ and how it functions.


This intricacy also means TMJ disorders (TMD) can cause pain and other complications across the face. Since your ears are located less than a half an inch from your TMJs, this includes ear pain.

Symptoms of ear pain from TMJ Ear pain might be a dull, ongoing irritation or it could be a sharp, searing pain. The pain may worsen with jaw movement, although not always. Inflammation and swelling due to TMD can spread to the ear causing ear pain. Additionally, straining the muscles connected to the TMJ can result in ear pain as well as tension headaches and pain behind the eyes.


By addressing the TMJ disorder, you may be able to address pain in your ears and elsewhere. If your ear pain is the result of a TMJ disorder, treatments that target only the ear, or ear infections, may be ineffective.


What are the causes of ear pain due to TMJ?

Inflammation in the TMJ

As with any joint in your body, when the TMJ is overused, injured, or are afflicted with a chronic condition such as osteoarthritis, it and the muscles around it can become inflamed. Generally speaking, inflammation is the body’s immune system’s response to an irritant. Although the inflammation originates in the TMJ, it can spread to tissues and muscles surrounding the area, including the ear.


Swelling in the TMJ

Swelling and inflammation usually go hand-in-hand, and blood flow to an affected area increases with inflammation. This can result in a buildup of fluid not only inside the TMJ, but in surrounding tissues. This buildup causes swelling, signified by an increase in the size or a change in the shape of the affected area.



Overuse putting pressure on the TMJ

The TMJ is one of the hardest-working joints in your body. You use it to talk, eat and drink, yawn, and even when you open your mouth to breathe or sigh. Overuse and subtle muscle spasms caused by teeth grinding (bruxism) and clenching, and repetitive actions such as chewing gum, puts extra pressure on the TMJ. This may result in inflammation and swelling. Pain and tenderness in the TMJ due to overuse can radiate to surrounding tissues, including the ears.


Stress

Being under stress can cause you to clench and/or grind your teeth which puts extra strain and pressure on your TMJs. These actions can cause  stress-induced TMJ disorder.


Presence of osteoarthritis or rheumatoid arthritis in the TMJ

Osteoarthritis is the most common form of degenerative arthritis. It can affect every joint in the body, including the TMJ. Osteoarthritis of the TMJ affects both the hard and soft tissues around the TMJ, changing the shape and functioning of the jaw.


Rheumatoid arthritis is a chronic,  autoimmune disease. It attacks the lining of the TMJ causing it to become inflamed and damaging the joint tissue.


Do I have an ear infection or TMJ related ear pain?

To properly diagnose whether your ear pain is the result of an infection or TMJ disorder-related, you should consult a medical professional. However, be aware there are some important differences between the two types of pain.

TMJ-related ear pain is most often felt in front of or below the ear. With ear infections, the pain is often inside the ear. If the pain sharpens when you move your mouth, this may also indicate a TMJ disorder is resulting in ear pain. Also, check for the TMJ disorder symptoms below, or see our TMJ disorder symptoms page.


Often, it’s best to first rule out ear infections. A quick visual inspection is usually enough to diagnose these infections. With TMJ disorders, the most effective way to diagnose a problem is with a Cone Beam CT Scan, which produces a 3-D image of your jaw joint, combined with a physical examination of a doctor experienced in orofacial pain and TMD.

What are some of the other symptoms of TMD?

 

While many people rightly associate jaw pain with TMJ disorders (TMD), the nature of the temporomandibular joint means pain can turn up elsewhere, including the ears. In fact, ear pain is one of the most common symptoms of TMD. Likewise, the most common cause of ear pain in adults is TMD, not ear infection. 

 

Other symptoms of TMD include:

 

  • Jaw pain
  • Headaches
  • Clicking or Popping sounds when moving the jaw
  • Locked jaw or limited range of motion
  • Ear fullness
  • Tinnitus (ringing in the ears)
  • Pain behind the eyes
  • Neck and shoulder pain
  • Other orofacial pain

 

What treatments exist for ear pain associated with TMJ?

 

Fortunately, it is possible to both diagnose and treat TMJ disorders. It’s important to seek professional help if you are suffering from a TMD as the disorders are easy to misdiagnose and mistreat. Further, each TMD will require its own treatment plan. While cases may be similar, they are never identical. Let’s look at some of the more effective types of treatments .

 

Home Exercises and Stretches for TMJ

 

There are a variety of home exercises and stretches that you can perform to strengthen your jaw and the connecting muscles. Over time, this could provide pain relief. One of the simple things you can do to relieve TMJ pain is practice holding your lips together while keeping your teeth separated. In this position, the TMJ isn’t engaged. Stretching exercises such as those below also help with pain relief.

 

  • Close your mouth. With your head facing straight ahead, glance to the right with your eyes only. Extend your lower jaw to the left and hold for 5-10 seconds. Repeat on the opposite side.
  • With your shoulders back, chest up, and jaw relaxed, pull your chin straight back, creating a “double chin.” Hold for three seconds and repeat 10 times.
  • Touch your tongue to the roof of your mouth, then slowly open and close your mouth.
  • Slowly open your mouth as wide as you comfortably can while holding your tongue in a neutral position. Hold in place for 5 to 10 seconds. Close your mouth then open it again slightly. Gently glide your jaw back and forth five to 10 times.

 

Additionally, you can gently massage your TMJ and the surrounding muscles. A hot or cold compress can provide immediate relief. And if you’re eating hard, crunchy foods, it’s time to change your diet. Opt for softer, easier to chew foods that won’t strain your joints and muscles.

 

If you want to massage your TMJ or use strength-building exercises, it’s smart to talk to a professional. He or she will be able to teach you how to perform these exercises appropriately.

 

When should you see a medical professional for TMJ ear pain?


Seek attention from a TMJ medical expert such as Dr. Katherine Phillips if you have persistent pain or tenderness in your jaw, which may be accompanied by ear pain and other symptoms. Untreated or undertreated TMD can lead to a host of long-term issues, including blocked eustachian tubes and possibly hearing loss.  Your TMJ specialist can discuss possible causes and treatments for your problem

Why it's important to work with a TMJ specialist.

TMJ disorders can be extremely complex. The symptoms are often diverse and vary from case-to-case. So too does the underlying cause. A treatment plan that addresses the TMD in one patient won’t necessarily treat the pain in another patient.

If you are suffering from ear aches and exhibiting TMD symptoms, you should consider working with a professional. He or she may be able to:

  • Provide physical therapy
  • Teach you how to perform strength-building exercises
  • Prescribe anti-inflammatory drugs and muscle relaxants
  • Build custom bite orthotics to realign the jaw and reduce stress on the jaw joint complex.

In some cases, surgery may be required or other treatment plans will have to be devised. Lifestyle changes, such as quitting smoking, may also help. A TMJ disorder specialist can work with you to develop an effective treatment plan that will resolve your disorder and provide pain relief.

How do doctors diagnose ear / TMJ related jaw pain issues?


TMJ disorders are often difficult to diagnose because the symptoms can mimic those of other medical conditions. Due to this, many sufferers go undiagnosed or underdiagnosed for years until they see a TMJ expert.


TMJ dentists take a detailed medical and dental history, and examine problem areas. Signs of overuse, such as worn down and cracked teeth due to grinding, will also be evaluated. As previously mentioned, a quick visual inspection is usually enough to rule out an ear infection. Diagnostics usually include imaging, such as advanced 3-D Cone Beam CT imaging or digital X-rays. 


When seeing your TMJ dentist, keep in mind:

  • Recent dental surgeries. Lengthy dental work that requires your mouth to be open wide for extended periods of time can cause or aggravate TMD.
  • Illnesses. Other health problems that coexist with TMJ disorders, such as chronic fatigue syndrome, sleep disturbances, or fibromyalgia.
  • Injuries. Just like other joints in your body, the TMJ can be injured which may lead to TMD. 
  • Changes to your mental health, such as stress, anxiety, or depression. When you are anxious, depressed, or stressed out, you may unknowingly tense up, clench your jaw, and even grind and gnash your teeth at night (bruxism). This puts extra pressure on your hard-working TMJs, resulting in over-use which can lead to pain and tenderness in the area and the joint itself.


Your dentist will examine your jaw, looking for the following:

  • Listen to your jaw. Damaged cartilage tissue can cause a popping sound and clicking sounds  in the TMJ.
  • Feel your jaw and around your face. Swelling along your jaw and throughout your lower face is a symptom of TMD. It can occur on one or both sides.
  • Look in your ears. Checking inside the ears helps rule out an ear infection.
  • Examine your mouth.  Cracked and worn down teeth are signs of bruxism (teeth clenching and grinding), which can cause TMD due to overuse.


Answering Your Frequently Asked Questions


Can TMJ disorders cause ear fullness and/or pressure as well?


TMJ disorders can result in a sensation of pressure or fullness in the ear, as well as other conditions such as tinnitus (ringing in the ears). The causes may include nerve irritation and changes at the base of the skull, or dysfunction in the muscles of the neck associated with TMD.


Can TMJ issues affect your hearing?


TMJ disorders may affect your hearing. It’s thought that pressure or inflammation from the TMJ can affect nerves and muscles in the area, leading to blocked eustachian tubes. When fluid cannot properly drain from the middle ear, it may result in difficulty hearing.


Is my TMJ related ear pain permanent?


Ear pain due to TMD does not need to be permanent. Successfully treating the causes of TMD and effectively managing TMD flare-ups can reduce TMJ pain and inflammation. This can reduce or eliminate any associated pain in surrounding tissues, including the ear.


Can the TMJ cause swelling behind or under the ear?


TMJ pain that radiates to ear pain is most often felt in front of or below the ear instead of inside the ear. This is because the TMJ is located below and just in front of the ear.


Does clenching my jaw cause ear pain?


Jaw clenching puts pressure on the muscles, tissues, and other structures around your jaw, including the TMJ. Excess stress on the TMJ can cause TMD, resulting in inflammation and swelling which can affect areas surrounding the TMJ, including the ear.

Are You Experiencing Ear Pain?

Dr. Katherine Phillips is a leading TMJ disorder specialist. Over the last 13 years (as of the publication of this article), she has treated thousands of patients suffering from a TMD. Using her vast experience and education, Dr. Phillips can help you devise a treatment plan that will provide both immediate and long-lasting pain relief. Get in touch today!

Contact Us Today For A Consultation!

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Dr. Kathrine Phillips
About The Author
Dr. Katherine Phillips, DDS, MS received her undergraduate degree from the University of Michigan and her dental degree from the University of Detroit Mercy School of Dentistry. She currently serves as the Secretary/Treasurer on the American Board of Dental Sleep Medicine (ABDSM) Board of Directors and treats TMD and sleep disordered breathing at Restore TMJ & Sleep Therapy in the Houston, TX area. 
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Teeth grinding is the most common cause of jaw pain. Grinding your teeth also results in fractured teeth and the destruction of dental work, which can even change how you look. People who grind their teeth during the day can make conscious changes to reduce their teeth grinding for those who grind their teeth at night . Fortunately, with a visit to Dr. Phillips, you can discover how to stop grinding your teeth. What is Teeth Grinding, and What Causes it? Grinding or clenching your teeth, or bruxism , is a common condition affecting millions of people and, if left untreated, can lead to broader health issues. According to the American Dental Association (ADA), a 2020 ADA Health Policy Institute report stated that half of the dentists saw a rise in clients with stress-related dental problems, primarily due to teeth grinding and jaw clenching. It can happen during the day or night and often goes unnoticed until the person is alerted by a partner or family member. Treating bruxism can prevent further damage to the teeth and relieve any symptoms associated with the condition, and there are several steps you can take to stop grinding your teeth and protect your oral health. People grind and clench their teeth for various reasons, including stress and anxiety, misalignment of the teeth and jaw, or an abnormal bite. In adults, teeth grinding is often caused by emotional tension and stress and can become a subconscious habit. In children, teeth grinding is usually due to an immature bite and can be triggered by new teeth erupting or the recent placement of braces. How Do You Know if You're Grinding or Clenching Your Teeth? Grinding or clenching your teeth can be challenging to identify since it usually happens when you are unconscious or sleeping. However, several signs could indicate you are grinding your teeth. Common symptoms of teeth grinding include: Waking up with a sore jaw Frequent headaches Increased sensitivity or pain in your teeth Tired or tight jaw muscles Pain that feels like an earache, but there is nothing wrong with your ear A locked jaw that is difficult to open or close completely Neck or face pain Noticing that your teeth feel different or worn down You or your sleep partner may also notice that you make clenching or grinding sounds during the night. At a dental appointment, your dentist may suspect teeth grinding if you have the following: Teeth that are chipped, loose, flattened, or fractured Worn enamel on your teeth Gum recession Possible Causes of Teeth Grinding Many people grind their teeth and tighten their jaws without realizing it, especially at night. Although stress and anxiety can lead to teeth grinding, other common causes are: Posture. Poor posture is not only horrible for your back; it's also bad for your teeth. When the body's joints aren't in proper alignment, it can result in jaw clenching and grinding. Misaligned teeth. If the upper and lower teeth don't fit together correctly, the misalignment may result in the tendency to grind teeth or clench jaw muscles. Sleep disorders. Sleep habits and sleep disorders can lead to teeth grinding at night. Chronic obstructive sleep disorder , also known as sleep apnea , is a known cause of sleep bruxism. Resolving sleep apnea can help stop teeth grinding. Sleep terrors and insomnia may also result in grinding teeth at night. Joint disorders. The temporomandibular region is around the jaw, mouth, and ears. This area contains the temporomandibular joints and jaw muscles, which allow the jaw to open and close. Disorders in this area can affect teeth grinding and a sore jaw. Stimulants. Stimulants like caffeine, nicotine, and alcohol can trigger teeth grinding. Avoiding these can help prevent teeth grinding. Stress. Stress is a common cause of teeth grinding and clenching. Finding ways to manage and reduce stress can help decrease teeth grinding. These can include relaxation techniques such as progressive muscle relaxation, yoga, deep breathing, meditation, and guided imagery can help relax the jaw muscles and stop teeth grinding. Chewing on Objects. Chewing on objects such as pencils or fingernails can trigger teeth grinding. You may also need to avoid chewing gum, which can exacerbate teeth grinding. Finding out how to stop grinding teeth at night takes getting to the root cause of grinding. Discovering the cause provides clues, pointing to the appropriate solutions. Prevent teeth grinding during the day. It is crucial to identify triggers that cause teeth grinding if you intend to stop grinding them during the day. Pay attention to your habits during the day and see if you notice when and if your grinding or clenching is worse. A TMJ specialist or dentist specializing in bruxism can provide you with exercises or relaxation techniques you can do throughout the day if you notice yourself clenching and, in some cases, offer medical treatment like muscle relaxants or Botox for bruxism. Prevent teeth grinding and clenching at night/in your sleep. You'll have to make changes during the day to stop grinding or clenching your teeth at night or in your sleep. Start by talking to your dentist or doctor to determine if you have underlying medical issues that could be causing the grinding. Additionally, your dentist may suggest you wear a mouthguard, splint, or other oral appliance. At the same time, you sleep to protect your teeth from further damage and keep your mouth in the proper alignment, helping your TMJ to relax. A custom-fitted mouthguard also helps lessen the impact of teeth grinding by covering the teeth to create a physical barrier that reduces damage. How To Stop Child/Baby Grinding Teeth Many children grind their teeth at night, but most grow out of it. If your child or baby grinds their teeth, the first thing to do is identify what might be causing the behavior. Stress, anxiety, or an underlying medical condition can cause your child to grind their teeth. If the grinding is stress-related, identifying and addressing the source of the stress, such as an overly demanding school schedule or peer pressure, may help. If a medical or dental condition causes the grinding, your child's dentist or doctor can help you determine the best action. If the grinding results from a habit, it can help redirect your child's attention when they start to grind and provide them with other activities that may help reduce their stress and anxiety. Side Effects of Teeth Grinding Grinding your teeth may seem like a harmless habit. After all, it's easier to notice this behavior if you're not on the lookout for it. 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Although some treatments aren't quite possible when you're asleep, their benefits can last even after you've gone to bed. Reductive coronoplasty. Reductive coronoplasty directly involves changing or leveling the biting surface of teeth. This procedure reshapes crowded or crooked teeth, improving teeth alignment. Conversely, additive coronoplasty can add to the surface of teeth to help treat bruxism. Dental Appliances: Mouthguards, night guards, and splints. A mouthguard does just that — it guards teeth. Typically used for sports, a mouth guard keeps teeth from injuries sustained during activity. A night guard protects teeth from grinding at night. Lastly, a bit splint guides jaw movement, enabling the jaw to land in the appropriate position. These appliances protect teeth differently, and finding the right one for your situation is essential. Biofeedback. Biofeedback allows a person to train themselves by monitoring auditory and visual stimuli from the body. Although biofeedback needs a person to be alert, the technique can still help sleep bruxism by reducing overall stress. Stress reduction techniques. Though implementing stress reduction techniques such as yoga, exercise, and meditation requires a person to be awake, they can also help with nighttime teeth grinding. Allowing muscles to decompress and relieve tension alleviates stress-induced teeth grinding, even at night. Tongue and jaw muscle exercises. Most people don't stop to think about it, but their faces and mouth are a team of tissue, muscles, bones, and joints that closely affect each other. The tongue, for example, affects how the jaw moves. You reduce teeth grinding by exercising the right muscles — like the tongue and jaw. Behavior changes. Behavioral modifications like changing your posture and avoiding environments that cause stress can reduce instances of teeth grinding. Cognitive Behavioral Therapy (CBT) can help change behavior and thought patterns that lead to teeth grinding. Medications. A doctor can prescribe medication to help treat bruxism if all other treatments don't work. When used for short periods, muscle relaxants can relieve tension in the temporomandibular area. In severe cases of teeth grinding, botox injections can alleviate muscle tension. Antidepressants and anti-anxiety medications assist in decreasing anxiety, allowing jaw muscles to relax and reduce bruxism. How Can a TMJ Specialist Help with Teeth Grinding and Clenching? A TMJ specialist is a dentist board-certified in orofacial pain and conditions affecting the TMJ. TMJ specialists have extensive knowledge and experience regarding the structure, function, and pathology of TMJ. In addition to more thorough diagnostic evaluations, they can often provide more effective and long-term solutions for teeth grinding than your doctor or dentist alone. This is because TMJ specialists use a holistic approach to treatment, focusing on the underlying causes of the teeth grinding, such as stress, anxiety, or misaligned teeth, rather than just treating the symptoms. They often work with other medical experts like dentists or sleep physicians for more comprehensive care and treatment. Protecting Your Oral Health Protecting your teeth is critical to taking care of your overall health. Chronic teeth grinding can result in costly dental work, poor oral health, and chronic pain. If you're experiencing a sore jaw, headaches, or cracked teeth, seeking an expert diagnosis to find the cause is the first step to finding a solution. Get the answers you need on how to stop grinding your teeth at night or keep from grinding in the daytime to protect your oral health. As a TMJ and sleep apnea dentist, Dr. Katherine Phillips specializes in diagnosing and treating bruxism. With her Master of Science in Orofacial Pain From USC and extensive experience in TMJ therapy, Dr. Phillips utilizes proven and effective evidence-based medical interventions to identify bruxism and help find the right treatments to suit your needs. Get in touch today for more information.
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The temporomandibular joint, or TMJ, is an anatomically complex joint, composed of muscles, joints, ligaments, bones, and discs. Proper jaw movement requires a high level of interaction and coordination among all these components, especially the articular disc (which absorbs stress), the adductors (jaw-closing muscles), the abductors (jaw-opening muscles), and jaw ligaments. This makes diagnosing problems or dysfunction with the TMJ extremely difficult. Properly diagnosing disorders of the TMJ—collectively referred to as TMD—requires both clinical examinations and medical imaging in order to develop an accurate assessment of the joint, its function, and its surrounding bone and tissue. If you are experiencing pain, discomfort, or dysfunction in your TMJ, you will first have a clinical evaluation. This is when your doctor or TMJ specialist will discuss your symptoms with you and examine your jaw, pressing on areas around it to identify any sensitivity. He or she will also observe the range of motion of your jaw and listen to and feel around your jaw while you open and close your mouth. In some cases, the doctor’s clinical findings are enough to diagnose a TMD and begin treatment. Other times, additional diagnostic imaging will be necessary to confirm the presence of a TMD.
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