TMJ and jaw pain in Toorak

What the TMJ is, and why it complains

The temporomandibular joint is the hinge just in front of each ear where the jaw meets the skull. It is an unusual joint: it hinges and it slides, it has a small disc of cartilage inside it, and the two sides are locked together by one bone, so neither can move without the other. That last point matters, because it means a problem on one side is felt as an unfair workload on both.

It is also one of the most used joints in the body. Talking, chewing, swallowing, yawning, and for many people a great deal of clenching that they are unaware of. Clicking on its own, with no pain and no restriction, is common and often means nothing. Clicking with pain, with a jaw that locks or with a bite that has changed, is worth assessing.

Why the neck is nearly always involved

The jaw does not sit on top of a fixed post. It hangs from a skull that is balanced on the top of the neck, and the muscles that close the jaw share nerve supply and reflex connections with the muscles that hold the head up. When the upper neck is stiff or guarding, the resting position of the head changes, and the jaw has to work from a different starting point.

That is why jaw pain, upper neck tightness and headaches in the temples so often arrive as a set. Treating the jaw as an isolated joint, without looking at what the neck underneath it is doing, tends to be the reason people find relief that does not hold.

Clenching is a nervous system habit

Dr Arthur Kaganovitch (Chiropractor) sees the pattern most often in exactly the people you would expect: those working long, high pressure days who are clenching through meetings without noticing, and grinding through the night on top of it. The jaw is one of the first places a body under sustained load starts to hold tension, alongside the shoulders and the breath.

That reframes the problem usefully. If the clenching is a nervous system that has not come down out of alert, then a night guard protects the teeth, which is worth doing, but it does not address why the jaw is being driven that hard in the first place. Care aimed only at the joint leaves the driver running.

So the work here is on both: restoring movement where the upper neck and the jaw have lost it, and settling a system that has been holding on. The teeth themselves stay with your dentist.

When jaw pain needs other care first

See your dentist for tooth pain, a bite that has suddenly changed, a broken or cracked tooth, or an abscess, because dental causes of jaw pain need dental treatment. See a doctor urgently for a jaw that has locked open and will not close, for facial swelling with fever, or for jaw pain that comes on with exertion and is accompanied by chest, arm or neck discomfort, which needs immediate medical assessment.

These are uncommon, and screening for them is part of why the assessment starts with a full history rather than with the jaw.

What we do

Your assessment includes a full case history, examination of the jaw joint and how it moves and tracks when you open and close, and a full spinal and neurological examination with particular attention to the upper neck, since that is where the connection usually lives.

We measure heart rate variability and run thermographic scans, which is how we see whether a system is sitting in the state that would explain the clenching, and we refer for spinal imaging if the examination indicates it. Then you get the findings explained in plain language.