What is it?
Jaw muscle pain is pain that comes from the muscles that move your jaw. The temporalis muscle in your temple, the masseter muscle in your cheek and the pterygoid muscles on the inner side of the jaw become tender in this condition. If pressing on the muscle with a finger during the examination reproduces the pain you have described, that points to the muscle rather than the joint as the source.
When a muscle stays contracted for a long time, the blood flow through it falls, and the waste products that build up make the muscle fibres more sensitive to stimulation. That is why the pain is most often dull, spread out and pressing; it does not feel like toothache, which is sharp and sits on a single spot. In time the pain can travel beyond the borders of the muscle and be referred to a tooth, the temple or the ear.
With muscle pain your mouth will usually still open, but because opening it further hurts more, you hold back yourself. Unlike conditions that come from the joint, there is usually no mechanical block; it is typical for the symptoms to be more noticeable in the morning and to fluctuate through the day. Even so, muscle and joint problems can be present together, which is why the two are assessed side by side.
Signs
You will not necessarily have all of these at once.
Why does it happen?
- 01
Clenching without realising it
Holding your teeth together and your jaw tense during the day puts a silent load on the muscles that lasts for hours. It is common in front of a screen, at the wheel or in moments of concentration, and most people only notice it when they are asked about it.
- 02
Grinding your teeth in your sleep
The contractions that appear during sleep can be stronger than those in the daytime and cannot be controlled while you are awake. A jaw that wakes up tired and stiff in the morning, together with wear on the teeth, counts as a clue in this direction.
- 03
Keeping the jaw open for a long time
Long procedures inside the mouth, wisdom tooth surgery, having your mouth held open during a general anaesthetic and chewing gum for long stretches all strain the muscles. The pain most often starts the next day and settles over a few days.
- 04
Chewing on one side and the neck muscle chain
Missing or painful teeth on one side shift your chewing to the other. The neck and shoulder muscles also share the same chain as the chewing muscles, which is why a stiff neck and jaw pain are so often described together.
How does it progress?
- 1
Local muscle pain
The pain is felt only over the muscle being pressed. Jaw function is largely preserved and the pain eases noticeably with rest.
- 2
Pain spreading within the muscle
The pain brought on by pressure spreads within the borders of the muscle itself. Opening your mouth becomes harder; you describe tiring while chewing and an increase towards the end of the day.
- 3
Referred pain
The pain travels beyond the borders of the muscle to a tooth, the temple, the ear or around the eye. A healthy tooth being taken for the painful one and treated most often happens at this stage.
- 4
Persistent pain
Once the symptoms pass three months, sleep, tension and mood become part of the picture. A splint on its own may not be enough in this period, and the approach is built on several fronts.
How is it treated?
The first step is explaining the diagnosis and reducing the load on the muscle. A soft diet, giving up chewing gum, avoiding opening your mouth very wide, reminding yourself during the day of the resting position in which your lips are closed but your teeth are not touching, and applying heat to the muscle help most people. Simple stretching and opening exercises are added in the way your dentist shows you.
If clenching and grinding in your sleep go with it, a night guard made from an impression can be used. The purpose of the guard is not to change your bite permanently but to spread the muscle load and protect the teeth; you will need to be seen regularly so the fit can be checked. Physiotherapy, massage and relaxation techniques are supportive; any decision about medication is for your dentist to make.
Where there is no response, the diagnosis is looked at again; conditions that come from the joint, changes on the joint surfaces, nerve pain and systemic causes are each assessed separately. For pain thought to come from the muscles, irreversible procedures such as grinding down teeth, root canal treatment or taking a tooth out are avoided.
- Your jaw tiring while chewing and easing with rest, together with tenderness in the temple, blurred vision or a fever
- Your mouth suddenly opening less than the width of a finger
- Swelling of the face, a fever or difficulty swallowing added to the pain
How is it prevented?
- Remind yourself during the day of the resting position in which your teeth are apart and your tongue rests on the palate.
- Give up habits that keep the muscles working non-stop, such as hard chewing gum, ice, pens and nail biting.
- Ask for breaks during long procedures inside the mouth, and rest your jaw without forcing it.
- Look again at the things that add to the muscle load, such as your sleep pattern, neck posture and screen height.
Frequently asked questions
- If the pain comes from a muscle, why does it feel like toothache?
- Tender points in the chewing muscles can refer pain beyond their own borders, so even when the source is the muscle you may feel the pain in one of your back teeth. With this pain there is usually no clear increase with cold, no throbbing that starts on its own and nothing that wakes you at night. Reproducing the same pain by pressing on the muscle during the examination makes the difference easier to see.
- Will a night guard take my pain away?
- If you clench and grind, a night guard helps to reduce the load on the muscles and protects the teeth from wear. It does not give the same result in everyone and may not be enough on its own; it is used together with exercises, changes to habits and, where needed, physiotherapy. An appliance that is not designed properly can affect your bite, so the check-ups should not be skipped.
- How do I tell whether the pain comes from the muscle or the joint?
- The examination makes the definite distinction, but there are some clues. With muscle pain the tenderness lies over the temple and cheek muscles rather than the joint, your mouth opens as far as the pain allows and no mechanical block is felt. With conditions that come from the joint, a sound, catching or a block that stops you opening comes to the fore. The two can also be present together.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.