What is TMD?

 

Temporomandibular Disorder (TMD) refers to pain and dysfunction involving the jaw joint (temporomandibular joint or TMJ) and the surrounding muscles. The TMJ connects the jawbone to the skull and plays an important role in talking, chewing, and facial
expression. TMD can cause jaw pain, clicking, stiffness, and headaches, and is often aggravated by stress, teeth grinding (bruxism), or jaw misalignment.

What are the symptoms?

You may experience:

  • Pain or aching in the jaw, face, temples, or around the ears
  • Clicking, popping, or grinding sounds when opening or closing the mouth
  • Stiffness or locking of the jaw
  • Pain when chewing, talking, or yawning
  • Associated symptoms such as headaches, ear fullness, or neck pain
  • Fatigue, insomnia or anxiety

How is it diagnosed?

Diagnosis is based on:

  • Dental, neurological, or ENT-related problems are ruled out as needed
  • A detailed clinical history and physical examination of the jaw and surrounding muscles
  • Identifying painful jaw movements, bite changes, and associated neck or facial tension
  • Imaging (e.g. MRI or CT) may be requested in selected cases, but diagnosis is usually clinical

What treatments do we offer?

We provide a multidisciplinary, non-surgical approach to managing chronic TMD:
1. Medication Optimisation

  • Review of pain medications to improve effectiveness and reduce side effects
  • Our clinic does not prescribe opioids or pregabalin, in line with local guidelines
  • We may advise your GP on safer or more appropriate alternatives

2. Targeted Nerve Blocks

  • In selected cases, we may offer peripheral nerve blocks (e.g. auriculotemporal or masseteric nerve) to reduce pain and muscle spasm
  • These are quick, minimally invasive injections performed under local anaesthetic guidance
  • Relief from nerve blocks may help facilitate further rehabilitation

3. Trigger Point Injections

  • For jaw and facial muscle tightness contributing to pain, we may offer trigger point
    injections into overactive muscles (e.g. masseter, temporalis)
  • These can reduce localised muscle pain and improve jaw movement

4. BOTOX for Muscles

  • We provide BOTOX injections to the affected muscles. These are initially offered as a
    trial procedure. If beneficial, that can be repeated for pain management.


5. Referral to Specialist Services

  • If needed, we may recommend:
    o Specialist physiotherapy for jaw and neck
    o Dental or oral medicine input for bite alignment or splint therapy
    o Psychological support if stress or anxiety are significant triggers

 

What to expect from treatment

  • Most patients experience noticeable improvement with a combination of self-care, targeted injections, and medication review
  • Treatments are minimally invasive and provided as day procedures
  • Long-term outcomes improve with active engagement in self-management techniques