You wake with an aching jaw. It clicks when you eat. By the afternoon there is a dull headache spreading from your temples. If this sounds familiar, you may have a temporomandibular disorder, or TMD: a group of conditions affecting the jaw joint and the muscles that move it.
TMD is common, particularly in adults under 50, and often linked to stress and clenching. It is also one of the chronic pain conditions where hypnosis has been tested.
What TMD involves
- Pain in the jaw, in front of the ear, or in the temples
- Tired, aching chewing muscles
- Clicking, popping or grating in the joint
- Difficulty opening the mouth wide, or the jaw locking
- Headaches, earache or neck pain
The most common form is muscle-related. The chewing muscles are overworked and sore, often because of clenching or grinding, by day or in sleep. Most cases settle with simple measures.
The trial
In a Danish randomised controlled trial, 43 people who had had jaw-muscle pain for more than six months were assigned either to hypnosis or to a control treatment of non-hypnotic relaxation.
In the hypnosis group, average pain intensity fell from 4.6 to 2.9 on a ten-point scale, a significant reduction. In the relaxation group there was no significant change.
The researchers also measured a reflex in the nervous system and found that the pain relief was generally unrelated to changes in it. That suggests the effect came from how the brain processed the pain, not from a change in the muscle or nerve signals themselves.
An earlier American study of medical hypnosis for TMD reported reductions in pain and in the use of medical care.
These are small studies, but they are consistent with the strong evidence for hypnosis in chronic pain generally. A Cochrane review of psychological therapies for TMD has looked at this field as a whole, and hypnosis has been described as a treatment option in the pain literature.
Why it might help
- Changing pain processing. Long-lasting pain involves the nervous system becoming more sensitive. Hypnosis works on that.
- Relaxing the jaw muscles. Many people do not realise they are clenching.
- Reducing stress, a major driver of clenching.
- Breaking the habit with awareness and cues.
- Improving sleep.
Note that hypnosis did not clearly outperform a mouth splint for muscle pain in a small trial of grinding, so it is best seen as part of a wider plan.
What treatment involves
- Relaxation, with particular attention to the face, jaw, neck and shoulders
- Suggestions of warmth, looseness and comfort in the jaw
- Pain-control imagery: the dial, or the ache dissolving
- A post-hypnotic cue for daytime clenching: “Whenever my teeth touch, my jaw lets go”
- Sleep suggestions
- Self-hypnosis practice at home
The resting position of the jaw
This is worth learning whatever else you do. At rest:
- Lips together
- Teeth apart
- Tongue resting lightly on the roof of the mouth, just behind the front teeth
Your teeth should only touch when you chew or swallow. If they are touching now, you are clenching.
A jaw-release routine
Five minutes, two or three times a day.
- Sit upright with your shoulders down.
- Let your lips close and your teeth part.
- Breathe slowly through your nose.
- Imagine warmth spreading through your cheeks and jaw, like a warm flannel.
- Let the jaw hang heavy, as if it were made of soft wax.
- Soften your tongue, your forehead and the back of your neck.
- Tell yourself: “Lips together, teeth apart. My jaw is loose and comfortable.”
- Set a cue: “Whenever I notice my teeth touching, I let go.”
Put a small sticker on your screen or phone as a reminder to check your jaw.
Standard self-care
- Soft diet for a while; avoid chewy, hard foods and gum
- Do not open wide; support your jaw when yawning
- Avoid nail biting, pen chewing and resting your chin on your hand
- Heat or cold packs
- Gentle jaw exercises from a dentist or physiotherapist
- Simple pain relief if needed
- A night guard if you grind, on your dentist’s advice
- Stress management and good sleep
Guidance favours conservative, reversible treatment. Be cautious about anything irreversible, such as grinding down teeth or surgery, without specialist advice.
See a dentist or doctor
- If the pain lasts more than a couple of weeks
- If your jaw locks open or closed
- If you cannot open your mouth properly
- After an injury
- If you have swelling, fever or a change in your bite
Seek urgent help for jaw pain with chest pain, breathlessness or pain spreading to the arm, which can indicate a heart problem. In people over 50, a new headache with jaw pain on chewing needs prompt medical attention.
The bottom line
For long-standing jaw-muscle pain, hypnosis has trial evidence of reducing pain, and learning to unclench is free. Use it alongside the simple self-care that settles most cases.
Next in the series: Hypnosis FAQ: 20 Questions Answered
This article is for general information and is not medical or dental advice.