Could Your Migraines, Headaches or Tinnitus Be Linked to Jaw Tension or TMD?

Many patients do not seek help because their jaw hurts.

They seek help because they are living with persistent headaches. They wake with pressure around their temples. They experience migraine symptoms that appear worse after periods of clenching. They notice ringing, buzzing or fullness in their ears. They may have disturbed sleep, difficulty concentrating or a constant feeling that their face and jaw cannot properly relax.

They may have already seen their GP, dentist, physiotherapist, neurologist or audiologist. They may have tried pain relief, migraine medication, massage, a nightguard or lifestyle changes.

Yet the muscles and joints responsible for moving the jaw may never have been assessed comprehensively.

For some patients, painful or overactive jaw muscles are one part of a much wider headache, facial pain or tinnitus presentation. Recognising and treating that muscular component can meaningfully reduce the overall symptom burden.

It is equally important not to assume that every migraine, headache or episode of tinnitus is caused by the jaw. These symptoms may have several possible causes and sometimes require medical, neurological, dental or audiological investigation.

The purpose of an expert TMD assessment is not to force every symptom into a dental diagnosis. It is to establish whether the jaw muscles or temporomandibular joints may be contributing and whether treating that component is likely to help.

What is TMD?

Temporomandibular disorder, commonly abbreviated to TMD, describes a group of conditions affecting the jaw joints, the muscles responsible for chewing, or both.

The temporomandibular joint itself is commonly called the TMJ. Patients may therefore use several different terms when searching for treatment, including:

• TMJ dysfunction
• TMJ disorder
• Temporomandibular joint dysfunction
• Muscular TMD
• Myofascial jaw pain
• Masticatory muscle pain
• Facial arthromyalgia
• Jaw muscle dysfunction
• Bruxism-related jaw pain

TMD may cause pain around the jaw, ear and temple, difficulty opening the mouth, disrupted sleep and headaches around the temples. Some patients also report buzzing, ear fullness, tinnitus or dizziness.

For a more detailed explanation of muscular TMD, splint therapy and treatment options, read our guide: Muscular TMD and TMJ Dysfunction: Why the Right Assessment Matters.

Can TMD cause headaches?

Headache is a recognised part of the TMD spectrum. The National Institute of Dental and Craniofacial Research includes headaches associated with painful TMD within its classification of temporomandibular disorders.

A headache may be more likely to have a TMD-related component when:

• It affects the temples, cheeks or areas around the ears
• It worsens after chewing or prolonged talking
• It is aggravated by teeth clenching
• It is present on waking
• The jaw feels tired, tight or painful at the same time
• Pressing the jaw or temple muscles reproduces the familiar headache
• Symptoms worsen during periods of stress or intense concentration
• The headache improves when the jaw symptoms improve

The masseter muscles, situated around the angle of the jaw, and the temporalis muscles, situated over the temples, are repeatedly activated when we chew, clench, grind or brace the jaw.

When these muscles become persistently overactive or painful, discomfort may be experienced beyond the immediate muscle itself. Muscular TMD can therefore present as facial pain, temporal pain or headache rather than obvious pain inside the jaw.

This is why treating a headache without assessing significant accompanying jaw tension may leave an important part of the presentation unaddressed.

Can TMD cause migraines?

Migraine and TMD are not the same condition.

Migraine is a neurological disorder. Painful TMD affects the jaw joints, chewing muscles or associated structures. However, the conditions may occur together, and TMD is recognised as being associated with migraine and other chronic pain presentations.

A patient may have:

• Migraine without TMD
• Muscular TMD without migraine
• Headache attributed predominantly to TMD
• Migraine alongside muscular TMD
• Jaw clenching that appears to aggravate an existing migraine disorder
• Several overlapping causes of head and facial pain

It would therefore be inaccurate to suggest that treating jaw tension will cure every migraine.

However, when a patient has both migraine symptoms and significant muscular TMD, treating the jaw component may reduce an additional source of pain, tension and sensory stimulation. For some patients, this may mean fewer headaches, less severe symptoms or improved day-to-day function, even where separate migraine management remains necessary.

In Dr Sheila’s clinical experience, carefully selected patients have reported substantial improvements in headaches and migraine-related symptom burden after the muscular component of their TMD was properly identified and managed. For a patient whose life has become organised around pain, even a meaningful reduction in frequency or severity can be transformative.

Could clenching or grinding be aggravating your headaches?

Teeth clenching and grinding are commonly described collectively as bruxism.

Bruxism may occur during sleep, while awake, or both. It may involve:

• Forcefully holding the teeth together
• Grinding the teeth
• Bracing the jaw without the teeth touching
• Repeatedly tightening the jaw muscles
• Habitually positioning the jaw forwards or sideways

Not everyone who clenches develops TMD, and not every patient with TMD grinds their teeth.

However, repeated muscular contraction may contribute to jaw fatigue, muscle tenderness, tooth wear and pain around the temples or face. The NHS advises patients with TMD to avoid clenching and notes that symptoms may be worse when chewing or during periods of stress.

Patients are often unaware that they are clenching. They may notice only the consequences:

• Morning headaches
• Facial tightness on waking
• Tenderness around the jaw
• Tooth sensitivity
• Fractured fillings or restorations
• A feeling of pressure around the temples
• Headaches after concentrating or driving
• Increased migraine symptoms during stressful periods

An experienced assessment looks not only for visible tooth grinding, but also for muscle activity, tenderness, movement patterns, dental damage and the relationship between jaw function and the patient’s symptoms.

Can TMD cause tinnitus?

Tinnitus is the perception of a sound that is not produced by an external source. It may be experienced as ringing, buzzing, humming, hissing, pulsing or another persistent or intermittent noise.

Tinnitus has numerous possible causes, including hearing loss and conditions affecting the ear. A GP may examine the ears and consider whether further audiological or medical investigation is required.

However, tinnitus and other ear-related symptoms are also reported by patients with TMD. Recognised symptoms can include:

• Ringing or buzzing in the ears
• Earache without an obvious infection
• A sensation of fullness or pressure
• Dizziness
• Changes in symptoms during jaw movement

Tinnitus and ear symptoms are included within contemporary TMD assessment guidance, although their presence does not prove that the jaw is the cause.

A jaw-related or somatosensory component may be considered when the tinnitus:

• Changes when the patient clenches
• Changes when the jaw moves from side to side
• Becomes more noticeable during periods of jaw pain
• Began at a similar time to the muscular symptoms
• Changes when pressure is applied around the jaw, temple or neck muscles
• Occurs alongside ear fullness, facial pain or headaches

In Dr Sheila’s clinical experience, some carefully selected patients with concurrent muscular TMD and tinnitus have reported meaningful improvement when the muscular component has been treated.

This does not mean that TMD treatment can be expected to cure tinnitus. It means that the jaw should not automatically be overlooked when tinnitus clearly changes with muscle activity or occurs alongside significant TMD symptoms.

Why tinnitus should still be investigated properly

It would be unsafe to assume that ringing or pressure in the ears is caused solely by jaw tension.

Patients may still require assessment by their GP, audiologist or an ear, nose and throat specialist, particularly where symptoms are persistent, one-sided or accompanied by hearing changes.

Urgent medical assessment is required where tinnitus occurs with sudden hearing loss, facial weakness or severe vertigo.

A responsible TMD clinician should be willing to say:

• This may have a muscular component
• This does not appear to be explained by TMD alone
• Further medical or audiological assessment is required
• Treatment should not proceed until another condition has been excluded

Experience is demonstrated as much through appropriate referral as it is through delivering treatment.

Why these symptoms are often treated separately

Healthcare is frequently organised around individual symptoms.

A patient with migraine may be assessed neurologically. A patient with tinnitus may enter an audiology pathway. Someone with worn teeth may receive a nightguard. Jaw pain may be treated with exercises, massage or pain relief.

Each of these approaches may be entirely appropriate.

The difficulty arises when no one considers whether the symptoms are connected.

A patient may simultaneously experience:

• Jaw clenching
• Morning headaches
• Migraine
• Ear pressure
• Tinnitus
• Facial pain
• Poor sleep
• Tooth wear

Treating only one symptom may leave the broader pattern unchanged.

TMD is increasingly understood as more than an isolated jaw or dental problem. It may coexist with headache and other persistent pain conditions, and it can affect sleep, eating and psychological wellbeing.

A comprehensive assessment therefore considers the patient rather than simply the procedure they believe they need.

What happens when muscular TMD is overlooked?

When muscular TMD is not recognised, patients may spend months or years repeatedly treating the symptoms without addressing a significant contributing factor.

They may experience:

• Persistent headache despite repeated pain relief
• Migraine symptoms that remain aggravated by clenching
• Increasing muscular tenderness
• Continued damage to teeth and restorations
• Poor sleep
• Difficulty eating comfortably
• Repeated ineffective treatment
• Growing anxiety about unexplained symptoms
• Intrusive tinnitus or ear pressure
• Reduced concentration and productivity

The consequence is not simply ongoing jaw discomfort.

Chronic pain, headaches and tinnitus can begin to change how someone sleeps, works, eats, socialises and plans their life.

This is why early, appropriate assessment matters.

Why experience matters

Treating muscular TMD is not simply a question of identifying a large masseter muscle.

An experienced clinician must consider:

• Whether the symptoms are genuinely muscular
• Whether the joint is also involved
• Whether the headache appears related to jaw function
• Whether migraine requires separate medical management
• Whether tinnitus requires audiological or ENT investigation
• Which muscles are contributing
• Whether the patient clenches while awake or grinds during sleep
• The health and condition of the teeth
• Whether a splint is already being used
• Whether prescription treatment is appropriate
• When not to treat

A generic approach may focus only on the area that is easiest to identify.

For example, treating only the masseter muscles may be inadequate where the temporalis muscles are heavily involved in a patient’s headache pattern. Conversely, treating muscles without recognising a predominantly joint-related condition may provide little benefit.

Inappropriate treatment may lead to:

• Little or no improvement
• Unwanted muscle weakness
• Changes in chewing function
• Facial imbalance
• Failure to investigate another cause
• Repeated treatment without a coherent long-term plan

The value of expertise lies in diagnosis, patient selection and treatment planning, not merely in carrying out a procedure.

The relationship between muscular treatment and splint therapy

For some patients, muscular relaxation and splint therapy may be used together because they address different aspects of the problem.

A well-designed dental splint may:

• Help protect the teeth and restorations
• Support management of clenching or grinding
• Distribute forces
• Form part of a wider reversible treatment plan

Splints are generally considered an adjunct rather than a universal cure. TMD guidance recommends conservative and reversible care and cautions against treatments that permanently alter the teeth or bite without a sound clinical indication.

Where clinically appropriate, prescription muscular-relaxing treatment may be considered to reduce excessive activity within selected muscles.

The purpose is not to immobilise the jaw or simply administer a standard amount of treatment.

It is to:

• Reduce excessive muscular contraction
• Relieve muscle-related pain or fatigue
• Preserve appropriate jaw function
• Support the wider management plan
• Review whether associated headaches or tinnitus change as the muscular symptoms improve

Neither treatment should be viewed in isolation.

Dr Sheila’s dental-led approach

Dr Sheila is a dentist and advanced facial aesthetics clinician with a special interest in muscular TMD, facial pain and the management of excessive jaw muscle activity.

Her dental background is central to her approach.

The consultation is not simply designed to establish whether a patient can receive treatment. It is designed to understand:

• The patient’s symptoms
• The impact on their daily life
• The relationship between jaw movement and headache
• Whether migraine has been diagnosed or requires medical review
• Whether tinnitus changes with jaw activity
• The condition of the teeth and restorations
• Whether a splint is being used
• Which muscles appear to be contributing
• Whether the presentation is muscular, joint-related or mixed
• Whether another clinician should be involved

Dr Sheila regularly assesses patients with complex symptom patterns and patients who have previously experienced limited results from generic treatment elsewhere.

This experience allows her to consider not only how treatment might be delivered, but whether it should be delivered at all.

Working with your dentist

Dr Sheila will continue to work with the patient’s regular dentist wherever possible.

The dentist remains important for:

• Assessing the teeth and oral health
• Identifying tooth wear or fractures
• Providing and monitoring splint therapy
• Reviewing the bite
• Maintaining dental restorations
• Considering other appropriate dental options

Muscular treatment does not replace dentistry.

Equally, splint therapy does not necessarily address every muscular, headache or facial pain component.

The most effective care may involve collaboration between Dr Sheila, the patient’s dentist and, where necessary, a GP, neurologist, physiotherapist, audiologist or ENT specialist.

Signs your headache may warrant a TMD assessment

Consider arranging a TMD assessment when headaches or migraine symptoms occur alongside:

• Jaw pain or tightness
• Pain around the temples
• Morning facial tension
• Teeth clenching or grinding
• Difficulty opening the mouth
• Jaw fatigue
• Ear pressure or tinnitus
• Tooth wear
• Broken fillings or dental restorations
• Symptoms that worsen when chewing
• Headaches that can be reproduced by pressing the jaw muscles
• A previous nightguard that has not resolved the symptoms

An assessment does not mean that treatment will automatically be recommended.

Its purpose is to understand whether TMD may be one part of the clinical picture and what form of care is most appropriate.

When to seek urgent medical help

Jaw tension should never be used to explain away concerning symptoms.

Seek urgent medical advice for a headache that:

• Begins suddenly and is extremely severe
• Occurs with weakness, numbness or difficulty speaking
• Causes confusion or drowsiness
• Occurs with loss of vision or double vision
• Follows a head injury
• Is accompanied by fever and neck stiffness
• Is new, progressive or substantially different from previous headaches

The NHS also advises urgent assessment where significant jaw or temporal pain occurs with frequent severe headaches or visual symptoms.

Seek urgent medical advice for tinnitus associated with sudden hearing loss, facial weakness or severe vertigo.

I have had jaw treatment before. Why are my headaches still present?

Some patients seek Dr Sheila’s opinion after previously receiving injections for clenching or jaw tension without experiencing any meaningful improvement in their headaches, migraine burden or facial pain.

A previous unsuccessful treatment does not necessarily prove that the jaw muscles are unrelated to the symptoms.

It may mean that:

• The dose was too low to produce a therapeutic reduction in muscular activity
• Only the masseter muscles were treated
• Temporalis involvement was overlooked
• Trigger points reproducing the patient’s headaches were not identified
• The treatment targeted muscle size rather than the patient’s pain pattern
• The underlying headache was predominantly neurological and required different care
• Muscular treatment was provided without splint therapy or wider TMD management

This distinction matters.

The temporalis muscles cover a substantial area of the side of the head and are active during chewing and clenching. Trigger points within the chewing and neck muscles can reproduce referred pain that resembles the patient’s existing facial pain or headache. 

A patient whose headaches are being perpetuated by several muscles may therefore achieve little benefit from a low-dose, masseter-only treatment.

Conversely, it would be inappropriate to continually increase the dose when the symptoms do not appear to originate from the jaw muscles at all.

Experience lies in knowing the difference.

A previous failure is information, not simply a reason to repeat treatment

When Dr Sheila assesses a patient whose previous treatment has not worked, she does not begin by assuming that the patient merely needs more.

She considers:

• What diagnosis was made
• Which muscles were treated
• What product and dose were used
• How the dose was distributed
• Whether the patient noticed any temporary change
• Whether chewing strength altered
• Whether the familiar headache could be reproduced during examination
• Whether jaw movement or clenching changes the symptoms
• Whether migraine has been independently diagnosed
• Whether tinnitus changes with jaw or neck movement
• Whether a dental splint is being worn and properly reviewed
• Whether the presentation requires medical, neurological or audiological investigation

Sometimes the previous dose was inadequate. Sometimes the wrong muscles were selected.

Sometimes the original diagnosis was incomplete. And sometimes the correct conclusion is that further muscular treatment is unlikely to help.

All four conclusions require experience.

Why Dr Sheila’s dosing approach is different

Muscular TMD treatment is frequently confused with a cosmetic masseter treatment.

They are not necessarily the same.

A cosmetic treatment may be primarily designed to reduce lower-face width or soften the appearance of a prominent masseter muscle. Therapeutic treatment is intended to influence excessive muscle function, pain and associated symptoms.

In appropriate patients, this may require a more substantial and carefully distributed dose.

Dr Sheila’s doses may therefore be higher than those a patient has previously received. However, they are not indiscriminately high. They are selected according to the patient’s anatomy, muscle strength, pain pattern, functional requirements and previous treatment response.

Higher doses may offer a greater opportunity to reduce significant muscular overactivity, but they also increase the importance of:

• Precise muscle selection
• Safe injection placement
• Understanding the muscles responsible for chewing and expression
• Preserving appropriate function
• Recognising asymmetry
• Monitoring weakness
• Reviewing the patient’s response before repeating treatment

This is why advanced therapeutic dosing should not be regarded as a routine extension of cosmetic injecting.

It requires a clinician who understands both what may be achieved and what may be lost if the treatment is excessive or incorrectly placed.

Twelve years of special interest clinical experience

Dr Sheila has treated muscular TMD for more than 12 years and has developed a particular clinical interest in patients experiencing complex combinations of:

• Jaw pain
• Clenching and bruxism
• Facial pain
• Headaches
• Migraine symptoms
• Temporal pain
• Ear pressure
• Tinnitus
• Sleep disruption
• Dental wear or fractured restorations

As a dentist, she understands that muscular relaxation cannot be separated from the patient’s dental health, bite, splint therapy and longer-term oral care.

As an educator and lecturer, she also teaches clinicians how to assess these patients, understand functional anatomy, select the appropriate muscles and use advanced dosing safely.

Patients are therefore not simply receiving a procedure.

They are receiving an assessment informed by twelve years of clinical pattern recognition, a dental understanding of the wider problem, and the experience of a clinician who teaches others how to manage these cases.

The purpose is not simply to inject more

The distinction should be made very clearly: Dr Sheila’s approach is not to use more treatment because previous treatment failed. It is to understand why it failed.

Where the previous dose was insufficient, a higher dose may be appropriate.

Where the muscle selection was incomplete, the treatment strategy may need to change.

Where active trigger points or referred pain patterns were missed, a more detailed muscular assessment may reveal a different clinical picture.

Where the symptoms are unlikely to respond to muscular treatment, Dr Sheila will explain this and recommend more appropriate care.

That is the value of experience. It is not merely knowing how to treat.

It is knowing who to treat, where to treat, how much treatment is required, how to minimise risk and when treatment should not be provided at all.

For patients who have already tried treatment without success, the next step should not automatically be another generic appointment. It should be a more comprehensive assessment.

Dr Sheila has spent more than 12 years treating muscular TMD and teaches and lectures other clinicians in the anatomy, assessment and advanced treatment of these conditions. Her approach combines dental knowledge, detailed muscular examination, individualised dosing, trigger-point assessment and collaboration with the patient’s own dentist.

The objective is not simply to weaken a jaw muscle. It is to understand what is driving the patient’s symptoms and give them the best possible opportunity for a safe, meaningful and lasting improvement.

What if previous jaw treatment has not worked, or caused a problem?

Many patients come to Dr Sheila after previously receiving treatment for jaw clenching or muscular TMD without meaningful improvement.

Others have developed excessive chewing weakness, facial asymmetry, an altered smile or uneven muscle activity following treatment elsewhere.

A previous unsuccessful result does not necessarily mean that muscular treatment cannot help. It may indicate that:

• The diagnosis was incomplete
• The dose was insufficient
• The wrong muscles were treated
• Trigger points were not identified
• The dose was distributed inadequately
• Significant temporalis involvement was overlooked
• The treatment was not integrated with splint therapy or dental care

Equally, the answer is not always to repeat the treatment using a higher dose.

Dr Sheila reassesses the original diagnosis, previous dose, product, placement, muscular pattern and relationship between jaw activity and the patient’s headaches, migraines or tinnitus.

Where a higher therapeutic dose is indicated, her twelve years of experience allow her to balance the opportunity for meaningful symptom improvement against the increased responsibility associated with treating powerful muscles at more substantial doses.

Where previous treatment has caused an unwanted result, Dr Sheila is experienced in assessing complications and is frequently approached by patients and clinicians seeking support. She evaluates what has happened, ensures that concerning symptoms are appropriately referred and develops a proportionate plan for review and management.

Her expertise extends beyond performing treatment. She teaches and lectures clinicians on muscular TMD, advanced dosing, anatomy and complication management.

For the patient, this means that treatment is not approached as a standard injection pattern.

It is approached as a clinical decision requiring diagnosis, functional understanding, technical precision and the experience to manage both the intended result and the unexpected one.

Frequently asked questions

Can TMJ dysfunction cause migraines?

TMD and migraine are separate conditions, but they may occur together. Muscular jaw pain and clenching can aggravate the overall headache burden in some patients. Treating TMD may help where a significant muscular component is present, although it cannot be assumed to cure an independent migraine disorder.

Why do I wake with a headache and tight jaw?

Morning headaches and jaw tension may be associated with sleep bruxism, clenching or muscular TMD. Other causes are also possible, so a full assessment may be required.

Can clenching cause pain in the temples?

Yes. The temporalis muscles extend over the sides of the head and are activated during clenching and chewing. Pain or overactivity within these muscles may contribute to temporal headaches in some patients.

Can TMD cause ringing in the ears?

Tinnitus is reported by some patients with TMD, particularly where the sound changes with clenching, jaw movement or muscular pain. Tinnitus has many other possible causes and may still require assessment by a GP, audiologist or ENT clinician.

Will treating jaw tension cure my tinnitus?

No result can be guaranteed. Some patients with a muscular or somatosensory component experience improvement when their TMD is managed, while others do not.

Can a splint help migraines or headaches?

A splint may support the management of clenching, tooth wear and muscular TMD in selected patients. Where the headache is associated with TMD, improving the jaw condition may reduce symptoms. A splint is not a treatment for every migraine or headache condition.

Will Dr Sheila work with my dentist?

Yes. Dr Sheila will work alongside your dentist to support splint therapy, dental assessment and other appropriate dental options.

Book a TMD assessment in London

If you are living with persistent headaches, migraine symptoms, tinnitus or ear pressure alongside jaw tension, clenching or facial pain, the jaw may be one part of the picture that has not yet been properly assessed.

The purpose of your consultation with Dr Sheila is not to promise that every symptom can be explained or resolved through TMD treatment. It is to understand the pattern properly.

Where a significant muscular component is identified, addressing it carefully and comprehensively may reduce pain, improve function and meaningfully change the patient’s quality of life.