Two things go wrong, sometimes together. Your jaw muscles clench through the night and refer pain up into your temples, or the disc inside the joint slips forward and thumps as you open — the click. About 30% of adults have a clickable jaw and never develop pain, so the click alone isn't damage ¹. The night clenching isn't a tooth problem; it is downstream of disturbed sleep ².

The conservative treatments work, and none alter your anatomy. A custom hard night splint and counselling rank among the top interventions for pain across 48 pooled trials ³. Jaw physiotherapy does the same job at the same effect size, with no reported harms ⁴, and neither beats the other head-to-head ⁵. Cognitive behavioural therapy has the strongest long-term evidence of any single treatment: four to eight sessions cut pain a full year later ^{6 7}. It is also the most under-prescribed, because most patients see a dentist first and a therapist last.

Conservative first, irreversible last. Run the home version for a month; if you are not much better by six weeks, see a dentist who treats TMJ specifically, then add physio and, for chronic pain, CBT.

The arc, if you catch it early. Within a week or two of the soft diet, rest, and heat, the muscle pain backs off. After four to six weeks of the splint worn nightly, mornings stop starting with the temple headache. By month three you chew on both sides without thinking. About 40% of cases remit on their own, and most of the rest respond within months ¹. CBT adds what a splint cannot: the daytime clenching habit, named and dropped, stays gone ⁶. Roughly 15% slip into chronic pain, where care aims for 30 to 50% relief rather than a cure ¹.