Why Surgery is Not the Answer to Your Jaw Pain

If you’re living with jaw pain, headaches, or clicking and popping in your jaw, it can feel like you’re stuck with two options: wear a nightguard or consider surgery. Many patients come to us saying, “My dentist gave me a nightguard, and when that didn’t help, they said surgery might be next.”

The truth? Surgery very rarely addresses the root cause of your pain. 

Less than 2% of all TMJ cases in our office required surgical intervention. 

Traditionally, most dentists consider stress to be the primary source of TMJ pain and other jaw discomfort. They often treat the symptoms, instead of correctly identifying the root cause. If patients pursue surgery instead of diagnosing and correcting the underlying cause, symptoms will come back or never fully go away.

You need to find the true source of dysfunction. Instead of simply treating your symptoms, focus on answering one key question:

Why is your jaw hurting, and why are your teeth wearing down in the first place?

Jaw pain and TMJ issues are rarely isolated problems. They’re often part of a bigger picture that may include tight or overworked muscles in the face, neck, and shoulders; bite problems that force the jaw into an unnatural position; or airway issues, especially at night. Sleep-disordered breathing or sleep apnea, poor jaw growth or development from childhood, and posture or habit patterns can all add extra strain to your jaw muscles.

Simply placing a nightguard or jumping to surgery without understanding this bigger picture risks masking the symptoms instead of solving the problem. You may also miss important issues like airway problems or sleep disorders, and pursue invasive treatments when more conservative options would have worked.

Effective TMJ care begins by stepping back and looking at the whole system, not just the teeth and joints.

A thorough assessment should evaluate your jaw joints and muscles, your airway, and your posture and habits. By looking at how these systems work together, clinicians can determine where your pain is coming from and how your daily activities and functions may be overworking your jaw and facial muscles.

For children and teens, this assessment often includes evaluating jaw growth and development to determine whether early orthodontic intervention could support better breathing, a healthier jaw position, and long-term joint health.

Pursuing Non-Surgical Treatment Options

Once you understand the true source of your symptoms, a clinician should guide a simple, patient‑owned plan that addresses the root cause of your pain and empowers you to take control of your own healing. The most effective plans take a holistic approach that combines oral appliances with other therapies, like osteopathic manual therapy, physiotherapy, and myofunctional therapy.

Depending on your situation, your plan might include:

• Oral appliances designed and 3D-printed in-house to improve jaw position and muscle balance. These appliances are very different from nightguards and are customized to correct the source of your pain, instead of just easing your symptoms.

• Airway-focused treatments, including collaboration with sleep physicians or ENT specialists when needed.

• Lifestyle and habit changes that address patterns around the pain. Your habits often reveal lifestyle changes that can help you reach your goals.
  
  

• Orthotropics treatment, especially in growing children, to support healthier jaw development, airway and function of the muscles. 

Surgery still has an important place in TMJ care, but it should be reserved for very specific cases, such as severe structural damage or joint disorders that don’t respond to conservative care. It should not be the default next step simply because a nightguard didn’t work.

If jaw pain, headaches, ringing in the ears or other TMJ-related symptoms are affecting your everyday life you should seek an evaluation as soon as possible. 

Many patients find relief from pain and uncomfortable jaw clicking and locking successfully and without surgery.

If you’ve only heard “nightguard or surgery,” know this:

You have other options. And you deserve care that looks beyond the symptoms to understand why your jaw hurts in the first place.