TMJ Tongue pain, Tongue Position and Deviate Swallows

Dr. Shapira tongue pain TMJ 32 Comments

TMJ Problems Can Be Identified Early By Identifying Scalloped Tongues

The normal swallow is completed with the teeth in full occlusion (contact between the upper and lower teeth).  When patients develop deviate swallows they turn their tongue into an orthotic that leads to cascading problems.  The scalloped tongue, most commonly found on the sides of the tongue are actually the impressions of the teeth as the tongue remolds for improper use.

Scalloped Tongues are 70-80 % Predictive Of Sleep Apnea

Patients with deviate swallows can adapt to incorrect jaw position when they are awake but as they fall asleep the muscles relax and the airway collapses.  This can be simple snoring, UARS (upper airway resistance syndrome) or Sleep Apnea.  Sleep Apnea in children leads to ADD, ADHD, Behavioral Disorders and decreased intellectual performance.  Deviate swallows are also associated with over closed bites and forward head postures.  Sleep Apnea affects every system in our body in a negative fashion.

Scalloped Tongues are a Warning Sign That Should Not Be Ignored

There is almost always abnormal swallowing in patients with scalloped tongues.  While our muscles can adapt, repeated adaptations lead to repetitive strain injuries. TMJ is a Repetitive Strain Injury similar to Carpul Tunnel or Tennis Elbow.  In children, it tells us to worry about airway and development.  In adults it usually means early intervention opportunities were missed.

When TMJ Causes Trouble With Your Tongue

tmj-tongue-pain-chicagoIf you are experiencing troubles with your jaw, TMJ could be the culprit. Otherwise referred to as a temporomandibular disorder, it revolves around issues with the temporomandibular joint. This vital hinge is the connection between the lower and upper jaw.

When everything is working properly, it is a true thing of beauty to see this essential part of the human body at work as a combination of bone, nerves, ligaments, and muscles engage in fluid movement. You should have no problem with biting, chewing, yawning, or talking.

However when something is out of balance, there is an issue with the formation of the jaw or mouth, the jaw is undergoing undue strain due to stress, or inflammation has affected any part of the joint and surrounding muscles, you could find yourself dealing with a gamut of unsettling symptoms.

Burning Mouth Syndrome can be a frustrating dillema and it is usually multifactorial.  It may be due to depression (common with chronic pain), from allergies or reactions to medications, may be secondary to dry mouth or snoring and/or sleep apnea.  Burning Mouth may be secondary to a neurological disorder.

Symptoms of a TMJ Disorder

The classic symptoms of a TMJ disorder focus on problems with the jaw. They can be caused by an injury, such as a blow to the face, continuous pressure on the jaw from teeth grinding at night and clenching during the day, or actual problems with oral structures.

Symptoms may include:

In addition to the possibility of sleep disorders that are connected to TMJ,  you may even find that you are experiencing trouble with your tongue.

How TMJ Affects the Tongue

tmj-tongue-problemsWhen TMJ disorders strike, problems that stem from the jaw can throw every thing off balance in the mouth. According to the TMJ Orofacial Pain Disorders Center, tongue position during swallowing and speaking can be part of the problem with TMJ.

Whether improper placement causes a TMJ disorder, or the TMJ disorder results in problems with the tongue, the two are closely related. Numbness, tongue tingling, and TMJ tongue pain are common symptoms that indicate a TMJ disorder.

Imagine the jaw is a mechanical structure that must be properly aligned at all times to allow a smooth and easy motion. When it is misaligned, normal functioning is impaired. If the tongue is not allowed to fall into the proper position, it causes strain and could hinder nerve functioning, resulting in discomfort that can truly be upsetting and get in the way of daily life.

Tongue Reflexes:  Both Helpful and Problematic

The tip of the tongue reflex also known as the nursing reflex or kissing reflex is essential for newborns to learn to breastfeed and causes release of oxytocin in the mother.  During kissing this release of oxytocin is involved in true, love and feeling safe.  This same reflex will make us play with a sharp edge of a chipped tooth until our tongue bleeds.  Patient can struggle with a sharp edge and create a host of TMJ problems with both muscles and joints.  There are other important tongue reflexes in other areas of the tongue.  Patients with narrow jaws elicit retrusive tongue reflexes that can exacerbate sleep apnea or cause severe gagging.

Finding Help for TMJ Disorders and TMJ Tongue Pain

In order to find a solution for TMJ tongue problems and other symptoms that pinpoint a problem with the jaw, it is important to take the first step and get help.

Obstructed-AirwayA thorough evaluation from Dr. Shapira is a good place to start. It is important to seek assistance from a dentist who specializes in TMJ disorders, has experience with the host of problems can result, and will draw on the latest developments in technology to resolve the problem.

Once your TMJ disorder has been properly diagnosed, we can begin to review your options for treatment. There is a broad range of solutions that can address your symptoms, including any issues that have been affecting your tongue.

Generally, the least invasive approach is the first place to start. Physical therapy, relaxation techniques, and the use of an oral appliance at night may be all that is needed to align your jaw properly, providing the relief that you are looking for. More involved treatment options may involve surgery and can be discussed.

Discover how TMJ can be treated effectively and become a thing of the past.

Comments 32

  1. Post
  2. Pl help mam, i am from india, i have dull pains all the day in my teeths, i feel dull when i chew for 3-4 bites, feel pressure or heavyness pain in upper teeths, dont know the reason as doctors here unable to find, pl help me

    Rajeev Murarka

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  4. Can you help me with some Doctors referral in dealing similar TMJ cases in sunnyvale (zip code 94087), california region

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  6. Hello,
    I have been having pain when swallowing food or drink since September. The pain may be less depending how I position my neck, i.e. if I crane my neck the pain is less, when I lower my chin there is more pain. I’ve seen a dentist, I have seen an ENT, had an endoscopy of the throat and a CT scan w/contrast to rule out cancer. Nothing was abnormal. I do have Eagle’s syndrome bilaterally, however, never had problems on the left side before and never this particular symptom. Two days ago when I went back to the ENT to go over my scan results, he did another quick exam of my mouth, where he pressed on the base of my tongue and ever since then, it has been worse than before. Of course the ENT has exhausted all his options and said to see my GP for a referral to another specialist, maybe a neurologist. I somehow feel like my tongue is involved because it hurts on the base quite frequently and all along the length of the side of my neck. And again, there is the pain when swallowing food or drink. I am now wondering if it could be TMJ – I do clench my teeth heavily, and was given a mouthguard to wear during the night a couple of years ago, but found it bothersome, so I didn’t wear it but a couple of times. Do you think this could be TMJ, and can you tell me how I can find a specialist in the Phoenix, AZ area?? Any help would be greatly appreciated – this constant dull ache is really reducing my quality of life. Thank you!

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    Pain with swallowing can definitively be a TMJ /MPD disorder. I would have palpation done to evaluate for possible blocked salivary gland or enlarged lymph node. You can try sucking on sour lemon drops if that either makes the pain better or worse it is likely related to a salivary gland in the floor of the mouth.

    More likely it is Myofascial Pain and needs to be addressed with functional evaluation and trigger point therapy and or TMJ orthotic. See to understand the pain referral patterns.

    It may be sympathetically mediated pain which can be treated with “Self administered SPG Blocks”

    It is also possible it is nerve impingement and an Atlas/Orthoganol chiropractor might help.

    It could be a symptom of your Eagles syndrome or possibly Ernst syndrome.

    Dr Nick Meyers is in your area but I frequently see long distance patients in my Highland Park office.

    Check my you tube channel to hear patients stories:

  8. My tongue ‘burns’ especially when I yawn. I wake with a dry mouth most mornings and eating is very uncomfortable due to great sensitivity brought on by a lack of protective saliva. This started about 4 months ago. It is quite debilitating and depressing.

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  10. Thanks very much for your prompt reply and the link. I’m not on any medication at present. I do have an on-going problem of not sleeping in bursts of no more than a couple of hours at a time which doesn’t help me feel too bright during the day. This has been going on for a long time. I might get about six hours sleep but in three instalments.

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  12. Hello,

    I have been dealing with an open bite which developed in adulthood for several years now and have seen various specialist and have undergone orthodontic treatment (relapse) in addition to a lingual frenectomy ( which I think made things worse). With worsening clenching/grinding and progression of open bite (along with postural issues as a result), I am sort of at a standstill. Being bounced around with various approaches to treatment, I am very confused. Having been offered extraction of 4 teeth to jaw surgery and spending lots of money on seeing specialist have left me wondering what to do next. I am wondering your thoughts or input and perhaps how to go about treatment. I do live in the Chiacagoland area and am considering a consultation. Your feedback would be greatly appreciated. Thank You

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    Dr Shapira response: The question is what is the underlying cause of the open bite. This is a video of a long term open bite patient treated without extraction or surgery.

  14. hi
    i am from india and having dull pain off and on in my cheeks and sometimes on jaw both sides, feel like pressure on middle lower teeth.
    sight postnasal drip and feel at times something stuck at the base of tongue and not able to swallow and something is there ….
    very troubled by this
    please advice..seen ENT doctor and they gave me OTC pain killers which i am taking for 2 weeks

  15. I have problems with tmj for a lot of years. Now my problems are swallowing ,speech and tongue switching. I am in the phila pa area dr Shapiro do you know who I can go see because I am being told this is not tmj but als . Please help! Thank you . I have gone into the city to big institution for facial dentists and they after hearing from my dentist that it is not tmj they are also saying it is als.

    Dr Shapira’s response:
    Elizabeth, ALS is a serious neuromuscular disease. It can occur in patients with TMD. While treatment may alleviate symptoms temporarily if you actually have ALS it is usually progressive. This does not mean treatment may not improve you quality of life.

    ALS is a difficult diagnosis and it varies greatly in its presentation.
    A recent article discusses possibility of false positive diagnosis of ALS:
    Research Article:

    Is firstly diagnosed ALS really ALS? Results of a population-based study with long-term follow-up which concludes “At the time of a first diagnosis of ALS, the possibility still exists that another, less severe clinical condition, is present.”

  16. Dr Shapira,

    For the past 2.5 months I’ve had a tension headache that started in my jaws and back of neck that gradually moved to the front of my head, the tension moves around from behind eyes, to teeth, jaws, top of head. my right jaw pops constantly. My right jaw hurts for a few days and then pain goes away, this process repeats itself. I went to my primary care over a month ago and he thinks this is all stemming from anxiety. I don’t disagree but it’s lasted for so long. Very annoying. The past few weeks I’ve started having very mild sharp pains behind my left eye or top of head or side of head. My head also has had some tingling, which strangely my tension seems to be better when I’m having tingles. When I bend over I feel lots of pressure in my nose and face. Can all this be from Tmj? I also know my allergies are really bad this time of year and they seems to inflame my sinus nerves, at least that’s what happened last year.

    Dr Shapira Response: Anxiety can be a trigger for TMJ disorders but that does not mean you should ignore the structural components. Primary care physicains know very little about these problems. The pain is normally Myofascial Pain or referred pain from the muscles. The Trigeminal nerve links the teeth and jaw neurologically to the sinuses, the ears and the brain. Almost 100% of headaches are trigeminal in nature and can respond well to
    Neuromuscular Diagnostic Orthotic.
    Sphenopalatine Ganglion Blocks are also very useful. Self Administration is key to best success.

    Pain like you describe is often eliminated or vastly immproved in just the first or second visit.

  17. Hello,
    I have been suffering from pain in right jaw, ear, neck , shoulder it goes till head all on right side . It’s severe sometimes . Ringing in ears, right throat ache and younger ache. I had wisdom tooth extracted it was impacted after since it’s more.
    Pls help

    Dr Shapira’s Response: Dear Sharon, You have described typical Myofascial Pain Patterns that are commonly seen secondary to TMJ disorders or part of TMD in general. Extractions of third molars, ie wisdom teeth frequently is traumatic and can set off a series of problems with both muscles and joints.

    You should have an examination by a doctor who understands Myofascial Pain and Dysfunction and neuromuscular dentistry. I can help. Please contact my office.

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  19. Hello,
    3 years ago I started having pain behind my eye. So I went and saw an eye doc. Then eye doc saw nothing wrong. Then my ear started to hurt then not long after my ear started hurting then one thing led to another. My jaw, my sinuses my neck sore throat then tingling on my tounge, headaches. I had lots of test done to rule things out. So I googled my symptoms and TMD came up. So I decided to get braces. I have 2 weeks left in them and I’m still hurting so much!!! I dont even know what to do anymore. It hurts to chew at times and the jaw pain and everything else makes me not a fun person to be around. I’ve taken ibuprofen, turmeric, tylenol. I dont know what else to do. I’ve been offered muscle relaxants but truthfully I’m scared to take them. I dont care for prescription. I just wanna feel normal again.

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    Eye pain or Retro-orbital (behind the eye) pain is a very common symptom of TMJ disorders. One common cause is referred pain from MPD or Myofascial Pain and Dysfunction. The MPD pain is often associated with abnormal overfunction of the jaw muscles and can rapidly cause both joint pain and many other diverse pains including sinus pain and headache. TMJ Disorders have been called “The Great Imposter” because they duplicate so many other disorders.
    Starting treatment with orthodontics is usually a bad idea because it is not reversible and if the pain gets worse you cannot go back. Diid you have teeeth extracted for your orthodontics? Almost always a bad idea due to negative effects on the airway and subsequent changes in head position.
    I suggest you try a neuromuscular orthotic to try to eliminate the pain as a first step to getting your life back and becoming free of pain. You can put yourself in control of MPD by learning how to use Travell Spray and Stretch that can turn off MPD pain quickly and over time improve the cause of pain. I suggest you leearn to Self-Administer SPG Blocks or Sphenopalatine Ganglion Blocks that can turn off autonomically related Sympathetic overload and pain and control the stress reactions that cause pain and make it difficult to resolve. SPG Blocks only use lidocaine and can bee self administeered with cotton tipped catheeters thru the nose.

  21. Dr Shapira, I am based in England, so getting an appointment to see you would be problematical. I have suffered with my jaw for many years, my dentist has made an oral appliance and referred me to a maxillofacial surgeon for a consultation. The surgeon confessed he didn’t know much about TMJ and diagnosed myofascial pain, for which he suggested painkillers. My dentist says there is nothing to be done except what we have already considered. I have many of the symptoms you describe, including tongue pain, numbness, tingling, tinnitus, pain around both ears and neck. This is a long shot, but do you know any TMJ specialist in England that you could recommend? Many sufferers in England are like me and its difficult to find someone who can help. Thank you.

  22. Post

    I suggeest you check These are the top neuromuscular dentists. There are some in France and Germany but I am not sure about Great Britain. I do see long distant patients but understand it can be diffiicult or impossible.

  23. Hello,

    I have been suffering for the past 2 weeks with awful jaw pain, ear pain, base of skull pain, teeth pain, tongue pain, clenching tongue to roof of mouth, neck pain, ringing in ears and clenching jaw now my bite feels off, my jaw poops and hurts more in the right side those teeth hit first when biting down. My teeth are so sensitive now to eat or drink hot or cold. Please help I would greatly appreciate.

  24. Hi Dr. Shapira,
    I never had any problems with my tongue until I had root canal on my upper first molar, and my dentist says now that the molar needed a larger crown because it’s bigger than the other molars. So there is less space for my tongue and I’m wondering if this is also related to tmj, which i have , however doesn’t really impact my life. I’ve had a great deal of dental work and wear a night guard. So is it possible my tongue will get the clue that there’s just less room for it… or I guess I could have it pulled, however just had a root canal before the crown… so i’m hoping it will lessen …. as I’ve had tmj symptoms for many years, but never before this incident, did i ever have tongue issues… ( I’m originally from NJ, and yes we jersey girls love to chat!

    Any info re tongue, would be most helpful…

    thank you very much!

    virginia fagan

  25. Post

    I suggest starting with a neuromuscular diagnostic appliance to eliminate symptoms ASAP. These are all typical TMD symptoms that usually are easily treated.

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  27. I have been under major stress the past two years. Jan. 25, 2018 I went to a new doc who’d, as a routine check, looked at my tongue and said I needed to keep an eye on it. I was severely fatigued at the time and my tongue had a film over it. Her comment sent me into a tail spun thinking I had tongue cancer, which sent me into a full panic attack that ended me in the ER that night, which at that point is when I noticed my tongue became sore. The ER didn’t understand why she’d said that because he didn’t see any issues with my tongue. I followed up with my old doc and he didn’t see any issues either. I began having pain from a crown that had been done a year prior, that was giving me problems but the dentist said nothing was wrong with it. I knew something was wrong so I got an emergency Endontist appointment and he discovered severe inflammation under the crown…hence the root canal process began. The same day the root canal began I went to a new ENT who ruled out tongue cancer too. Two days after the root canal I got an infection in the tooth and my lympth node swelled. He refused to give me an antibiotic! I went back to the ENT and he prescribed me an antibiotic. A few days later I then went to a new dentist because I wanted my tooth pulled because of all the issues I was having with it but he encouraged me to finish out the root canal. So…12 days later I had the root canal completed and the next day my tongue began turning brown from the bacterial mouthwash and antibiotic and my tongue and hurting and has not been the same since. I went back to my ENT last week and he gave me prednisone which has helped with the burning and pain. Having shared all this…the Endontist and dentist, as well as the new holistic dentist I went to the other day regarding my tongue (who did a bite test and discovered the crown was too high and filed it down), said I grind my teeth pretty bad. I’ve been fitted for a mouth guard and will be getting it tomorrow. I also scheduled an appointment with a chiropractor who specializes in TMJ that I’ll be seeing tomorrow. I’ve had so many tests done to figure out what’s going on but everyone is stumped about my tongue…however…cancer has been ruled out completely! Praise God!!! But…the pain and burning is awful!! Could a nerve have been hit when the Endontist deadened my mouth. I know stress has caused a lot of this as well.

  28. I have suffered from a numb spot on the tip of my tongue that feels as if there is a mass there. Several MRI’s, and CT scans, show nothing. Blood work is clear. The spot is about the size of a pencil eraser. As I talk, the spot gets sore and makes it hard to move my tongue. I also noticed I have a scalloped tongue and my throat clicks when I swallow. Finally, I do not sleep well most nights.

    The pain in that area of my tongue is only present when I talk. The feeling of numbness and that there is a mass there is always present. The scalloped tongue is only present after my tongue has been at rest in my mouth.

    I have been to many ENT’s, oral surgeons, GP’s and my dentist. They all say it’s not cancer and really have no idea what to do/say.

    It’s impacting my quality of life and ability to speak without pain.

    Any thoughts? I am located near Medina, Ohio. 44256. Thanks so much for your time!

  29. Post

    I would check for a tongue tie as a first step. There is unlikely an organic disoorder afteer so much diagnostic imaging therefore it iis probably a functional disorder. The scalloped tongue means it is likeely you have an underdeveloped maxilla and a deviate swallow. A diagnostic neuromuscular orthotic may give you relief. A Sleepm study would also be helpful.

  30. Post

    TMJ disorders are often called the Great Imposter due to the many varied issues related to jaw function. A diagnostic neuromuscular orthotic is often used as a first step in diagnosis and treatment. Severe fatigue may be related to jaw and airway issues. If you do not find resolution I would suggeest coming in for an evaluation. This will usually give you a good understanding of how these symptoms are all related.

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