How Jenna, a labor and delivery nurse, cured her TMJ after four years of being told she couldn't.
Four years. Seven thousand five hundred dollars in night guards, Botox, and dental splints. Soft food, a bite adjustment she regretted, and a jaw that locked every time she tried to laugh. Then her couples therapist mentioned a book.
Jenna is a 38-year-old labor and delivery nurse. She had TMJ pain for four years. Night guards, Botox, splints, dietary restrictions, and about $7,500 in dental specialists, and nothing had worked. Then her couples therapist mentioned The Way Out by Alan Gordon. Ten months later, she was pain-free. A 2023 BMJ analysis of 153 trials and 8,713 patients found that brain-based treatment outperformed dental splints and surgery for chronic TMJ pain.
Yao et al., 2023, BMJFour years of dental treatment that didn't hold, and a life she quietly cut to fit her jaw.
Jenna was 34 in the spring of 2021 when she thought she'd slept on her jaw wrong. A few days of ibuprofen. Then it came back. Then the clicking started, and then the headaches radiating from her jaw up into her temples. That was the beginning. Four years ago.
Her general dentist diagnosed her with bruxism and fitted her for a custom night guard. Four hundred and fifty dollars, not covered. She wore it every night for six months. Morning jaw was a little less stiff. Daytime pain was unchanged. The clicking got worse, if anything. Her primary care doctor added ibuprofen 800 and Flexeril. "Try to relax your jaw during the day," the doctor said, kindly, like it was helpful advice.
In January 2022 she saw an orofacial pain specialist. A $350 consult, not covered. The diagnosis: myofascial TMD with disc displacement with reduction. The plan: a custom hard splint at $1,200, fitted over three visits, plus twenty sessions of physical therapy. The PT was warm and skilled. Jenna liked her. Pain was briefly better after each session, back to baseline by the next morning.
Summer 2022: a second orofacial pain specialist. A new MRI. Eight hundred dollars out of pocket after insurance. Bilateral disc displacement with reduction. Stop eating chewy food, the specialist said. Jenna gave up bagels, apples, steak, corn on the cob, and her mother's puff-puff. She lost seven pounds she didn't mean to lose. In March 2023 she started Botox into her masseter and temporalis muscles. $800 cash every eight weeks. Three rounds. The last one barely worked.
In November 2023 a different dentist offered to balance her bite by selectively grinding down her teeth. Six hundred dollars for two sessions. She read the Cochrane review afterward. No evidence it helps TMD. She was angry at herself for agreeing to it. Trigger point injections in January 2024, $450, helped for three days and came back worse for a week. By March 2024 a third orofacial pain specialist was offering arthrocentesis at $1,800 per side. She said she needed to think about it.
By 2024 the pain had changed her. She'd stopped singing in her church choir in early 2023 because sustained jaw opening flared her pain for two days after. She told herself it was too much to drive on Sundays after night shifts. That wasn't the reason. She stopped laughing fully. Her jaw locked for a second when she laughed hard, so she switched to a half-laugh, a controlled laugh. Chris noticed. She said it was nothing. In October 2024 she flew to her cousin Chidinma's wedding in Houston. Three hundred people. Her mother flew in from Lagos. Jenna couldn't eat most of the food. When the DJ played an old highlife song her grandmother used to dance to, her mother pulled her onto the dance floor. Her grandmother had died in 2019, three months after Jenna's pregnancy loss. Jenna's jaw locked mid-laugh. She excused herself and cried in a bathroom stall. Not because of the pain. Because she was thirty-eight and her grandmother was gone and her grandmother's song was playing in the next room and her own body wouldn't let her laugh out loud on the happiest day of her cousin's life.
"Seven thousand five hundred dollars out of pocket over four years," she says. "Night guards, Botox, splints, a bite adjustment I still regret. That's a year of daycare if we have a baby. I spent it so I could keep cutting my food into tiny pieces."
Mpls Orofacial Pain Center · Invoice
03 / 07 / 2023 · 10:42 AM
I stopped eating apples at 35 years old. That's a small thing that turned into a big thing.Jenna, Year 2
The book her couples therapist mentioned once.
Jenna had been in couples therapy with Chris since earlier in 2024. The therapist was warm, skilled, and not a TMJ specialist. In a session in November 2024, a few weeks after the wedding in Houston, Jenna mentioned the jaw pain again, in passing. The therapist said, "Have you ever read The Way Out by Alan Gordon? It's mostly on back pain, but the framework applies to TMJ too. Read the first few chapters. See if anything rings true."
Jenna downloaded the audiobook the next morning and listened to the first chapter on her commute. She pulled into the hospital parking lot and sat in her car for fifteen minutes before clocking in. Gordon was describing a patient whose pain moved, got worse under stress, and didn't match what the imaging showed. He could have been describing her.
Three things hit her during that chapter. Her pain tracked her emotional state, not what she'd eaten. Her worst jaw days were after loss deliveries. Her best days were on vacation. She'd been assuming the pain was about chewing the whole time. The direction had been backwards.
Her MRI findings appeared in people without any pain. She looked it up on her phone during her lunch break. Up to 35% of asymptomatic people have the same disc displacement she'd been told was her problem. She sat in the break room and felt her professional identity shift. She was a nurse. She was a patient. Her own research literacy had missed this.
Her TMJ had started four months after she was cleared to try for another pregnancy, after the loss in 2019. She hadn't told Chris or her therapist or anyone how scared she was about trying again. She'd held that grief in her jaw for years without knowing it. "Pain is a prediction, not a measurement." That sentence was from Chapter 2. She listened to Chapter 2 three times that week.
Functional
Her MRI showed bilateral disc displacement with reduction. A real finding. Also present in about 35% of pain-free people (Larheim 2001). Three dentists examined her bite, two said it was fine, one ground down her teeth for $600. Four night guards, a custom splint, PT, three rounds of Botox, and trigger point injections. None of it touched the pain at the source.
Strong matchInconsistent
Pain moved. Jaw joint, masseter, temples, neck, right side, left side, both sides. Worst on the drive home from a loss delivery, regardless of what she'd eaten. Pain vanished almost entirely during three weeks visiting Chris's family in Ghana in 2023. Same mouth. Same teeth. Different context. Pain came back the second day after they got home.
Strong matchTriggered
Pain spiked on the drives home from loss deliveries. Every single time. For three years. Flared before she called her mother about the pregnancy conversation. Flared during annual performance reviews. Dropped on the first real vacation day, before she'd changed anything physically. Rose within minutes of reading a difficult email, even lying still on the couch.
Strong matchWhat the ten months actually looked like.
It was not a straight line down. At month two her pain spiked worse than any flare in four years. She was certain the book was nonsense. It wasn't.
Started listening to The Way Out on her commute. Read the OPPERA study on her phone during a night shift break. Read Yao 2023 in the BMJ next, 153 trials on TMD. Kept everything to herself for two weeks. Didn't tell Chris. Didn't stop the night guard yet. Stayed on her soft-food rules because that had become automatic.
Started somatic tracking for five minutes before every shift, sitting in the hospital parking lot. First week she felt stupid. Second week her jaw softened on its own while she watched it. Ate an apple on December 24th for the first time in two years. Cried a little. Didn't tell anyone.
A night shift with two traumatic deliveries in a row, the second a loss. On her drive home the next morning she felt jaw pain like the worst of four years condensed into one flare. Locking. Radiating into her ear. Couldn't open her mouth more than two fingers. Almost called the orofacial pain specialist to schedule arthrocentesis. Texted her couples therapist instead. The reply came within an hour: this sounds like an extinction burst, read Chapter 6 again. She pulled over in a Walgreens parking lot and read Chapter 6 on her phone. Four days later pain was a 5.
Told Chris what she'd been doing. He cried. He'd watched her try things for four years and she'd hidden this one from him because she didn't want to disappoint him again. He read the book in a weekend. She stopped all jaw-related avoidance: bagels, apples, gum, hard candy, laughing out loud. Ate a whole toasted bagel with cream cheese one morning. Started humming in the car again.
Went back to choir after two years out. Sang the alto part for three songs at a friend's wedding in June. Her jaw felt fine afterward. Told her choir director about the gap and why. Her choir director hugged her and said she'd been waiting for her to come back. She and Chris started talking about the pregnancy question again.
At her cousin Chidinma's baby shower, in the kitchen with her mother making egusi. Same mother from Lagos, same cousin from the wedding a year earlier. Jenna eats an entire bowl. Her mother watches her chew and catches her eye across the island and smiles. That night she tells her mother that she and Chris are going to try again.
The three things that changed everything.
She stopped protecting her jaw.
For four years Jenna had been treating her jaw like a broken thing. No apples, no bagels, no gum, no corn on the cob, no crusty bread. She cut her food into tiny pieces. She kept her jaw slightly slack all day, on purpose, because she'd read somewhere that would help. She never opened her mouth wide. She ordered soup when she went out. Every meal was a calculation.
The week she admitted the new experiment to Chris, she ate a toasted bagel with cream cheese. Then an apple in her car on the way to work. Then chips. Then gum on a night shift, as a small private victory. A few weeks later she laughed with her whole face at a friend's joke and didn't track what happened afterward.
Every time she'd cut her food into tiny pieces, she'd been sending her brain the same message: this mouth is broken, be careful. When she started eating normally, she sent a different message. The brain listens to what you do, not what you say.
She stopped charting her jaw like one of her patients .
Before, she checked her jaw fifty times a day. Noticed the clicking. Noticed the tightness. Noticed whether it was worse on the left or the right today. She kept a pain diary. Rated her pain on a 1 to 10 scale every morning. Googled "TMJ flare up" at night. Read forums. She'd been doing Q-2-hour assessments on her own face the way she did them on her patients.
She stopped the diary. Stopped the ratings. Deleted her bookmarks to three TMJ Facebook groups. When she noticed her jaw, she noticed it without turning it into data. A click was just a click. Tightness was just tightness. Most of the time the sensation faded within a few minutes.
Monitoring the pain had been teaching her brain the pain was important. Stopping the monitoring told her brain this wasn't an emergency. Attention is a fuel source.
Take the danger label off a click and the click stays a click.
She felt the grief she'd been clenching through.
The pregnancy loss in 2019. Her grandmother's death three months later. Two stillbirths during a single night shift in October 2022. Covid deliveries. The slow pressure of coaching other women through labor while her own body wouldn't let her have a baby. For five years she'd said "I'm fine." She'd said it to her mother on the phone to Lagos. She'd said it to Chris. She'd said it to herself.
After she told Chris about the book, she started letting herself cry again. About the pregnancy. About her grandmother. About the stillborns she'd caught at work and gone home and said nothing about. Back to couples therapy for two months of sessions on grief. She wasn't trying to process her TMJ pain. She was trying to let her body carry less weight in general.
Her jaw had been doing emotional labor for years. Every time she said she was fine when she wasn't, her jaw absorbed it. That's not a metaphor. Clenching is a nervous system response to unfelt feeling. When she started feeling the feelings, the jaw stopped speaking for her.
Back in her own life.
Jenna has been pain-free since summer 2025. Not flare-free. Pain-free.
She's back on the L&D floor full time, three twelve-hour night shifts a week. She eats anything. Steak. Apples. Chewy bagels. Corn on the cob. Tortilla chips and popcorn on her days off, gum on a long shift, hard candy on a road trip with Chris. No food rules.
She went back to choir in June 2025 after two years away. Sang the alto part for three songs at a friend's wedding that same month. Hit a high C at a Christmas service in December and held it without thinking about her jaw. Chris says he'd forgotten what her full open-mouthed laugh sounded like.
She still gets a flare maybe once a month. Usually before a big conversation. Sometimes before her period. Almost never after a meal, anymore. The difference is she knows what it is now. It arrives, she doesn't panic, she keeps doing whatever she was doing. Usually it's gone within a few hours. She doesn't call any specialists.
"I'm a labor and delivery nurse," she says. "I've coached hundreds of women through the hardest day of their lives. I forgot I was allowed to be one of those women too. My body was holding things I hadn't let myself feel. Once I let myself feel them, it didn't have to hold them anymore. The pain going away wasn't the point. The point was getting back into my own life."
Does Jenna's story sound familiar?
If you've been told your jaw is structurally damaged, if you've paid thousands out of pocket for treatments that helped for a few weeks and came back, if you've been told to stop eating the things you love and just manage this for life, there's a good chance your pain follows the same pattern Jenna's did.
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