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A number of debilitating symptoms, some of which may not seem to be connected with an oral health issue, can be caused by temporomandibular joint disorder. Commonly referred to as TMJ Disorder or TMD, the condition can be responsible for pain and discomfort in a number of facial and body areas, which can ultimately have a significant effect on your livelihood. Here at Smile-R-Us Family Dental of Dr. Karia and Dr. Shah, our experienced dentists are concerned with your overall well being in addition to the health of your teeth and gums. We offer a number of customized treatment options for TMJ Disorder that can reduce symptoms and improve your day-to-day life.

What is tmj disorder?

Dr. Shah focuses on the treatment of jaw disorders, more commonly known as TMJ. In addition to her training in general and family dentistry, Dr. Shah is also a specialist in handling tooth and jaw alignment, having completed advanced dental courses in orthodontics (the study and handling of tooth alignment and problems associated with proper bites) and TMJ.

The term "TMJ" is the acronym for "TemperoMandibular Joint". This is the ball and socket joint that allows the lower jaw to open, close and move sideways when chewing and speaking. Everyone has two of them, and they are located about one centimeter in front of the ears.

The temporomandibular joint is the connection between the upper and lower jaw, aiding in your ability to chew, bite, speak, and yawn. Issues such as jaw misalignment, arthritis, teeth grinding or clenching, a breakdown of cartilage, simple overuse, injury, or other factors which can affect the joint may lead to TMJ Disorder. The condition is experienced by millions of individuals all over the world. Since many people experience symptoms of TMJ Disorder that do not initially seem related to the jaw, the problem may progressively get worse until seen and diagnosed by an experienced dental professional.

What are the signs and symptoms of TMJ disorder?

  • Sore jaw muscles and joints especially right after waking up in the morning.
  • Clicking and/or popping sounds in the jaw joint when opening or closing the mouth.
  • Chewing surfaces are flat and/or worn down through the tooth enamel. This exposes the second, soft and yellow layer of the tooth.
  • Incisal edges of teeth are worn and sensitive to cold or tooth brushing.
  • Loose or broken teeth, crowns or bridges for no particularly obvious reason.
  • Generalized feeling of tooth pain.
  • Grinding, clenching or bruxing.

Some causes of TMJ disorder

  • Trauma
  • Repetitive unconscious jaw movements called teeth grinding or bruxism
  • Teeth are not aligned properly (i.e. upper and lower teeth do not fit together and contact in the proper place).
  • Failure to replace missing teeth, and the resultant facial and joint collapse.
  • Excessive gum chewing or nail biting
  • Jaw trusting – a habit of moving the jaw forward, backward, or side to side.
  • Arthritis or other disease or lesions of the joint.

Treating TMJ

Assisting patients with temporomandibular joint disorders (TMD) is one of Dr.Shah's specialties, and in many cases she can relieve pressure, headaches and jaw pain that does not respond to other types of treatment.

At your initial exam with Dr. Shah, she will check your jaw as well as the state of your teeth and gums to locate any signs of mal-occlusion (lack of alignment of your teeth and jaw bones). If you are one of the many people suffering from TMJ, Dr. Shah will advise you on treatment options which can include night guards to protect your teeth from grinding, Invisalign to adjust your teeth and bite into place or, in some cases, traditional braces.

In any case, the handlings are tailored to the individual needs of each patient so that they can have a comfortable bite and chew and talk without pain.

Treatment options for TMJ

  • Pain relief: Ibuprofen has been used for temporary relief of pain in the temporomandibular joints and headaches associated with TMJ pain. If the pain is more neurological in nature, the pain will not respond well with these drugs.
  • Gentle jaw stretching and relaxing exercises you can do at home. This is the choice for TMJ related to stress, excessive gum chewing or temporary pain of the TMJ.
  • Nightguards are the most widely-used treatment for TMJ. They can be used to alleviate pain right away and also to prevent teeth from continued enamel wear and root exposure due to teeth grinding, clenching or bruxism.
  • Tooth reconstruction. This is used for those with collapsed bites, when missing teeth are not replaced or where excessive enamel wear has already occurred. Teeth reconstruction involves restoring the teeth to the correct size, height and shape in order for the jaws to line up properly. This relieves TMJ pain and creates a beautiful smile.
  • Invisalign or traditional braces is used to correct crowding and teeth malalignment.
  • Surgery can be done to reposition the TMJ’s to a more favorable location, correct a lower face asymmetry, or remove tumors.

More about TMJ

In many cases the first time a person realizes they have TMJ is when they get a painful popping in their jaw or their jaws lock up and will not open and close properly. These are both extreme instances and cases of TMJ can and should be diagnosed much earlier. Some of the specific situations Dr. Shah looks for include:

Bruxism (grinding teeth)

Many people clench and grind their teeth at night without knowing it. This can be because the person's teeth don't line up properly or even because their muscles are too tight to allow the joint to move freely.

Occlusion (tooth alignment)

More serious problems with TMJ start simply with a person's teeth not aligning properly, giving them a bite that feels off in a given direction. This can worsen over time, and can often be handled simply by locating the teeth in the mouth that don't fit properly and adjusting these with a new crown or veneer. In some cases braces or Invisalign may be a better solution.


Unexplained headaches can come from malocclusion. When you bite down forcefully your teeth may not come together properly, and this forces your jaw backwards. The lower jaw moves and this can pinch the nerves and blood vessels. Your jaw is ultimately connected to nerve which runs to your temples, and this can be a source of headaches or migraines. Click here for more information about headaches and TMJ.


A nightguard is a custom made, highly technically fabricated appliance placed on the upper teeth to relieve pain of the jaw joints, to prevent wear of tooth enamel, and to protect teeth, crowns and bridges from breaking or getting loose. It also helps prevent teeth grinding and/or clenching. It must be custom-made by a dental lab. Avoid the use an over-the-counter nightguard, because these are not made for your teeth. If a nightguard is not custom fit it can cause more harm than good. Click here for more information about night guards.

Headaches & TMJ

Many Americans suffer from chronic headaches or migraines. TMJ can be one cause or contributing factor to this. One focus of Dr. Shah's practice is to properly examine and diagnose TMJ and handle the pain and other symptoms that go along with it.

If the joints in your jaw are out of alignment, you may end up clenching your jaw or grinding your teeth. The extra pressure forces the lower jaw backwards, which can then pinch the nerves and blood vessels. The nerves by your jaw sockets connect to your temples, which is where the head pain starts.

Depending on what Dr.Shah finds during the initial exam, she may recommend a nightguard to prevent clenching or grinding at nights, or further orthodontic work to get your teeth and jaw properly aligned.

Frequently asked questions (faq)

Because the symptoms of TMJ Disorder often overlap with other conditions, an examination from one of our dentists can help you determine whether your temporomandibular joint is causing or exacerbating the issue. This exam may include checking your jaw joints for clicking or popping sounds, running tests to ensure your jaw is biting properly, or taking X-rays in order to gain a more accurate view into whether there is a structural disorder within the joint.

If you are experiencing long-term symptoms of TMJ Disorder, pain and discomfort may continue or get worse until treated. Consulting with one of our dentists can be an effective way to gauge whether action should be taken in your particular case.

Many times, TMJ Disorder develops because of your jaw’s anatomical structure. Surrounding muscles or existing scar tissue may be interfering with your bite, causing some of the facial pain and bodily discomfort characteristics of the condition. Low-level infections and auto-immune diseases have also been known to cause TMJ Disorder, as well as mental or physical stressors.

Many self-help remedies exist to temporarily alleviate symptoms of TMJ; however, these should not be considered long-term treatment options that can address and correct the cause of the condition. Applying heat and cold packs to the side of the face and temple can reduce discomfort if you are experiencing pain in the area surrounding the jaw. Additionally, depending on where your symptoms lie, massage therapy may provide temporary relief. Limiting pressure on the jaw and avoiding foods that require intensive chewing – such as taffy, gum, and carrots – can also minimize pain for some individuals. If you are diagnosed with TMJ Disorder, one of our skilled dentists will talk with you about the best treatment options for your unique needs. He will then create a completely custom-designed treatment plan designed to successfully treat the condition and reduce your symptoms. For more information on TMJ Disorder and the treatment options available at our practice, or if you would like to schedule a consultation.