Facial Pain (TMJ/TMD)

No subject in dentistry is shrouded in more controversy than TMJ therapy.  There are many "experts" on the subject but there is little agreement as to diagnosis and treatment.  TMJ refers to the joint upon which the jaw hinges when the mouth opens and closes, located on each side the head about one inch in front of the ear. 

  • Muscle Disorders:  By far the most common TMJ problems are caused by muscle spasms, which originate due to a lack of harmony in the muscles that move the joint on either side.  Some muscle disorders cause only pain, while others can cause physical damage to the parts of the joint.  One common cause of muscle disorders is a misalignment of the bite.
  • Internal Derangements:  Internal derangements are when internal parts of the joint are misaligned or malformed.  These problems can result from muscle or arthritis-related disorders as well as trauma.
  • Tumors:  Though very rare, some TMJ problems can be caused by tumors in or around the joint.  These are often difficult to diagnose, as different types of tumors show up differently in different types of radiographs.

Not all facial pains are caused by TMJ problems.  Some other types of pain can be caused by neurological disorders and vascular disorders.  Controversy arises because there are many different therapies for TMJ problems, all of which have proponents who claim the various benefits of each therapy.

We treat TMJ patients according to careful diagnosis and analysis of signs and symptoms.  Dental Leaders strongly believes in reversible therapies whenever possible, and commit to irreversible treatments (reconstruction, equilibration or reshaping of teeth, etc.) only after their effectiveness has been proven by reversible means.  The Dental Leaders team adheres to strict standards of integrity and clearly discusses with patients limitations of care when their symptomatology is beyond that which is treatable by proven means.  The practice has the most modern instrumentation to diagnose muscle disorders, as well as a strong network of consulting doctors and therapists—yielding great success in treating TMJ problems far and above that of most practices.  

Any patient for whom TMJ surgery has been recommended is urged to get a competent second opinion prior to committing to surgery.  While surgery can be a successful treatment modality in some cases, it is only indicated for a small number of patients and should be confirmed beforehand as the right treatment pathway.