TMJ Jaw & Face Pain

Temporomandibular Joint Disorder (TMD) is a collective term referring to a number of clinical problems involving the Temporomandibular Joints (TMJ’s) and associated muscles and structures of the area.

TMD is thought to be fairly common as several researchers have found clicking and popping noises in the jaw joints to be present in 40-60% of the general population. Considering that normal healthy TMJ’s are completely silent at all times, the 40-60% figure is a rather staggering one to consider.

The good news is that TMD symptoms are quite variable in nature, with most being a mild annoyance. However, a small percentage of patients with TMD have symptoms which degenerate into crippling chronic pain and limited jaw mobility.

A recent National Institute of Health study indicates that over nine million Americans suffer from TMJ pain on a regular basis.

Common Causes of TMJ

Long-term strain on the TMJ’s (temporomandibular joints) caused by a sleep pattern of chronic grinding and/or clenching of the teeth (bruxism). This may lead to permanent damage to the teeth and TMJ’s themselves.

Certain types of malocclusion (bad bites) can chronically over-stress the TMJs and related structures every time the individual chews. This in turn can lead to temporomandibular joint damage.

Accidents involving direct or indirect trauma to the head, face, and / or neck may lead to partial or total TMJ disc dislocation, stretched or torn TMJ ligaments, and impaired joint function.

Extensive dental procedures which have over stressed the muscles, joints, ligaments, nerves, may also lead to TMJ ligament inflammation or damage. This in turn could lead to muscle spasms and / or TMJ disc dislocation.

General anesthesia intubations which strain weak TM joints or damage healthy TM joints by overextending the joint while the patient is asleep.

Arthritis of the TMJ’s particularly in patients with TM disc dislocations.

Systemic diseases such as gout, lupus, scleroderma, and fibromyalgia may also contribute to TMJ – like symptoms or problems.

Growth and / or developmental disturbances of the structures of the face and TM joints may cause malformation of the TM joint structures and thus dysfunction.

Some other reasons for TMD are less identifiable and may result from a combination of small events such as lying against a partially strained or damaged (but previously asymptomatic) TMJ while sleeping. Other reasons include irritability of facial muscles due to an inadequate diet, muscle tension due to caffeine, nicotine, and sugar. Lastly, studies have also shown a link between stress and the frequency of teeth grinding at night. This chronic and prolonged nightly activity ultimately damages the TM joints or impairs the body’s ability to heal a damaged joint.

Diagnosis of TMJ

The first step in the management of TMJ disorders is to determine that the concern is not another type of medical or dental problem behaving as if it were a TMJ problem.

This determination is made following a TMJ Screening Appointment that includes a preliminary clinical examination of the jaw joints, muscle system, bite, and teeth; completion of a thorough TMJ history form and screening x-rays of the teeth and jaw joints.

We also advise patients to seek a concurrent proper medical exam from a medical doctor (ideally an ENT) to rule out the presence of medical problems which may be occurring in combination with or disguising themselves as TMJ problems.

Following a TMJ Screening Examination, a preliminary diagnosis can be rendered. If the preliminary diagnosis is TMJ disorder, then further tests will be indicated to identify the exact nature of the problem, and to assist in developing a treatment strategy.

FAQ's about TMJ

How long until I see results from treatment?

Results will vary by individual. However approximately 95% of our patients will experience significant relief within a treatment time frame ranging from a few days to 6-8 weeks.



These patients are typically sent to one of the few highly trained and experienced TMJ surgical specialists in the world, Dr. Mark Piper in St. Petersburg, Florida. Dr. Piper evaluates each patient for the value of surgical intervention. To learn more about Dr. Piper and TMJ, you can visit his website at:

What happens to the 5% of patients who are not successfully treated via professionally designed and managed orthotic appliances?