We understand that Temporo-mandibular disorder (TMD or TMJ as it’s commonly called) is very complicated to the general public. One could have read different materials, visited different practitioners and received very different opinions. We hope to explain TMD in layman’s terms, and hopefully this page can be helpful to you.

With years of experience seeing TMD patients, the most common routes where patients come to visit us are:

  1. Headaches or facial pain referral by MD/ENT where they ruled out sinus or other facial or neurological issues
  2. Self-referral or professional referral when patients experience painful jaw joint clicks or TMJ clicks

When presenting with the same symptoms to a surgeon, a chiropractor, or a physical/massage therapist, patients could receive recommendations of surgical intervention, manipulation, or massage therapy, respectively. They all have their merits. We, in fact, work with different local practitioners to achieve the best outcome on an individual basis.

As dentists with very extensive and specific training in evaluating bite harmony with muscles and the TM joint, we have treated and have seen fascinating responses with bite corrections, either with nightguards, splint therapy (orthotic), or partial/complete bite adjustment. We believe it is a non-invasive way of treating a sometimes very painful, chronic problem when compared to surgical intervention. Granted there are times when surgery is indicated, but it is of our opinion that the majority of the patients can achieve great improvement with this effective and conservative treatment.

Please call us at 508-478-3800 if you are suffering from TMD related issues. We will love to help you figure out the best course of treatment.

Patients with classic TMD symptoms present with clicking of the jaw joint, severe headaches, jaw pain, TM joint pain, myofacial pain or combination of different symptoms. Yes, there will also be a group of people who can present with intermittent ringing in the ears or pain behind their eyes. Unbeknown to some, tooth related symptoms such as cold sensitivity, toothaches could be related and are indicators of possible future TMD. When we evaluate a patient who comes in with possible TMD symptoms, we look closely at signs and symptoms of the joint, muscle, and teeth. A brief breakdown of what we look for is below:

Temporomandibular Joint 


With advanced trainings in reading CT scans and MRI, the doctors can diagnose any structural deformation, joint clicks, deviations on opening, and joint pain/inflammation. With the proximity of the TMJ to the ear canal, earaches or ringing in the ear could also be a common symptom.


Muscles govern the movement of the jaw. People who clenches, grinds, or have habits with excessive use of lower jaw can experience symptoms similar to overworked, tired muscles. Symptom includes headaches, facial pain, pain behind eyes, incoordination of muscles, tederness to touch are common with TMD.


Often times, a poor bite or a bite that does not function in harmony with the joint, can cause joint and muscle symptoms (as illustrated above). Common signs and symptoms that we usually see with teeth are: cold sensitivity, excessive wear, mobility of teeth, fractures, and pain on chewing. Also, hyperactivity of the muscle will cause accelerated tooth wear (as above).

Reasons for treating TMJ

TMJ sufferers report that their symptoms generally worsen during periods of prolonged or unexpected stress, and that intense outbreaks of the condition can lead to all sorts of joint, muscle or teeth symptoms described above.

The most common cause of TMJ is the misalignment of the teeth, often called “bad bite.” It is possible for the dentist to realign or adjust the teeth without the need for painful or expensive surgeries. Often times, the goal of treatment is to prevent or delay major work that could be needed in the future. The realignment/adjustment will often times stop the pounding headaches, myofacial pain, and the jaw joint pain.

The grinding teeth symptom is particularly common and usually occurs at night. The grinding will eventually erode the structure of the teeth and lead to much more severe dental problems in the future. Concurrently with periodontal disease, untreated TMJ is one of the prime underlying factors in eroded jawbones and loose teeth.

It is important for anyone experiencing the symptoms of TMJ to visit the dentist for an exact diagnosis.

What does treating TMJ involve?

Conservative in nature, Drs. Goodman and Ko will proceed with the least invasive option first. Often times it will be appliance therapy (ie. Nightguard - below) to alleviate any muscle or joint symptoms. Dental appliances can also act as a useful diagnostic tool. Once the symptoms are controlled with appliances and/or at times with pharmaceuticals, further treatment could involve orthodontics, bite adjustments, prosthetics (restorations,crowns,veneers), and in very rare instances, surgery.

If you are experiencing any symptoms of TMJ, we encourage you to contact our office today at 508-478-3800 to schedule an appointment.

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