TMJ/TMD Treatment

What are TMJ Disorders?

Temporomandibular joint and muscle disorders, commonly called “TMJ,” are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement. We don’t know for certain how many people have TMJ disorders, but some estimates suggest that over 10 million North Americans are affected. The condition appears to be more common in women than men. TMJ is referred to by different names such as TMD, TMJ disorder, and TMJ dysfunction.

Disorders of the jaw joint and chewing muscles – and how people respond to them – vary widely. Researchers generally agree that the conditions fall into three main categories:


Myofascial pain, the most common temporomandibular disorder, involves discomfort or pain in the muscles that control jaw function.


Internal derangement of the joint involves a displaced disc, dislocated jaw, or injury to the condyle.


Arthritis refers to a group of degenerative / inflammatory joint disorders that can affect the temporomandibular joint.


A person may have one or more of these conditions at the same time. Some people have other health problems that co-exist with TMJ disorders, such as chronic fatigue syndrome, sleep disturbances, or fibromyalgia, a painful condition that affects muscles and other soft tissues throughout the body.

These images show the anatomy and the changes with temporomandibular joint as the mouth opens and closes. No other joint in the body is used as much as the TMJoint. This is why it is important to find a doctor that is highly educated and experienced. Dr. Keller has treated not only celebrities and politicians, but also other dentists and their family members. He is truly the “Doctor’s Doctor”.


What are the symptoms?

  • Headaches and migraines
  • Pain in the face, jaw, or neck
  • Jaw muscle stiffness
  • Limited movement or locking of the jaw
  • Waking up with sore muscles
  • Clicking, popping, or grating in the jaw joint when opening or closing the mouth

What Causes TMJ Disorders?

There should be a balance between how the teeth fit together with the muscled and joints that move and support the jaw movements. Most TMJ dysfunction issues arise when the balance is compromised, and it usually involves minor events that stress the structures that over time result in significant tissue injury.

The most common signs and symptoms of TMJ are headaches, neck pain, ear pain, ringing in the ears, facial pain, and clicking or popping of the joint. The compromises seldom fix themselves but will usually get worse over time without professional intervention.  Early recognition and treatment are best while the healing capacity is the greatest. Treatments for TMJ issues should be as conservative as possible.

The first essential step is to determine the cause of the pain or joint noise. Then, conservative diagnostic treatment addresses the structural, functional and postural components to see if the injury can be managed and if adequate healing can occur.  For this reason, we incorporate physical therapists into our office to help alleviate pain and promote healing.

Conservative Treatments

We recommend and orthotic or splint to fit over the lower teeth to diagnose and treat the TMJ dysfunction.  Splints can be used 24/7 or as needed.  Regular adjustments are needed to find the best functional position.  Once this is found, long term options may be essential to ensure the problems do not recur.  Many of our patients have been stable and symptom free for over 40 years.


Other types of treatment, such as surgical procedures, invade the tissues.  Surgical treatments are controversial, often irreversible, and should be approached with caution where possible. We only recommend surgical treatment as a last resort, or to those with tissue damage beyond the body’s natural repair mechanism. We treat each patient as an individual and recommend treatment based on what we would recommend to our own family members.

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