TMJ & Facial Pain


TMJ & Facial Pain

Tempromandibular Joint Disorders (commonly referred to as TMD or TMJ) are real disorders caused by problems with the function of the jaw. Often times jaw problems are a symptom or side effect of a larger problem affecting the body, much like a fever is a symptom of the flu. Our primary responsibility is identifying why the TMD occurs in the first place. In the absence of a severe traumatic injury (such as car accident) to the head and neck, the primary cause for most TMD is an unidentified sleep breathing issue (Sleep Apnea or Upper Airway Resistance Syndrome). Proper diagnosis and focus on the true cause of TMD is paramount to successful treatment.

Symptoms of TMD

  • Frequent headaches (Migraine, Tension, and/or Cluster), especially in the morning
  • Frequent and recurrent ear pain or ‘infections’ that don’t respond to antibiotics
  • Popping and clicking of the jaw joints, often painful
  • Locking or restricted movement of the jaw
  • An inability to open your mouth far
  • Pain when chewing
  • Face, Neck and/or Back pain
  • Unexplained tooth, eye, ear, and head pain
  • Ringing of the ears

All of these are often related to TMJ dysfunction.

Ways to Treat TMD

Many patients who have this problem assume the only treatment options are surgery or continued chronic pain. This is not the case. Many patients have several options. In order to determine the right treatment for each patient, the symptoms of the disorder will be analyzed to identify the true underlying causes.

  • Orthodontics
  • Decompression appliance therapy (short-term appliance to alleviate pain)
  • Oral Splint / Custom Night Guard (long-term appliance to improve breathing and protect the teeth/TMJ.
  • CPAP machine
  • Cosmetic Dentistry
  • Nutritional Counseling
  • Myofunctional Therapy
  • Botox Treatment
  • Physical Therapy (cold laser treatment, trigger point therapy, prolotherapy)
  • Surgical Intervention (jaw surgery, tongue surgery, tonsil/adenoid surgery, sinus surgery, etc.)


Why Does My Jaw Make Noise?

One of the earliest signs of jaw joint problems is a hearing a noise when opening or closing. The noise may happen all the time or just on occasion. For some people, the noise is loud enough to hear across the room and for others it is very quiet and difficult to perceive. The reason the jaw makes noise is because of the improper movement your jaw ligament between the jaw bone and socket. When not moving properly, this ligament dislocates and the sound of popping on and off the jawbone is heard. This is never normal or healthy.

Why Does My Jaw Get Stuck or Locked?

The jaw can become locked or stuck in either an open or closed position when the ligament dislocates between the jaw bone and socket and does not return to its normal position. Another cause for jaw lockage occurs when the muscles that control the jaw spasm and prevent normal movement. Both conditions can be very dangerous if left untreated. TMD conditions are progressive and will get worse over time.

How Do You Diagnose TMJ Problems?

TMD conditions are diagnosed through a complete clinical examination which includes analysis of: range of motion, joint sounds, X-rays, photographs, patient interview, dental history and medical history, and often times sleep related breathing evaluation. Successful treatment outcomes are heavily reliant upon complete diagnosis. This is why, prior to suggesting any treatment options we will have a complete diagnosis of your condition.

Are Grinding/Clenching Related to TMJ Problems?

Previous diagnostic information such as X-rays are certainly beneficial in understanding your dental history (how you got to where you are). But, some routine dental x-rays are not diagnostic for all the conditions we are screening for. It will frequently be necessary to take a new 3-D image of your jaw joint. This image is called a CBCT scan or Cone Beam and is not typically found in most dental offices.

My Other Dentist Had X-Rays Taken, Can We Use Them?

Any abnormal forces (including from clenching and grinding) can have a negative effect on the health of your jaw joint. The jaw joint functions best when it is able to slide and rotate with light forces and plenty of lubrication. When clenching, grinding, or even eating hard/chewy/crunchy foods there is increased stress on the joint space which results in a decrease in the lubrication and increase in force.

What May Happen If I Do Nothing?

TMD is a progressive condition which means it gets worse over time. Unfortunately, the future (if left untreated) will be worse than the present. Although every person is different and symptoms vary drastically case to case; the usual progression pathway is something like this: short term sharp pains, jaw inflammation, muscle tenderness, jaw joint sounds, restricted range of motion, jaw locking, grinding and arthritis of the jaw, wear and destructions of the teeth, loss of teeth of permanent damage to a portion of the jaw joint. loss of the ability to chew and function normally, continued and worsening pain through the process.

Will My Insurance Cover This?

Grabill Family Dentisty is not a participating provider with most medical or dental insurance companies. As a courtesy, we are happy to help in filing paperwork, insurance forms, and any documentation to assist in the processing of your claims. Typically, TMJ and sleep treatments are filed under medical insurance. We feel it is important for you to fully understand the policies you have and their payment allowances. Since we are out-of-network providers, your insurance company may be unwilling to provide any information to us other than the basic plan benefits. Therefore, we may ask you to contact your insurance provider to obtain your plan’s specific benefit information.

How Much Will This Cost?

Treatment costs vary depending on the severity of your condition, complexity of the diagnosis, and your interest fixing the condition vs. maintaining your condition. We will talk more about what is best for you and promise you will always have a crystal clear idea of expenses before we begin anything.


Dr. Kolkman was awarded his Fellowship in the AGD by amassing over 1,000 hours of continuing education in the areas of cosmetics, sedation, implants, and biological dentistry. He received extensive training on the TMJ and bite problems at the Kois Center for Advanced Dental Education.


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