TMJ/TMD Diagnosis and Treatment

TMJ and maxillofacial pain can present as ear pain, tooth pain, limited jaw movement, headache and TMJ noises (clicking, popping and grating sounds). There are many successful, nonsurgical treatment options available for individuals suffering from TMD in Reno, Nevada. If you have any questions or would like to schedule an appointment with our orofacial pain practitioner, Dr. Kim, please call Northern Nevada Center for Orofacial Pain at 775-583-7755.

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Temporomandibular Joint Disorders

Temporomandibular disorders (also known as TMD) are complex disorders that can present with pain around the ear, head, teeth and/or sinuses. It is not uncommon for these symptoms to be confused with other maladies such as infection of the ears or sinuses, dentoalveolar disease and headaches. Myofascial pain or myalgia is pain in the muscle that can also produce similar symptoms.

Signs and Symptoms of a Temporomandibular Disorder

Those suffering from TMD often experience symptoms like:

  • Pain or tenderness around the face, teeth, gums, ear, joints in the jaw and neck
  • Difficulty chewing
  • Locking jaw, where one is unable to fully open or close their jaw
  • Joint noises accompanied with pain
  • Ear ringing or ear congestion
  • Headache
  • Painful or mobile teeth, uncomfortable bite
  • Limited jaw movements

What are the most commonly treated problems?

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Anterior disc displacement with reduction (clicking or popping jaw)

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Anterior disc displacement without reduction (closed lock)

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TMJ arthritis

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Muscle pain

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Clenching and grinding teeth

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Jaw movement disorders

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It is not uncommon for an orofacial pain patient to have seen multiple medical and dental providers. The majority of sleep apnea patients are not aware that there are other alternatives to CPAP therapy. If you suffer from orofacial pain or sleep apnea, call us today to schedule a consultation.

Diagnosis & Treatment of Temporomandibular Joint Disorders

Diagnosing Process

Our goal in treating TMD disorders is to follow evidence-based therapies and ensure that we exhaust all conservative, reversible treatments prior to discussing more invasive options. The majority of our patients improve without surgical intervention. However, in some cases TMJ arthrocentesis can be quite beneficial.

TMD can be caused by intracapsular problems (such as capsulitis or arthritis) or extracapsular (musculoskeletal) problems. Diagnosing TMD usually starts with a review of a patient’s medical and dental history and a comprehensive exam that also includes joint and muscle testing. In milder cases, we recommend a conservative approach to treating TMJ disorders, which can include a soft diet, application of moist warm heat followed by symptom-specific jaw exercises, physical therapy and anti-inflammatory medication if tolerated. TMJ imaging may also be recommended.

Occlusal guards are designed specific to the patient’s symptoms. However, we do not recommend any irreversible changes to occlusion, as occlusion is rarely the cause of TMD. However, bite changes may sometimes occur as a result of TMD.

Steroid, platelet-rich plasma (PRP) and hyaluronate injections may also be recommended if TMJ pain escalates. Trigger point injections can also be very helpful for patients with muscle pain and jaw-opening limitations and for diagnostic purposes. Medicated muscle injections may also be considered in select patients.

In cases where TMJ may be attributed to stress tension or other psychological factors, cognitive behavioral therapy and myofunctional therapy have also been helpful in treating some TMD cases.

Treatment Options May Include

  • Pharmacotherapy (medications)
  • Oral appliance therapy
  • Home exercises and physical therapy
  • Trigger point and nerve block injections
  • Cognitive behavioral therapy, myofunctional therapy
  • Correction of closed and open lock
  • TMJ injections (steroid, sodium hyaluronate injections)
  • Medicated muscle injections
  • Joint reduction closed or open lock
  • Arthrocentesis with oral surgeon

Insurance We Accept

We are a non-participating provider with Medicare Part B. We also accept Medicare DME and Prominence Health Plan (Commercial and Medicare Advantage Plans).

If you have questions or need additional information, please give us a call.