TMJ Disorders

Are you having problems with your jaw? Are you concerned that you may have a jaw joint dysfunction? According to the National Institute of Dental and Craniofacial Research, TMJ disorders affect more than 10 million Americans. Talk to your dentist about TMJ, and learn more about TMJ therapies here.

What is TMJ?
TMJ stands for temporomandibular joint. Problems with the jaw joints occur when the joint is misaligned, injured, or stressed. TMJ problems may be caused by, grinding or clenching teeth, stress, arthritis or injury to the head, neck or jaw.

Where is the TMJ?
The TMJ joints (left and right) connect your lower jaw to your skull. They are each located on the side of the face, in front of the ear, near the temple. Your TMJ works with muscles of your face and neck enabling the lower jaw to open, close, move side to side, and front to back. The joint itself is contained within a fluid filled capsule. In this capsule is your lower jaw bone, the temporal bone, and a fibrous disc. These three surfaces allow for rotational and sliding movements of the joint.

Outside of the joint is a complex system made of muscles, bones, nerves and your teeth.

When any aspect of this system is not functioning properly, a TMJ disorder may develop.

Do You Have a TMJ Disorder?

  • Does your jaw click or pop?
  • Do you have grinding sounds in your jaws?
  • Do you have pain in around your jaw, neck, face, temples or teeth?
  • Do you have limited mouth opening?
  • Are you aware that you clench or grind your teeth? Possibly when you are stressed?
  • Does your jaw ever lock open or closed?
  • Do your teeth have trouble coming together?
  • Have you ever had trauma to your face/jaws?
  • Are you missing several teeth or have dentures that don’t fit well?

TMJ Disorders
TMJ disorders may develop for many reasons. Having a jaw joint disorder is like having a bad knee or a bad back. It’s an orthopedic problem that may require long term management. Broadly stated, TMJ disorders can originate in two main categories:

  • Inside the joint
  • Outside of the joint

Inside Joint

  • Arthritis––degeneration cartilage and bone
  • Pathology––tumors/cysts including cancers
  • Disc problems––damage or displacement

Outside Joint

In the same area as these complex joints are a network of muscles and nerves extending into the head and neck, adding to the complexity of the TMJ. This can complicate diagnosis and treatment.

  • Muscles–strain/sprain/spasms
  • Teeth-missing/unstable bite
  • Nerve problems

Often, TMJ disorders will present with an overlap of symptoms from both inside and outside of the joint. An inside the joint problem can lead to an outside of the joint problem or vice versa.

Diagnostic Process
Dr. Bonine is experienced in diagnosing and treating TMJ disorders. Your consultation will consist of a review of:

  • Your history
  • Physical exam
  • Clinical testing
  • Radiographic exams (CT or MRI scans)

Sometimes diagnosing the problem can take weeks to months and it may require the use of bite splints, botox, or diagnostic injections.

Goals of TMJ Treatment

  • Increasing your comfort
  • Improving your function
  • Providing you with education and information to help you manage your TMJ disorder

With treatment we can decrease pain and increase function 90% of the time.


Education and Self-Care

  • Understanding your TMJ problem and its causes.
  • Jaw rest, modified diet, eliminating habits, practicing good posture

Non-Surgical Therapies

  • Botox
  • Bite splint
  • Medications including anti inflammatory medications, muscle relaxants, anti depressants
  • Physical therapy and posture management
  • Stress coping therapy

Surgical Therapies
If non-surgical therapies are unsuccessful, surgical options may include:

  • Tooth replacement and bite correction
  • Arthrocentesis––injections in the joints (like a steroid injection for an arthritic knee)
  • Manipulation––stretching of the joint under general anesthesia
  • Total joint replacement

Long Term Maintenance

Having a TMJ problem may require long term maintenance like physical therapy.

Your TMJ Team

Dr. Bonine looks forward to coordinating with your dentist in the management of your TMJ disorder. If you don’t have a dentist, we can help you coordinate with one. Because of the diverse nature of therapies, in addition to Dr. Bonine, your treatment team may also consist of a dentist, physical therapist, massage therapist, orthodontist, neurologist, or rheumatologist. Together, we will work together to maximize your improvement.

Affordable TMJ Therapies

Please consult with your insurance company with specific questions prior to your consultation. You can also apply for Care Credit to cover the cost of your therapy and may be able to make affordable payments over time. We also accept VISA, Discover, MasterCard, and American Express.