What is TMJ disorder?


hat is TMJ? TMJ, or temporomandibular joint disorder, is a painful condition in which the temporomandibular joint, the main joint in the mouth, is overworked or misaligned. It can lead to headaches, oral and neck pain, and difficulty opening and closing the mouth. Many patients describe an audible popping or clicking sound when yawning or chewing. Unfortunately, these symptoms are often mistaken for stress or something else other than a bad bite! If you’re experiencing jaw and tooth pain, facial pain, ear pain and congestion, headaches, or neck, shoulder and back pain, you could have TMJ. TMJ can also cause numbness in the arms, hands, and fingers, along with clicking, popping or locking of the jaw. If you are experiencing any of these symptoms, contact Dr. Frey today.


What are the signs of TMJ?

TMJ can be very painful, and unfortunately, the symptoms are often mistaken for stress or something else other than a bad bite.

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Pain around the head can be caused by a muscle imbalance with the TMJ and Bite

Neck Pain


Our heads’ weigh 10 pounds on average and our bodies work hard to keep it centered above our shoulders.  Any imbalance can cause aches and pain.

Facial Muscle Pain


Large muscles around the head and neck hold on to the TMJ and when stressed can cause pain around the face

Jaw Popping


This is a sign of imbalance with the bite and muscles of the head and neck.  The sound you hear is a signal that the articulator disc is coming off its track

Ear Pain


Many anatomical structures are shared between the jaw joint and the ear like the DML (distal-mallear ligament). When tight pressure from muscles or ligaments exists these symptoms can result.

Difficulty Chewing


Struggling to eat and chew can be related to a bad bite which means unhappy muscles.



Sleep Apnea or hypoxia can have a TMJ related component in approximately half the cases.

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Phase 1

Resolve or greatly diminish your symptoms and pain.

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Phase 1 is a test and is reversible.What that means is that the treatment is made to resolve or greatly diminish the pain symptoms you are experiencing without doing anything irreversible like a surgery. The way we do this is by trying to find what we call, “physiological rest” of all the muscles of the head and neck and hold it there with a bite splint.  We accomplish this by finding harmony between the muscles of the head and neck, the bite and the TM joint itself.  We do that by working backwards!   We first relax all the muscles of the head and neck using sophisticated medical instruments like TENs machines and Electromyography sensors.  Once we relax the muscles of the head and neck, the jaw joint will usually decompress and the teeth are relaxed apart from one another.  At this time, we capture that position of the jaw joint using a dental impression material and build the bite to this relaxed position.  We call this an orthotic and they can be made so they do not come out ( fixed)  or in a removable appliance.

Phase 2

Keep the pain from coming back permanently.

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Once a bite is found that is in harmony with the muscles of the head and neck and the TM Joint and your pain is greatly reduced or completely resolved we want to maintain the position that the splint is holding your bite together indefinitely.  There are several ways of accomplishing this.  The most common ways are utilizing porcelain such as crowns and veneers or orthodontic braces to maintain the position of the jaw and muscles that we found in Phase 1


TMJ Success Stories

Our past patients are our biggest fans. Hear what they have to say about their journey with PWS.

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Frequently Asked Questions.

If you want to learn even more, we invite you to reach out for a free smile consultation where we can answer all of your questions in depth.

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What Is Electromyography (EMG)?

Getting the EMG data as low as possible is the key to getting you out of pain! Low EMG’s tells us that you are relaxed and in a healthy position. Using TENS machine and other exercises to decompress the jaw joint will help get these muscles as calm as possible.

What Is A TENS Machine?

Transcutaneous electrical nerve stimulation (TENS or TNS) is a device that will send an electrical impulse to the nerve that innervates all the muscles of the TMJ. We use this machine to relax the jaw muscles (low earthquakes on the Richter scale). We use the TENS to buzz all the tension out of the muscles before we capture your physiological correct bite position.

What Is The Fixed Anterior Guided Growth Appliance?

The Fixed Anterior Guided Growth Appliance, also known as FAGGA, is a Phase 2 option for TMJ patients. This appliance allows for the physiologic growth that can grow the jaws properly. With this appliance, we are now able to cure patients of sleep apnea, poor posture, and can allow the jaw bones to accommodate all the teeth in a place that is in harmony with jaw joints, vertebrae, and muscles of the head and neck. This is the essence of Face-forward orthodontics, which can also be referred to as Orthopedic Orthodontics.

What Happens If TMJ Is Left Untreated?

Chronic pain is the main component of TMJ — pain in your jaws, mouth, teeth, ears, neck, shoulders, and head. Chronic pain leads to depression, alcoholism, addiction to pain medication, and a diminished daily existence. Many TMJ sufferers grind their teeth while they sleep, a condition known as bruxism. Left unattended, this leads to cracked and damaged teeth, and usually is accompanied by insomnia. Ear problems such as tinnitus are another result of TMJ, as can be inner ear problems leading to problems with vertigo. The continued pressure on your misaligned jaw can lead to permanent jaw damage, including possible jaw locking or jaw dislocation due to damaged cartilage.

How Does TMJ Affect My Ability To Open My Mouth Normally?

As with your other joints, there is only one correct alignment and when it is askew problems will result. One of these is a locking of your jaw joint or the inability to fully open your mouth. This can be caused by overworked masseter muscles that are stiff and may actually spasm. Or the soft cushion/disc between the ball and socket of the jaw joint can move into a position that precludes normal jaw joint function, limiting the movement.

What Causes TMJ?

TMJ can be caused by a number of issues. Some of these include:

  • Unbalanced bite
  • Airway issues
  • Skull deformation
  • Genetics
  • Injury or trauma
  • Unbalanced dentistry

Can I Test For TMJ At Home? Do I Need A Doctor?

While there is no substitute for a professional evaluation with Dr. Frey, there are a few tests you can try at home to get a sense of possible TMJ. If — in addition to facial pain, migraine headaches, or other symptoms — these tests point to TMJ, it’s time to make an appointment with Dr. Frey to address your TMJ.

  • Opening your jaws — Open your mouth while looking in the mirror. If your lower jaw doesn’t move straight downward, subtly moving to one side instead, this is a sign of TMJ.
  • Clicking or popping — Your jaw should open and close silently. If you hear a clicking or popping sound, these are signs the joint is not functioning properly.
  • Inability to fully open your mouth — When your mouth is fully open, most people are able to vertically insert three stacked fingers between the teeth. If you are not able to do that, your jaw muscles have unnatural pressure caused by TMJ.

What is the TMJ treatment process?

TMJ specialist Dr. Frey is a leading expert in neuromuscular dentistry and has treated hundreds of patients with persistent pain from TMJ disorder. Neuromuscular dentistry emphasizes the importance of the position of the jaw, teeth, and surrounding tissues.

TMJ treatment is divided into two phases: Phase 1 is curing the symptoms of TMJ disorder, and Phase 2 is preserving the results of the treatment permanently with restorative, or orthodontic procedures. Phase 2 can also involve permanent splint therapy, bite adjustments and doing nothing.

TENS Machine (TNS)

  • PHASE ONE: In phase one, a TENS machine (see below) is used to locate your jaw’s most relaxed natural position. We call this the “physiological resting position.” This machine will de-program overworked jaw muscles with tiny, relaxing electrical impulses. We can also de-compress the joint using other exercises.  We prove that the jaw muscles are relaxed by evaluating EMG (electromyography data – see below) which is like looking at a Richter Scale measuring an earthquake. We then capture this position with high-quality molding material, and realign your bite into the optimal, relaxed, position.

You will then wear a custom shaped orthotic to rehabilitate the jaw muscles. Don’t worry, the orthotic rests atop your existing teeth and looks perfectly natural. It will not alter your speech, and no one will notice you’re wearing it. Almost immediately, and more so as your muscles acclimate, you will notice that headaches, back and neck pain, ringing in the ears, vertigo, and many other symptoms associated with TMJ will disappear.

  • PHASE TWO: Phase two of the treatment begins once you’re completely comfortable with your new bite. In order to sustain the results of your TMJ treatment, Dr. Frey may recommend additional cosmetic dental procedures as part of a full-mouth rehabilitation plan or orthodontics depending on your personal situation. There are many options to choose from once your TMJ symptoms have vanished

Can TMJ Be Treated Without Surgery?

At our dental office in Beverly Hills, we treat TMJ organically without surgery or the need for splints. We provide a more sophisticated approach with a full neurological workup, not just a nightguard or splint.

Why Does TMJ Cause Pain?

The three components of your bite — the teeth, the masseter muscles, and the temporomandibular joint — all must work together for correct function. When the three are working together, you don’t have any facial or jaw pain and chewing is silent. But when one of the three components creates alignment problems, this leads to problems with the bite that will create pain in the jaw and face that can also radiate down into the neck and shoulders.

The pain is due to the continued stress of the misaligned jaw trying to find alignment. Considering we use our jaws and the temporomandibular joint almost continually for eating, talking, breathing during exertion, and even yawning, the constant pressure caused by misalignment creates overused muscles and tension. This leads to pain originating in the joint and spreading outward.

What Are The Symptoms Of TMJ?

If you’re experiencing jaw and tooth pain, facial pain, ear pain and congestion, headaches, or neck, shoulder and back pain, you could have TMJ. TMJ can also cause numbness in the arms, hands, and fingers, along with clicking, popping or locking of the jaw. If you are experiencing any of these symptoms, contact Dr. Frey today.

What Is The Difference Between TMJ, TMD, And TMJD?

These three acronyms all point to the same thing — temporomandibular joint disorder. Sometimes TMJ is used to solely describe the joint. Sometimes TMD is used to describe problems with the joint. TMJD is rarely used, and simply adds the D for disorder. The common term for temporomandibular joint disorder, and the term Dr. Frey uses throughout this site and his practice, is TMJ.

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