Your temporomandibular joint is the hinge that connects your jaw to your skull, just in front of each ear. It lets you chew, talk and yawn. When it stops moving cleanly, the result is TMJ disorder, and the pain often shows up somewhere other than the joint itself.
Symptoms patients come in with
- Clicking or popping when the jaw opens
- Facial pain or swelling around the joint
- Grinding or clenching at night, known as bruxism
- Headaches and migraines, often on waking
- Aching in the neck and shoulders
- A jaw that will not open fully, or locks
- Earache or ringing with no ear infection behind it
Headaches and neck pain are the two people least expect. Patients are often referred round several specialists before anyone looks at the bite.
What causes it
TMJ disorder rarely has a single cause. The common ones are a bite that does not meet evenly, night-time grinding, arthritis in the joint, a direct blow to the jaw, and long-running stress that keeps the jaw muscles clenched. Habits matter too: chewing gum all day, biting nails, resting your chin on your hand, and sleeping face down all load the joint.
How we diagnose it
Dr. Chu starts with a clinical exam of the joint, the muscles and how your teeth meet, then runs a computerised Joint Vibration Analysis. That records the sound and vibration the joint makes through a full open and close, which shows whether the disc inside the joint is displaced and at what point in the movement. It takes a few minutes and tells us something a visual exam cannot.
Treatment options
A custom orthotic. A splint worn over the lower teeth that holds the jaw in a position where the muscles can rest. Most patients wear it at night, some through the day at first. This is the starting point for the majority of cases.
Neuromuscular bite adjustment. We look at three things together, the teeth, the muscles and the joint, and use imaging and muscle testing to find the position where the jaw sits with least tension. Where the bite is the underlying problem, adjusting it is what stops the symptoms coming back.
Botox. Administered in our office, in line with California state law, to relax the muscles that spasm and pull. It is useful where clenching is severe and the muscle pain is the dominant symptom. Effects last around three to four months.
Self-care alongside treatment. Soft foods for a few weeks, no gum, heat before and ice after flare-ups, and cutting out the habits above. None of this fixes the joint on its own, but it stops you undoing the treatment.
Read more on whether a splint or mouthguard will help your TMJ pain.
What your first visit looks like
Expect around an hour. We take a history of the pain, when it started and what makes it worse, examine the joint and muscles, check how the teeth meet, take imaging, and run the vibration analysis. You leave with a diagnosis and a written plan, including what each stage costs, before anything is booked.
Cost and insurance
TMJ treatment sits in an awkward gap: some medical plans cover it, some dental plans cover part of it, and many cover neither. We will tell you which category you fall into before treatment starts rather than after. Ask us about payment options at your consultation.
Book a TMJ consultation in Anaheim Hills
Darren Chu DDS is at 6200 E Canyon Rim Road, Suite 210E, Anaheim, CA 92807, open Tuesday to Thursday 7:15am to 5:00pm and Friday 7:15am to 2:00pm. Call 714-637-8003 to arrange an evaluation.