If you have chronic pain in your head, face, or neck you may not realize that the pain is originating from a disorder in the temporomandibular joints (TMJ) of your jaw. Often, symptoms relating to this disorder can persist or go undiagnosed for years because they are similar to the symptoms of many other ailments.

Many dentists or “Neuromuscular dentist specialists” are trained in conservative therapies for TMJ, such as a night guards. However, patients should be referred to an oral and maxillofacial surgeon if their condition requires further attention. Specifically, if patients are experiencing a lack of improvement with physical therapy, bite plates, and/or medication. At Orange County Oral Surgery and Periodontics, our oral and maxillofacial surgeon, Reza Bolourian, M.D., D.D.S., F.A.C.S. has vast experience with treating all stages and facets of TMJ. We collaborate closely with your dentist and physical therapist, as well as each patient, allowing all to become integral partners in their treatment planning.

Trouble with your jaw?

  • Have you been fitted for a “Night guard” with no to minimal improvements?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth, or trouble opening your mouth wide.

Do You Have a TMJ Disorder?

  • Are you amongst the 12% of the United States population suffering from TMJ disease?
  • Do you have TMJ pain? Do you wake up with sore, stiff muscles around your jaws?
  • Facial pain, jaw and neck Pain, ringing in the ears and frequent migraines?
  • “Do you hear a constant Clicking Noise” in your ears when you talk and chew?
  • Do you have teeth that no longer touch when you bite?
  • Difficulty opening your mouth to bite into an apple?
  • Does your jaw click, pop, grate, catch, or lock when you open your mouth?

The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

TMJ Treatment

There are various treatment options for TMJ that Dr. Bolourian can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Bolourian will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care combined with professional care.

The initial goals are to relieve the muscle spasms and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Self-care treatments can often be effective as well and include:

  • Resting your jaw
  • Eating soft foods
  • Applying ice and heat
  • Exercising your jaw
  • Practicing good posture

Stress management techniques such as biofeedback or physical therapy may also be recommended. A TMJ splint and NOT a nightguard fits over your bottom teeth and helps keep your teeth apart, thereby relaxing the muscles, creating sufficient space within the joint and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth but many TMJ issues are not caused by grinding your teeth. 

An anterior positioning TMJ appliance moves your jaw forward, relieves pressure on parts of your jaw, and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. These appliances also help protect tooth wear. 

As a surgeon specialized in full range of TMJ surgeries, Dr. Bolourian may offer minimally invasive procedures to greatly improve the symptoms of your TMJ pain and/or clicking noise if above treatments have not helped. Arthrocentesis and arthroscopic procedures are minimally invasive outpatient modalities designed to significantly reduce pain and improve range of motion. Arthroscopic procedures enables us to utilize a small camera to view the joint directly and address many TMJ conditions without cuts and bruises on the face. Dr. Reza Bolourian, M.D., D.D.S., F.A.C.S. is one of the few surgeons in the country trained in arthroscopic procedures of the TMJ.

What about bite correction or surgery?

Open joint surgery is sometimes needed, but are reserved for severe cases. Dr. Bolourian does not consider TMJ surgery unless all other modalities have been tried unsuccessfully.