Temporomandibular Disorder – TMJ vs. TMD

Most everyone has heard of “TMJ” and most associate TMJ with jaw issues – usually clicking noises, pain when chewing, and sometimes the jaw locking in place, but few realize that ‘TMJ’ actually refers to the jaw joint or ‘temporomandibular joint’. TMD or Temporomandibular Disorder is the general term dentists use to describe misalignment in the TMJ. According to the National Institute of Dental and Craniofacial Research, more than 10 million Americans are affected by TMD, and most commonly; women. Of those, symptoms range from mild to severe, and about 15 percent have more severe symptoms that require professional treatment.

Looking TMJ in the Mouth

The temporomandibular is the joint located to the front of the ear, linking the jawbone to the skull. With TMD the muscles of the jaw and neck as well as the bones of the skull and face can be affected. In addition to recurrent issues in the areas of the head, neck, or jaw – the function of the whole body can become altered over time.

Although most people have relatively mild forms of the disorder, researchers point out that up to 85 percent of patients who suffer from severe TMD also experience painful conditions in other parts of the body. Some radiating effects of a misaligned jaw can include;

  • Inflammation
  • Arthritis in the TMJ – due to aging or trauma
  • Muscle Spasm –can appear when the jaw is held open for long periods – as in the dental chair
  • Postural changes – which can lead to back and shoulder issues
  • Fractures – at the time of injury, often undiagnosed
  • Breathing issues (sleep apnea)
  • Difficulty walking and foot problems (due to postural changes)
  • Digestive issues
  • Migraine headaches
  • Facial fatigue, swelling
  • Generalized stress and depression

TMD results from the jaw being out of position – a situation that can create intense pain in the jaw, ear, and head. It’s important to diagnose Temporomandibular Disorder as quickly as possible – particularly if there is pain, to alleviate the adverse side effects that can lead to long term health issues.

Treating the Milder Cases at Home

The most common jaw joint and muscle problems are short term and simple treatment may be all that is necessary to relieve discomfort. There are steps can be taken that may ease symptoms, such as:

  • Avoid hard, chewy foods
  • Use ice packs, or moist heat
  • Keep jaw movements to a minimum (no gum chewing)
  • Don’t stress out – take some time to relax and let the jaw mend itself
  • Once the initial pain subsides, incorporate gentle jaw stretching exercises

If pain persists and symptoms of TMD do not subside on their own, making an appointment with a holistic dental practitioner is the best way to address the problem. When properly diagnosed and treated TMJ can most often be resolved in a relatively short period of time, without the need for drugs or surgery.

When the Pain and Popping Persists

There are a number of treatment options a natural dentist might recommend – depending on the health of the patient and the severity of symptoms. The conventional approach to treating TMD is usually aimed at alleviating the symptoms; discomfort and pain. But natural dentistry focuses on rooting out and treating the cause. Therefore, treatment options considered are drug-free, nontoxic and carry no side-effects.



Temporomandibular Disorder (TMD)


What Conditions May Overlap with TMD?


Temporomandibular joint and muscle disorders


Well, if you’re the patient getting operated on, maybe you don’t think it’s so cool. Unless you’re the rare exception who likes needles in your gums.

But you should be excited, because this technique will allow your gums to be shaped with minimal risk, pain, and down-time. Its inherently minimally invasive and low-maintenance. There is no cutting or suturing, and healing is quick.

This technique was developed fairly recently by a man named Dr. Chao, and it is taking off internationally as the preferred method of gum shaping after periodontal or gingival treatment.

Note that this is solely meant to restore the gum line for the purpose of aesthetics and functionality. It is not gum disease treatment, and it must be done in a disease-free mouth. So this is something I’d do after my patient has successfully undergone therapy for gum disease and only needs the gums to shrink back up around the teeth.

It sure beats the traditional method, however, of grafting gum tissue from another area of the mouth.

Dr. Sperbeck, West Los Angeles


How do people end up with recessed gums? Gum recession is a common result brought about by gum disease  (or its more advanced stages of gingivitis and periodontitis) and abrasive over-brushing (brushing your teeth too harshly too often with the wrong brush). Perhaps poor dental work in the past has caused an imbalance in the mouth, possibly a bite malfunction that has, over time, negatively affected occlusal (bite) functionality.

As a side note, yes, even slight imbalances in bite mechanics can cause long-term diseases and vulnerabilities that seem unrelated. That’s why holistic dentistry is so important: we get to the root of the problem, considering the whole patient. If you try treating gum recession without first considering the possibility of TMJ problems, mercury poisoning and tissue rejection from amalgam fillings, or miscalculated restorations, you may only have to do it again, with poorer results each time.

So why is gum recession a problem? Recessed gums weaken and loosen the roots of teeth, exposing the vulnerable parts to physical injury and infectious bacteria. Gum recession sets the stage for tooth decay and tooth loss. Practicality aside, bad cases of gum recession are not aesthetically pleasing and may cause patients to be self-conscious.

In my next post, I’ll talk a little bit more about the Pinhole Surgery Technique (PST) by Dr. Chao that’s used to correct gum recession without surgery.

What about you? Have you had any experience with gum recession, or do you know someone else who has? News of this Pinhole Surgery Technique may be a welcome relief, then… or maybe something you wish your dentist knew a long time ago.

Dr. Sperbeck, West Los Angeles


Traditionally, the way gum recession is treated is by performing gum grafts. Gum grafts are essentially stitching extra gum tissue (taken from elsewhere in the patient’s mouth) to the affected area, sewing everything up, and waiting several months for it to merge and heal and return the patient to normal. This method is effective and is how dentists are trained to treat more severe cases of gum recession. However, gum grafting is slow, invasive, riskier, and generally an involved, expensive process that interferes with the patient’s daily life.

That’s why I am so excited about the PST. If you saw the video I previously shared, you can see an illustration of the two methods compared side-by-side. The PST is a quick, simple, low-maintenance procedure with healthy and natural-looking results. I imagine patients would watch it and think, “Why on earth have dentists not come up with this sooner?” I agree. Sometimes solutions come along that are just so logical, so sensible, it makes you wonder why we even started out with more complicated treatments. Kudos to Dr. Chao!

PST is a method by which a tool is inserted directly into the gum tissue and is used to gently, partially separate the tissue from the underlying facial bones. The tool is like a hooked needle, which sounds awful, but it means nothing gets sliced up; the only mark left behind is — you guessed it — a little pinhole that heals up in a matter of hours.

After the insertion and loosening of the gum tissue, the gums are then pushed downward (or upward, depending on where we’re working) in sweeping motions around sterile teeth. When the gums are nice and cozy up against the teeth again, treatment is finished. Collagen is then inserted behind the gums to stabilize them and speed up the healing process.

Essentially, the Pinhole Technique not only physically manipulates the gums so that they once again surround and envelop the teeth, but also stimulates the surrounding area so the gums continue to grow and flourish and stay put in their proper place. A clean, disease-free environment is important, however, and this technique is not appropriate while gum disease is present.

Healing takes place in a matter of days, even overnight for some cases. The patient may not have to take time off work or interrupt his or her busy life. The pain and medical risks are minimal, if any. It is truly amazing, and I’m excited to incorporate it into my practice. I hope many future patients will benefit from this new technique.

Dr. Sperbeck, West Los Angeles