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TMJ/Sleep Therapy & Pain Management

Dr. Paul Nagode Family Dentistry Serving Atlanta, Cobb County, Buckhead, and the surrounding Sandy Springs areas.
TMJ is a complicated condition with many possible causes and symptoms; however, as a knowledgeable, experienced healthcare professional, Dr. Nagode can help determine an accurate diagnosis and the best treatment to diminish or eliminate the discomfort or structure damage you’ve experienced.

What is it?

Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD), but you may hear it wrongly called TMJ, after the joint. Your temporomandibular joint is a hinge that connects your jaw to your skull's temporal bones and lets you move your jaw up and down and side to side so that you can talk, chew, and yawn. While referred to as a single joint, there are two hinge points in front of each ear that enable jaw movement by rotating in several different directions, creating a gliding movement, as in chewing. Tendons, muscles, and joint pads help move and protect the joint when healthy and functioning normally.

TMD can manifest itself as jaw pain, headache, ear pain, neck pain, toothache, clicking or popping sounds, etc. Commonly, symptoms will begin suddenly, seemingly “out of the blue.”


What Causes TMD?

There is no one cause of TMD.  Anything that causes tension in the jaw and temporal muscles or a joint discrepancy can lead to problems with the TMJ.  Examples include:

  • Injury

  • Clenching or Teeth grinding

  • Sleep disordered breathing

  • Stress or Muscle Tension (neck, shoulders, back)

  • Arthritis

  • Dislocation or erosion of the joint

  • Improper occlusion


The National Institute of Dental and Craniofacial Research estimates that 5-12% of Americans suffer from facial pain and other TMD symptoms.  Interestingly, women between the ages of 20-40 are 1.5 to 2 times more likely to develop TMD than men and affect more young to middle-aged people than the elderly.


What Are the Symptoms?

Common symptoms include: 

  • Pain or tenderness around jaw, cheeks, ears, and neck

  • Headaches or migraines

  • Problems when you try to open your mouth wide

  • Jaws that get "stuck" or "lock" in the open- or closed-mouth position

  • Clicking, popping, or grating sounds in the jaw joint

  • A tired feeling in your face

  • Earache, dizziness, ringing in the ears

  • Trouble chewing or a sudden uncomfortable bite -- as if the upper and lower teeth are not fitting together properly

  • Swelling on the side of your face

  • Obscure tooth pain or sensitive teeth


How is TMD Diagnosed and Treated?

Some of our patients have spent time seeing their PCP, an ENT, and a neurologist before mentioning their headache, earache, and neck pain.  If you suffer from any symptoms, start by talking to your dentist or primary care physician.  A thorough, detailed examination of the TM joint, the surrounding musculature, and your occlusal relationships performed, and the findings evaluated.

Even a very slight misalignment can cause pain, inflammation, and joint wear over time.  A poor bite can force your TMJ to work in such a way that it was not meant to function over a long period.  Also, keep in mind that pain management can alleviate discomfort without remedying the underlying cause.

Treatments can include:

  • Medications (anti-inflammatories, topical muscle relaxers, oral medicines)

  • Targeted Exercises

  • Physical Therapy

  • Corrective Occlusal Therapies and/or Appliances (orthodontic aligners, occlusal guards, occlusal adjustments)

  • Sleep Apnea Treatment

  • Steroid Injections

  • Restorative Dental Treatment (to balance the biting surfaces of your teeth)

  • Alternative Therapies (acupuncture, ultrasound, Transcutaneous electrical nerve stimulation (TENS)

  • Surgery


There are many causes, symptoms, and treatments for TMD.  Dr. Nagode’s purpose is to bring relief to those suffering from joint pain, recurring headaches, and related discomfort in the most effective, least invasive way possible.

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