TMJ / TMD Treatment
Dentist Silverlake LA
Relief from Jaw Pain, Clicking, and Headaches
The temporomandibular joint — your TMJ — is one of the most complex and heavily used joints in the body. It connects your lower jaw to your skull and is involved in every bite, every word you speak, and every yawn. When something goes wrong with this joint, the effects ripple outward — chronic jaw pain, headaches, ear pain, clicking or popping, difficulty opening your mouth, and facial tension that can affect your quality of life every single day.
Patients from Silver Lake, Los Feliz, Echo Park, Atwater Village, and Glendale come to us for TMJ evaluation and treatment because we offer both conservative dental management and access to surgical care — all under one roof.
At Silverlake Dental Group, TMJ disorders are first evaluated and treated by Dr. Joshua Barkhordar. Most patients never need surgery, and we always pursue the most conservative effective approach first.
What is TMJ / TMD
TMJ refers to the temporomandibular joint itself. TMD — temporomandibular disorder — is the umbrella term for any dysfunction, pain, or pathology affecting that joint and the muscles surrounding it.
TMD is surprisingly common. It affects an estimated 10 million Americans and is significantly more prevalent in women than men. It can arise from a single identifiable cause or from a combination of contributing factors that interact over time.
What Causes TMD?
TMD rarely has a single, simple cause. Common contributing factors include:
- Bruxism — Nighttime teeth grinding and clenching places enormous, repetitive stress on the TMJ and surrounding muscles. This is one of the most common drivers of TMD symptoms.
- Bite misalignment — When the upper and lower teeth don’t meet properly, the jaw compensates with uneven muscle activity that strains the joint over time.
- Joint injury or trauma — A blow to the jaw, whiplash, or other trauma can damage the joint structures directly.
- Disc displacement — The TMJ contains a small disc of cartilage that cushions the joint. When this disc shifts out of position, it can cause clicking, locking, and pain.
- Arthritis — Osteoarthritis or rheumatoid arthritis can affect the TMJ like any other joint.
- Stress — Emotional stress increases muscle tension throughout the body, including in the jaw — often causing clenching during the day or grinding at night without awareness.
- Hypermobility — Some patients have naturally loose joint ligaments, allowing excessive jaw movement that strains the joint over time.
Signs and Symptoms of TMD
TMD symptoms vary widely between patients — which is part of why it often goes undiagnosed or is mistaken for other conditions. Watch for:
- Jaw pain or soreness, especially in the morning or after eating
- Clicking, popping, or grating sounds when opening or closing the mouth
- Locking of the jaw — difficulty opening or closing fully
- Headaches, particularly in the temples or behind the eyes
- Ear pain or a feeling of fullness in the ears — without an ear infection
- Facial muscle tension or fatigue
- Neck and shoulder pain connected to jaw muscle strain
- Teeth that are wearing down unevenly
- A change in how your teeth fit together
Not every symptom needs to be present, and severity varies enormously. Some patients have mild, occasional discomfort. Others have chronic, debilitating pain that affects eating, speaking, and sleeping.
How We Diagnose TMD
Accurate diagnosis is the foundation of effective TMD treatment. At your evaluation, Dr. Barkhordar will:
- Take a thorough medical and dental history, including trauma history and any previous TMJ treatment
- Evaluate jaw range of motion — how far you can open, whether there is deviation or limitation
- Palpate the joint and surrounding muscles for tenderness, clicking, or inflammation
- Assess your bite and tooth wear patterns
- Take 3D CBCT imaging to evaluate the bony structures of the joint, identify any arthritic changes, and assess disc position
This comprehensive evaluation allows us to identify the specific type and severity of TMD you have — and design a treatment plan targeting the actual cause rather than just the symptoms.
Treatment Options
We always start with the most conservative, least invasive approach and escalate only if needed. The majority of TMD patients respond well to non-surgical management.
Custom Occlusal Splint (Night Guard / Bite Appliance)
A precision-fitted oral appliance worn over the teeth — usually at night — is often the first line of treatment for TMD. Unlike over-the-counter guards, a custom splint is designed based on your specific bite and jaw relationship, repositioning the jaw into a more relaxed, stable position that reduces stress on the joint.
Occlusal splints reduce clenching forces, protect teeth from bruxism damage, allow the jaw muscles to relax, and in many cases significantly reduce or eliminate TMD symptoms over weeks to months of consistent wear.
Physical Therapy & Jaw Exercises
In many cases, the muscles surrounding the TMJ are as much a source of pain as the joint itself. We work with physical therapists who specialize in TMJ and orofacial pain to address muscle tension, improve range of motion, and correct postural habits that contribute to jaw strain. Specific jaw exercises prescribed for home use complement in-office treatment.
Bite Equilibration
If bite misalignment is a contributing factor — specific teeth hitting too hard or too early during chewing — selective reshaping of the biting surfaces can improve how the teeth come together, reducing uneven loading on the joint. This is a conservative, reversible technique used when bite issues are clearly contributing to symptoms.
Medications
Short-term use of anti-inflammatory medications, muscle relaxants, or low-dose tricyclic antidepressants (which have muscle-relaxing properties at dental doses) can help manage acute flare-ups and reduce muscle spasm. These are typically used as adjuncts to mechanical treatment rather than as standalone therapy.
Arthrocentesis (Joint Lavage)
For patients with joint inflammation, disc adhesion, or limited opening that hasn’t responded to conservative treatment, arthrocentesis is a minimally invasive in-office procedure in which the joint is flushed with sterile fluid under pressure. This removes inflammatory byproducts, breaks up adhesions, and restores lubrication — often producing significant improvement in range of motion and pain relief with minimal recovery time.
Arthroscopy & Surgical Repair
For severe, refractory cases — advanced disc displacement, significant arthritic changes, or joint pathology that has not responded to conservative management — we offer a referral to a TMJ specialist to evaluate for arthroscopy and open joint surgery. These are reserved for the small percentage of patients who truly need surgical intervention after conservative options have been exhausted.
Frequently Asked Questions (FAQs)
Can TMD go away on its own? Mild, acute TMD — often triggered by stress or a period of heavy clenching — sometimes resolves with rest, soft diet, and over-the-counter anti-inflammatories. Chronic TMD, particularly when there is joint pathology like disc displacement or arthritis, typically requires active treatment. Ignoring it rarely leads to improvement and can allow the underlying condition to worsen.
Is TMD related to my teeth grinding? Very often, yes. Bruxism — nighttime grinding and clenching — is one of the most common contributors to TMD. Treating the bruxism with a custom night guard frequently improves TMD symptoms significantly. We often find both conditions present together and treat them in combination.
Will I need surgery? The vast majority of TMD patients — well over 90% — respond to conservative, non-surgical management and never need surgery. Dr. Barkhordar always exhausts conservative options before any surgical discussion is raised.
Can stress cause TMD? Yes. Stress is one of the most significant drivers of jaw clenching and muscle tension, both of which contribute to TMD. Managing stress — through lifestyle changes, therapy, or relaxation techniques — is a meaningful part of comprehensive TMD management for many patients.
How long does TMD treatment take? It depends on the severity and the cause. Some patients notice significant improvement within a few weeks of starting splint therapy. Others with more complex or long-standing conditions require months of management. Dr. Barkhordar will give you a realistic expectation at your evaluation.
If you’re living with jaw pain, clicking, headaches, or limited jaw movement — you don’t have to. Call Silverlake Dental Group at (323) 922-6016 to schedule a TMJ evaluation with Dr. Barkhordar.
From a family of dentists with quality care
We would be happy to work with you!