TMJ/TMD and Therapy

Temporomandibular joint dysfunction encompasses a broad range of problems and symptoms. Many names are used by different doctors and patients. The term TMJ refers to the temporomandibular joint. TMJ dysfunction, also called TMD, is a disease process. TMD is a painful cycle that occurs when the teeth, chewing muscles, and jaw joints are failing to work harmoniously together. It can begin by clenching or grinding the teeth, a misaligned bite, trauma to the joint itself, arthritis, or emotional stress. The most common cause of TMJ pain is myofascial pain dysfunction, which involves the muscles for chewing.

TENS Nightguard

TENS Night guards are based on establishing a balance between the muscles of the head and neck, the temporomandibular joints, and the teeth. TENS therapy (Transcutaneous Electrical Nerve Stimulation)  is used to relax the muscles of your head, neck and jaw. Our Team is highly trained to set up the TENS Unit and assist Dr. Reiner in finding that perfect relaxed position. Dr. Reiner is a neuromuscular dentist who is trained in TENSing the jaw to find that relaxed position. TENS Nightguards are a custom made othotic appliance for your lower teeth to use during sleep. Our team will take impressions of your upper and lower teeth to make models of your teeth.  Then the TENS unit will be connected in the proper areas of your head and neck to start the process of relaxing the muscles. Once the jaw and muscles are relaxed and the lactic acid has moved out of the muscles (about 45 minutes) then the relaxed jaw position (the TENS Bite) is achieved. Dr. Reiner will finish by taking specific measurments of the space between your teeth and a special bite to send to the lab to make your custom TENS nightguard.  When the orthotic appliance is completed you will return to have the appliance seated and adjusted so you can start sleeping in the relaxed jaw position. 



The Joint Explained

The temporomandibular joint, found in front of your ears on both sides, connects your lower jaw (mandible) to your skull (temporal bone) via a set of muscles and ligaments. There is a firm disc between the mandible and the temporal bone that is biconcave, meaning it is concave on each side. This is called the articular disc. In normal function it rides between the two bones as your mandible moves, cushioning and protecting the bones. The TMJ is the only joint in the body that requires perfectly simultaneous coordination between both joints on both sides to work properly. There is a series of large and small muscles that function primarily to open, close, and make fine adjustments to the mandibular movement. The masseter (at the side of your jaw) and anterior temporalis (at your temples) are the outside closing muscles. Inside your mouth are the medial and lateral pterygoids, which close and adjust fine mandible movements. There are small muscles called the digastricus under your tongue which open the lower jaw.It is important to know that all the other muscles of your head, neck, and even shoulders and upper back participate in more extreme movements of your mandible like wide opening or clenching. Because of this, your lower jaw position plays a major role in head and neck posture, even affecting the shoulders and upper and lower back.


The most common symptoms of TMJ dysfunction include:

  • Facial pain

  • Jaw joint pain

  • Back, neck, or cervical pain

  • Postural problems (forward head posture)

  • Pain in the face

  • Limited opening of the mouth

  • Headaches

  • Clenching/bruxing

  • Teeth sensitivity to cold

  • Deviation of the jaw to one side

  • The jaw locking open or closed

  • Sinus-like symptoms

  • Dizziness or vertigo

  • Visual disturbances

  • Tingling in fingers and hands

  • Insomnia – difficulty sleeping

  • Ringing in the ears, ear pain, and ear congestion feelings

  • Pain in the muscles surrounding the temporomandibular joints

  • Pain in the occipital (back), temporal (side), frontal (front), or sub-orbital (below the eyes)

  • Pain behind the eyes – dagger and ice pick feelings


If you are experiencing TMD and would like to hear about a treatment option that can offer some relief then contact us at, 

Dr. Debra Reiner Cosmetic and Family Dentistry 734-847-1955

for a TMD Orthotic Appliance Consultation.

The material contained on this website is offered as information only and not as professional advice. Users should consult their own dental professionals for such advice.