Temporomandibular Joint Disorders (TMJ)

Offered at our convenient location in Alexandria, VA

tmj disorder test

Place two fingers on both sides of your jaw in front of your ears. Then, open your mouth slowly until fully wide. If you heard or felt a pop, click, or shift, or if you felt any pain, you may have temporomandibular joint disorder (TMJD.) Men and women experiencing this pain often just live with it because they are unaware that there are treatments. If you even have the slightest indication that you may have TMJ disorder, please contact our office to schedule a consultation and Dr. Kitchen or Dr. Ahmed will be more than happy to assess the condition and provide appropriate treatment.

What is Temporomandibular Joint Disorder?


Causes of TMJD

There are different causes of temporomandibular joint disorder. Below are some of the more common causes:


Bruxism, or grinding of the teeth, is one of the main causes of TMJ disorder. It is considered a microtrauma, meaning it is internal trauma caused on the temporomandibular joint. The strong, continuous side to side motion and pressure can irritate and inflame the joint or surrounding membranes. It can also cause misalignment of the teeth, contributing to the pain. This mostly happens when one is sleeping.


Clenching of the jaw is considered a microtrauma as well. The strain placed on the TMJ from continually chewing or biting while awake can contribute to jaw pain. This can be from biting on a pencil, chewing gum, or biting fingernails. Stress can also cause one to clench their jaw.


Macrotrauma, differing from internal microtrauma, is injury to the jaw caused by an outside source such as getting hit on the jaw. If the impact on the temporomandibular joint is great enough, it can cause cartilage and joint damage or potentially dislocate the joint.


The jaw is just as susceptible to osteoarthritis as any other joint in the body. Normal wear and tear and age are the main triggers, but it can also be caused by instances such as degenerative joint disease. Destruction of cartilage does not happen from a single cause, but some combination of the aforementioned overtime, such as continual trauma (micro or macro) or aging.

While the aforementioned are the more common causes of TMJ disorder, some other causes include:

  • Stress
  • Female sex hormones
  • Chewing gum
  • Prior dental work
  • Infection
  • Autoimmune disease

TMJ Treatment Candidates

TMJ disorder is generally more common in women than men, but patients of any gender who experience the following signs or symptoms may be suffering from TMJD:

  • Clicking, popping, locking and / or soreness in the front of the ear
  • Sore jaw muscles
  • Headaches
  • Bite related problems
  • Ringing in the ears
  • Bruxism (teeth clenching and grinding)
  • Sinus concerns
  • Pain when yawning

How is TMJ Disorder Treated?

Phase 1 Treatments

Phase 1 treatment refers to TMJ therapy that is not permanent. These include treatments such as splints, retainers, physical therapy, and medication.

Splints and Retainers

TMJ therapy often includes splints and retainers which can help correct poor bites, decreases stress at the joint level, and reduces muscle hyperactivity including clenching and grinding habits. Splints cover the whole surface of the teeth. The goal is to alter biting surface, correct an imbalanced bite, or change jaw positioning to provide a better bite.

Retainers are designed to prevent the teeth from moving a shifting back to their original placement after dental work. This can also have the beneficial effect of shifting the jaw into proper placement. Retainers that cover the teeth surface will also aid against grinding.

These options may be followed with bite treatment through bite adjustment (equilibration), orthodontics or restorative dentistry as needed.

Physical Therapy

Physical therapy can be helpful for sore muscles, cervical neck issues, sleep position, improved posture, and self – help advice such as biofeedback.


Medications for inflammation, muscle relaxation, and sleep are commonly used to relieve TMJ pain. Dr. Kitchen or Dr. Ahmed will assess if a candidate qualifies for medication during the consultation.

Phase 2 Treatments

Once the aforementioned treatments have been tried, phase 2 treatment may be necessary if bite alignment has shifted or if it is necessary to maintain the new jaw positioning. Phase 2 treatments are permanent, so they are only performed after attempts of phase 1 treatments, like splints or retainers, which are non-permanent or removable.

Dental Work

If a patient’s bite has shifted after phase 1 treatments, dental work may be necessary to maintain proper jaw and teeth placement.

This may include:

  • Crowns : A crown is a small tooth-shaped prosthetic device that is placed on top of a tooth that is damaged, cracked, or misshapen. It is also what’s used as part of a bridge placement, which is described below. A crown may be used as a phase 2 treatment for TMJ disorder if there is potential of the jaw returning to the poor placement because of a misshapen tooth. The tooth may be misshapen due to injury, oral hygiene, or because of grinding or clenching which could have been the cause of the TMJ disorder.
  • Bridge : If a tooth or teeth are missing, a bridge can be placed to fill the gap and help keep the jaw in place. A bridge consists of a prosthetic tooth adhered in the middle of two crowns. The two crowns are placed over the two teeth surrounding the gap, and the prosthetic tooth implant is fastened into place in the gap. This process can keep the jaw in proper placement.


Although non-surgical remedies are ideally sought out first, serious joint problems may require surgical intervention.

This option is appropriate when:

  • Non-surgical treatments have failed
  • The pathology is identifiable
  • Extreme pain is experience
  • Mechanical function is poor

Determining the cause and effect relationship is key to identifying the problem. TMJ therapy is most successful when initiated at an early stage of discomfort. This is especially true if there is minimal damage to the jaw joints. Contact us today if you suffer from any symptoms of TMJ disorder and request a consultation at our Alexandria, Virginia location today.

What to Expect After TMJ Treatment

Pain associated with muscle and bite issues usually respond extremely well in a very short time. Regardless of the treatment undergone, patients should be conscious of the foods they eat, trying to stay away from hard foods and not chewing gum as much if at all. Also, patients should try to not open their mouth very wide if possible, giving the jaw time to relax and heal. Jaw exercises are sometimes helpful for treatment; the doctor may provide a custom regimen depending on the case. Teeth clenching should be avoided, as well as cradling phones between the jaw and shoulder. Oral hygiene should still be maintained, but patients should be cautious of how wide they open their mouth when brushing and flossing.

After TMJ therapy, patients can enjoy less pain, less irritation, less headaches, less popping, and less locking.


The initial temporomandibular joint therapy consultation at our Alexandria, Virginia location is necessary to determine the extent of treatment a patient needs to undergo to alleviate TMJ disorder symptoms. It will begin with the patient describing the pain or irritation they feel when they open their mouth, chew, yawn, and just on a regular basis. An examination will then be performed, which may consist of a normal check up, X-rays, and a few tests to determine if the patient has TMJ disorder.

Depending on Dr. Kitchen or Dr. Ahmed’s findings, a custom treatment plan will be developed.

If you experience pain of the jaw when chewing, taking, or even at rest, contact us. Even if you are not sure you have TMJ disorder, please still contact us. This is a condition that often times goes undiagnosed, and patients simply live with the pain and irritation. We at Old Town Smiles in Virginia are dedicated to providing accurate diagnoses and proper care so our patients leave feeling great and pain free after treatment. Feel free to fill out this convenient online form and a member of our staff will get back to you shortly.


The cost of temporomandibular joint disorder therapy will vary depending on the treatment needed and the extent of the individual case. After the private consultation, a custom treatment plan will be created and a quote will then be provided. Contact Old Town Smiles today to schedule your private consultation.

Contact us here or call today to schedule your appointment.(703) 836-7000