Diagnosing TMJ

TMJ PainTMJ stands for Temporomandibular Joint, the one that moves your jaw.  It is the hinge that opens and shuts the mouth.  However, unlike a simple hinge joint like the knee, it also allows some sideways movement.  Many of us, especially youth, have experienced an occasional clicking noise when we open or shut our jaw and occasional tenderness near the ears and temples.

However, in some people these symptoms become so severe that they have extreme difficulty chewing food, severe morning headaches, and even earaches or neck and shoulder pain.  It becomes a serious quality of life issue.  In many of these cases the Nashville Dental Group can alleviate or cure these problems with a series of office visits and a simple dental appliance to ensure proper placement of the jaw.

General causes of inflammation:

  • If the jaw bone gets out of position and does not re-position itself properly, bone begins rubbing against bone, which is similar to metal rubbing against metal in a car engine that does not have enough oil.  The resulting damage can cause inflammation.  If the inflammation gets severe enough, then it will completely prevent the joint from repositioning itself.

  • Some habits like jaw clenching pull the ball end of the jaw bone deeper into its socket in the rest of skull.  This action compresses the cartilage and fluids that cushion the movement in the joint.  When they do not get the appropriate “rest” these tissues may be come inflamed.  It would be something like a blister on your foot.  (A blister is a fluid filled sack on the skin to protect the underlying skin from something that is rubbing it too much.)

Eliminate TMJ Pain with an Easy to Use Appliance

With a simple appliance, you will regain:

  • The ability to enjoy eating a full meal without painful chewing
  • The ability to wake-up without a debilitating headaches, earaches, or neck and shoulder pain.

There are two keys to successful treatment of TMJ:

  1. Ensuring that the bone and cartilage in the joint all fit together properly.  Typical causes of the jaw bone not fitting properly include over stretching the joint, a traumatic injury, a poorly fitting bite, poorly aligned or missing teeth, and habitual clenching of the teeth. The part of the jaw bone that fits into the rest of the skull has a knob on it that fits into a socket.  The joint includes precisely fitting cartilage and fluid sacks.  These parts that work somewhat like bushings on a car suspension; they make sure the joint moves without the pain and irritation that happens when bone scrapes bone.

    However, if the jaw bone is not fitting properly, it no longer has the help of the cushions.  The jaw bone then rubs against other parts of the skull, typically causing a clicking sound and often causing discomfort or eventually severe pain.  (Again, this action is somewhat like metal rubbing against metal in a car’s suspension when it needs repair.)

  2. Reducing the inflammation Inflammation is the body’s response to damage.  Depending on the situation, the extra fluid provides some protection to the injured parts and may provide some additional nutrients to the affected area to promote healing.

Practical Treatment

Dental X-rayProblems in most joints in the body can often be resolved with appropriate periods of rest and structured activity.  However, short of starvation, not talking, not breathing through your mouth, or an intravenous diet, we must use our jaws.  Resting the jaw without any aid is very difficult.

In the mildest cases of TMJ Disorder the patient can use medicine to reduce inflammation.  If jaw clenching or grinding causes the TMJ Disorder, the patient may want to augment the medicine with therapy to help them cope with the tension in their lives without jaw clenching.

However, if a person’s quality of life is badly affected with morning headaches, difficulty chewing and eating, or ear pain, then it may be necessary to immobilize the jaw when the person is not eating or talking, in order to give the joint some rest.

At our Green Hills office we custom fit a removable dental appliance to your mouth shape and bite pattern to provide that forced rest.  You remove it when you eat and do other daily tasks.  You can wear it while sleeping and other times when it is practical.  One of the keys to the process is meticulously determining how the jaw should fit when it is resting in your current physical condition.  As the treatment progresses, we must schedule additional appointments to ensure that the appliance continues to fit properly.

Our Process

Dr Farringer is a member of the American Academy of Head, Neck and Facial Pain and has been treating TMJ disorders successfully for over 20 years.

During your first visit we will talk with you about your symptoms and examine how your jaw is functioning and how your bite is positioned.  If we believe we can help you and if you agree to a series of visits, then we will make a mold of your teeth and carefully measure your bite in various places inside your mouth.  Measuring the bite does not require large tools that will further increase the pain of opening your mouth.  From these measurements we will make a dental appliance.  Conceptually, it will be similar to the mouth guards worn by many athletes; however it will be much, much firmer and will aid in the position of your jaw.

During your future visits over a period of a couple of months, we will ensure that the appliance continues to be balanced.  As the jaw gets rest, the inflammation goes down, which then changes your bite.  So, during the follow-up visits we will adjust the appliance so that it continues to be balanced.  If we do not perform these follow-up visits, then the appliance can actually worsen the condition because the jaw will not close properly.  These follow-up visits are crucial to successful treatment!

Smiling TeethResults

Typically patients begin to experience relief within a week of beginning treatment, though it often takes 2 months of follow-up treatments to achieve full success.  If you suffer from TMJ Disorder because of personal habits such as unconscious teeth grinding, the appliance is likely to become a permanent part of your daily habits, unless you receive other therapies to reduce that habit.  Every few years you should have our office double check that the appliance is still balanced.  You should be comfortable with your appliance within a week of wearing it consistently.


  • Enjoy a meal without pain in your jaw, especially near your ears
  • Eliminate the funny clicking noises when your jaw moves,
  • Reduces or eliminates certain types of earaches, headaches, and neck and shoulder pain, especially those occurring in the morning.

Contact us for an appointment with Dr. Farringer.