One of the most rewarding parts of dentistry is being able to help people who suffer from a condition known as TMD – temporomandibular joint disorder. This is a syndrome where a person can experience a mixture of various symptoms, including the following:
Head, neck, shoulder and back pain
Jaw joint discomfort
Jaw joint clicking
Pain on yawning
Tender and enlarged facial muscles
Painful and sensitive teeth
Eye disturbances
Ringing in the ears – tinnitus
Headaches and migraines
Frequent teeth breakages
Ear pain
Abnormal jaw movements
Difficulty sleeping
These symptoms may have been going on for years or even decades and tend to get people down. Commonly, patients have tried different treatments with limited success and have had diagnostic scans that haven’t picked up anything obvious and ruled out other causes.
Our thorough examination assesses the teeth, facial muscles and jaw joints. Often, the road to comfort is travelled using a combination of treatments and different beneficial complementary therapies when trying to attain comfort. We aim to reduce the frequency and intensity of symptoms. It is fantastic when patients improve and, of course, even better if the symptoms go completely. We have had several patients who have been relieved of years of extreme headaches and pains after just a few visits.
Examples
Case 1
This woman came in with severe pain in her facial muscles and had been suffering from daily headaches for five years. Many people would consider this before photo to be a great smile; however, on close inspection, you can see worn teeth. The patient, in essence, had worn her teeth down and “lost her bite”. This had destabilised her facial muscles and turned the pain receptors on. Edge Bonding was performed, which restored her teeth to their natural shapes and brought them into contact in a harmonious fashion. We were delighted when the patient reported that she had stopped all her pain medications and that the headaches and facial pain had entirely resolved.
Before
After, edge bonding.
Before
After, she loved the natural appearance that edge bonding creates.
Restoring teeth to their natural contours allows them to slide around in a balanced way. The teeth also look younger when revitalised to their original shape.
Before, looking up at flattened teeth.
After, the bonding has restored the worn cusps.
Below shows how before treatment, the teeth are worn and don’t meet at the front – this tends to be unstable. After bonding the teeth contact and so the chewing forces are spread more evenly over all the teeth which maximises comfort.
Before
After
Teeth work best when they are tooth-shaped, not worn, so they need to be a particular shape to slide around when you talk and chew.
Before, wonky unstable bite.
After, balanced bite.
When the bite is restored, grinding habits can be reduced for some people. This protects the teeth and also increases the lifespan of any restorations. However, complete stability forever is unrealistic which means she may need more dentistry in the future.
After
The results for this patient were dramatic. Her pain level went from 10 to 0 (where 10 is agony and zero is very slight pain).
Before
After
Case 2
Two of this lady’s upper front teeth never grew in, leaving her with a narrow arch smile. When the smile is narrow, the teeth can occasionally bump into each other, wearing down the teeth and causing discomfort. This patient also suffered from sore jaw joints and facial muscle tenderness.
Before, worn, trapped, narrow smile.
After, a rebuilt, freer, broader smile.
Below right shows temporary teeth are placed to trial the new bite to ensure the teeth, joints and muscles remain comfortable.
Before, severely misshapen teeth.
After, these are the temporary crowns.
Before, uneven and worn teeth
After, the lower worn teeth are rebuilt to more natural shapes. The upper teeth have temporary crowns on them.
and these are the finished porcelain crowns.
Before, showing a collapsed bite.
After, the teeth are rebuilt to a more ideal bite pattern by fitting porcelain crowns and veneers.
Before, worn teeth.
After, these porcelain crowns are placed to mask the dark teeth and improve tooth shape.
Case 3
This woman sought treatment because some of her veneers kept breaking, and she didn’t like her short teeth. In this case, gum contouring was performed to improve the appearance of the teeth and reduce the likelihood of future restorations coming off. In essence, we built in stability and have reduced how often she has to go to the dentist!
Before, short square type, worn teeth and uneven gumline.
After, the gum line has been levelled and the lower worn teeth rebuilt with bonding.
Before
After, showing the porcelain crowns.
Before
After
Before
After
Before
After, she was so delighted with her smile.
Case 4
This gentleman had a long history of dental problems requiring multiple dental appointments due to teeth and fillings breaking. All the teeth had worn down from acid erosion and grinding to such an extent that he wasn’t showing enough tooth length when he smiled. A full-mouth approach was taken where the teeth were rebuilt to natural shapes using a combination of composite veneers, new white fillings, porcelain crowns and bridges.
Before, inadequate tooth on show.
After, the patient gains smile confidence and an inner feeling of calm with improved stability.
Before, the face has lost support due to the worn-down teeth.
After, the correct face support is reestablished, known as a dental facelift.
Case 5
Unfortunately, this gentleman lost his front tooth, which was abscessed, and he wanted to avoid wearing a long-term denture. Porcelain bridges and implants rejuvenated and brightened his smile.
Before
After
Before, the upper teeth are in-standing, which is less than ideal.
After, we brought the teeth out with crowns supported by teeth and implants.
Before
After, the bite is much more stable when teeth are placed in their correct positions.
Before
After, a more attractive, broader smile.
Case 6
This lady had just retired and wanted to have her teeth fixed before entering the next phase of her life. First, the underlying gum disease was stabilised, and then the teeth were rebuilt with crowns and bonding. The missing teeth were replaced with implants and bridges. When enough teeth are replaced, eating becomes a joy instead of a slow and laborious process.
Before, teeth were lost from gum disease.
After, she’s in love with her smile.
Before
After, the patient wanted a natural look.
Before, looking up at worn misshapen teeth.
After, the teeth are restored to more normal shapes.
Frequently Asked Questions
What is TMD?
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TMD stands for temporomandibular joint disorder. It refers to problems affecting the jaw joint, muscles, and bite, often leading to pain, clicking, or restricted movement.
What symptoms can TMD cause?
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TMD can cause a wide range of symptoms, including headaches, jaw pain, clicking or popping joints, sensitive teeth, ear pain, ringing in the ears (tinnitus), facial muscle tenderness, neck or shoulder pain, and even difficulty sleeping.
What causes TMD?
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The causes can be complex and may include jaw misalignment, teeth grinding (bruxism), stress, injury, arthritis, or a combination of these factors. Lifestyle and posture can also play a role.
How is TMD diagnosed?
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Diagnosis is made through a thorough dental examination, which may include checking your bite, jaw movement, and muscle tenderness. Scans or X-rays may be used to rule out other causes.
Can TMD go away on its own?
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Sometimes symptoms improve naturally, but many people experience ongoing or worsening problems if left untreated. Early intervention can help reduce pain, prevent further damage, and improve quality of life.
How is TMD treated?
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Treatment often involves a combination of approaches. These may include custom bite splints or night guards, bite adjustments, physiotherapy, relaxation techniques, medication, or referral for complementary therapies. Each plan is tailored to the patient.
Can grinding my teeth really cause facial pain and headaches?
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Yes. Teeth grinding puts extra strain on the jaw joints and muscles, which can lead to facial pain, tension headaches, and even broken or worn-down teeth.
Will I need surgery for TMD?
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Surgery is very rarely needed. Most cases are managed successfully with conservative treatments such as splints, bite therapy, physiotherapy, and lifestyle adjustments.
How long does it take to feel better?
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Improvement varies from person to person. Some patients notice relief after just a few visits, while others may need longer-term management. The goal is always to reduce the frequency and intensity of symptoms, ideally resolving them completely.
Is TMD linked to stress?
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Yes. Stress can lead to clenching and grinding, which put extra pressure on the jaw joints. Managing stress, alongside dental treatment, often plays a key role in reducing TMD symptoms.
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