TMJ & TMD, Headaches & Migraines

Is chronic pain keeping you from enjoying the things you love?

It may seem strange, but it’s true. A bad bite (called malocclusion) can cause problems you may not associate with your mouth. Tooth malocclusion occurs when the upper and lower teeth in your mouth don’t come together the way they’re supposed to. Malocclusions can cause teeth to wear unevenly or break, major headaches, TMJ pain and even trigger migraine symptoms.

Neuromuscular dentistry is a non surgical treatment approach that can dramatically reduce or eliminate these symptoms while beautifully restoring your smile.

Most dental treatment that involves changing your teeth in some way such as tooth replacement, filling cavities, and crowning teeth may change your bite. Restorations that are too high or too thick may cause jaw joint and muscle pain. Given time and ibuprofen, the muscles may stretch and the headaches may stop. Your dentist may be able to adjust your bite but when left untreated the symptoms can become worse.

Automobile accidents can also cause trauma to your TM Joints. In fact, home, occupational, or physical assault can trigger muscle spasm and pain. When whiplash injury takes place the head and neck are forced to move beyond their normal range of motion, injuring the muscles and ligaments controlling its motion. Symptoms may not be felt until hours or months after the accident.

TMJ Pain

TMJ stands for Temporomandibular Joint. This is the joint in front of the ear hole that tmj2connects the mandible (lower jaw) to the temporal bone of the cranium. The temporal bone houses the hearing and balance apparatus as well.

The most common symptoms include headaches, dizziness, stiffness in the jaw joint, ear aches, ringing in the ears, teeth that do not touch when biting, neck pain, pain behind the eyes, problems swallowing, fainting, shoulder or back pain, tingling or numbness in the fingers, clicking jaw, inability to open mouth wide, clenching/grinding teeth, worn teeth.

Diagnosis & Treatment

As part of the TMJ assessment, Dr. Vo will perform a comprehensive head and neck evaluation, medical history, take special X-rays and other tests that include muscle function. In general, the diagnostic studies available for TM Joint diagnosis and evaluation are:

  • X-rays of the TM Joints & Skull
  • Range of Motion
  • Muscle palpation
  • Joint Vibration Analysis (ultra-sound sonography)
  • Diagnostic Study Casts of the Mandible & Maxilla

Treatment is a multidisciplinary, non-surgical, reversible team approach among many health professionals to restore comfort, and improve jaw function to an acceptable level.

This may include:

  • A repositioning splint
  • Cold laser
  • Massage therapy
  • Chiropractor
  • Nutrition counselling
  • Acupuncture
  • Jaw exercises

Grinding & Clenching

Grinding and clenching are two of the most common causes of the wearing away of tooth enamel. However, they are also extremely preventable when detected early. Squeezing the teeth together is called clenching. Grinding the teeth together is called bruxism.

Your upper and lower teeth are supposed to glide together smoothly, touching only when you are chewing food. Unnatural grinding or clenching can cause wearing and cracking of the teeth, as well as serious jaw impairment.

If bruxism persists, as it does in an estimated 20 percent of the population during waking hours and 8 percent during sleep, it can have a negative effect on your tooth enamel, bone, gums and jaw.


Bruxism starts early in life while the teeth are still in the process of developing. An estimated 15 percent of children reportedly grind or clench their teeth. Although the condition eventually wanes, with only 3 percent of the elderly continuing to brux, it takes a toll during the intervening years.

While enamel subject to normal stresses wears down at the rate of .3 millimetres every 10 ten years, it is not uncommon for bruxers to experience two millimetres of enamel erosion by their mid-twenties. What’s more, night time bruxism can occur as often as 40 minutes for every hour of sleep, producing up to 250 pounds of force per square inch. That’s enough pressure to crack a walnut!


Clenching is more likely to occur during the daytime, with women likelier to clench than men. One theory is that women are more predisposed to be vigilant. For example, they are more alert to the sound of a baby crying. This type of conscious attentiveness translates into more frequent closings of the jaw rather than sideways grinding motions.

The Consequences of Bruxism & Clenching

Over the years, the accumulated toll of bruxism and clenching can produce a wide range of damage that includes:

  • Front teeth worn down so they are flat and even in length.
  • Micro-cracks and broken fillings, eventually leading to nerve damage.
  • Teeth ground down to the dentin, causing sensitivity to heat and cold.
  • Gum recession, due to pressure on the gum line.
  • Loose teeth, caused by the rocking effect of bruxism, and gum pockets, also produced by the back-and-forth rocking effect.
  • Headache and aching jaws due to overuse of muscles.

Bruxism & Clenching Treatments

While there is no cure for bruxism, the condition can be managed through treatment. If you suspect that you clench or grind your teeth, consult with Dr. Vo to undergo a bruxism evaluation and to evaluate the extent of wear and tear on your teeth, gums and jaw, and to provide a practical remedy to offset further damage.

The Custom-Fitted Nightguard

Wearable day or night, a custom-fitted nightguard acts as a bumper guard, absorbing the force of the clenching or grinding. While horseshoe-shaped over-the-counter night guards are also available, they tend to be uncomfortable and are so soft that they may get chewed away. In addition, over-the-counter night guards do not account for occlusal discrepancies that may be the source of your bruxism problems, thus making your grinding and clenching problem worse. Custom-fitted nightguards, made of hard acrylic, can help bruxers avoid such problems.