TMJ Friends

The TMJ specialist is a dentist who has usually had extra training to help him become more familiar with TMJ disorder. It is always a good idea to ask the dentist what training he or she has had. Please refer to our article entitled “How to Choose a Doctor” for more information on researching a doctor’s credentials. Also keep in mind that there is NO board certification for so called “TMJ Specialists.” A dentist or doctor needs no expertise to have the label.  One TMJ Specialist may have 500 extra hours of training, while another may have five hours.  There are also no standards for diagnosis or treatment of TMJ disorder.  Each dentist has his or her own ideas and treatments.  This is why it is very important to resarch your doctor and the treatment plan he or she proposes (for more assistance with this, please see the TMJ Friends forums).  The TMJ specialist will most likely perform a more extensive examination than your general dentist. He might take different types of x-rays such as a panorex or tomogram, or order an MRI.

You may question why to see a general dentist if you could just see a TMJ disorder specialist. Most cases are manageable at the general or family dentist level, and do not need further intervention from a more specialized (and often more expensive!) doctor. Keep in mind that these cases can be managed without invasive or irreversible treatment such as grinding your teeth down or changing your bite. If any sort of invasive or irreversible treatment is proposed, it is very important to secure a second or third independent opinion (meaning, do not allow your current doctor to refer you to your second opinion). The TMJ specialist will be your primary diagnostician based on results from tests, physical examination, your symptoms, how your teeth fit together, etc.

Depending on what your diagnosis is, this doctor may do a multitude of things, like splint therapy, trigger point injections, iontophoresis, ultrasound, or transcutaneous electric nerve stimulation (TENS unit). They may refer you to other doctors such as a neurologist, ear nose and throat doctor, pain specialist, or oral surgeon.

Your TMJ disorder specialist should come up with an easy to understand treatment plan for you which can include any of the above.  It should also freely discuss cost. Usually, dentists refer to this treatment plan by “Phase One” and “Phase Two.” Phase one is generally reducing pain, stopping any inflammatory or degenerative processes. This part of the plan is usually conservative. When pain has subsided, and a correct diagnosis has been established, you move on to Phase Two, which can include braces, equilibration and total reconstruction including crown work and bridges. These treatments are non-reversible and invasive. There is very little scientific research showing their effectiveness, so please do your research.

Please keep in mind that diagnosis and treatment varies from doctor to doctor. At this point of treatment, many patients see a psychologist to help deal with the pain and associated effects of TMJ disorder on their life and their family. This can be a very important aspect of treatment since chronic pain effects so much in a patient’s life. If the patient has headaches, burning pain, migraines or any neurological symptoms, they can be referred to a neurologist.

For more information on doctors who treat TMJ disorder, like oral surgeons, neurologists, and pain management specialists, see our What Type of Doctors Treat TMJ Disorder? article.  Also, visit our forum to speak with other patients about their experiences.