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Cosmetic/Restorative Dentistry

TMD/Bruxism/Teeth Grinding

While most TMJ pain or discomfort resolve themselves without any major treatment, some patients will need more long-term solutions. Because TMD can look so different depending on the patient and symptoms, treatment can also vary drastically, and unfortunately, there isn’t one method that works for every patient. Pain management is usually an important aspect of TMJ treatment, as most patients request help with TMD due to some level of pain. 

Bruxism, also known as teeth grinding, refers to any type of forceful contact between the teeth. This can be a loud and grating contact or a silent and clenching contact. Most people grind their teeth from time to time with little to no damage to the teeth or jaw. However, those who continually grind their teeth can cause severe damage to their teeth, as well as other oral health complications.

Common Questions About TMD/Bruxism/Teeth Grinding

  • Adults and children both can suffer from the condition.
  • Children usually develop bruxism as a result of a cold or infection. Often pain from teething or earaches will induce bruxism in toddlers and children.
  • Alcohol, drugs, and certain sleep disorders can exacerbate the condition, making it worse.
  • Stress and anxiety can significantly increase how often and how severely you grind your teeth.
  • Having an abnormal bite caused by missing or malaligned teeth may also contribute to tooth grinding

Occasional bruxism usually does not result in damage to the teeth or jaw. However, chronic teeth grinding can cause serious dental issues, including:

  • Tooth or dental restoration fracture
  • Loosening of teeth
  • The loss of a tooth or teeth
  • Eventual tooth wear that will require bridges, crowns, root canals, implants, or possibly even dentures to repair

Not only is bruxism bad for your teeth, it is also damaging to the jaw. This may result in:

  • Hearing loss
  • Changes to the appearance of your face
  • Temporomandibular Disorders, or TMD

Disorders that arise from problems with the occlusion (the contact between teeth), jaw joint, and surrounding facial muscles that control chewing and move the jaw.

The Temporomandibular Joint, or TMJ is the jaw joint;

  •  It is a hinge joint that attaches the mandible, or lower jaw, to the skull
  • During normal function, the joints move smoothly up and down, allowing you to chew and talk
  • Facial muscles attach to the joint to help position the jaw during movement.

Symptoms of TMD

  • Clicking, popping, or grating sounds in the jaw during functioning
  • Jaws that get  ‘locked’ in the open- or closed-mouth position
  • Difficulty chewing or an uncomfortable bite
  • Swelling, pain, or tenderness in the face
  • Limited ability to fully open you mouth
  • Toothaches
  • Headaches or neck aches
  • Dizziness
  • Earaches
  • Hearing problems
  • Upper shoulder pain
  • Ringing in the ears

Causes of TMD

  • Grinding or clenching that puts pressure on the teeth and TMJ
  • Presence of osteoarthritis or rheumatoid arthritis in the TMJ
  • Stress, which can cause a person to clench grind their teeth and tighten the muscles of the face
  • Dislocation of the disc, or soft cushion, between in ball and socket of the TMJ
  • An injury to the jaw, TMJ, or muscles of the head and neck
  • Dr. Faiella will start by taking a thorough history of your symptoms 

  • A clinical exam will be performed to check for pain or tenderness in the joint or facial muscles, clicking or popping of the joint during movement, limited motion or locking of the jaw, and to evaluate your occlusion, or the way your teeth come together during closing and all movements

  • A panoramic x-ray may be taken. This image shows the entire TMJ, bones of the jaws, and teeth

  • Depending on the severity of your condition, Dr. Faiella may refer you to a specialist for further tests and evaluation

In most cases, conservative treatment options are the preferred option, reserving surgery as a last resort.

Depending on your symptoms and the factors contributing to the condition, Dr. Faiella may recommend one, or a combination, of the following;

Occlusal Guard

  • This plastic mouthpiece fits over the upper or lower teeth and helps to prevent them from fully coming together.
  • This helps to ease muscle tension and reduce pressure on the teeth and TMJ by putting the teeth in contact with the splint in their most correct and least traumatic position. It also protects the teeth from excessive wear caused by long-term clenching and grinding.

Warm compresses 

  • Applying heat to the TMJ several times a day can dilate blood vessels and help to relax sore and tightened muscles.

Changes in your diet

  • Avoiding chewy foods such as gum or certain meats, as well as crunchy or hard foods can help to alleviate TMJ and muscle inflammation.
  • Food should be cut into smaller pieces.
  • Avoid caffeine and alcohol which may increase the frequency and severity of bruxism.


  • Over-the-counter-NSAIDS, such as Aspirin or Ibuprofen, may help to alleviate muscle pain and swelling.

Dental Treatment

  • Dr. Faiella may recommended certain dental treatments, including crowns, bridges, orthodontics, or implants, to create a more balanced bite.

Avoid extreme jaw movements

  • This includes yawning, excessive chewing, clenching your teeth, and resting your chin on your hand or other objects. Relaxation techniques can help to reduce muscle tension and avoid clenching.

If the non-invasive treatment options do not reduce your pain or tenderness, Dr. Faiella may refer you to a specialist for further treatment.