Reviewed by Dr. Nicole M. Berger, DDS — South Florida Smile Spa, Pompano Beach, FL
TMJ treatment in Pompano Beach at South Florida Smile Spa starts with sorting out what is actually hurting, because “TMJ” has become shorthand for any pain near the jaw joint, and most of it does not come from the joint at all. The temporomandibular joints sit just in front of each ear and are worked by some of the strongest muscles in the body; in most patients the pain, clicking, headaches and stiffness come from those muscles being overworked by clenching and grinding, which responds well to conservative care. Dr. Nicole M. Berger treats TMJ disorders with a custom occlusal splint or nightguard, Botox in the jaw muscles, bite correction where the teeth are the cause, and a self-care program, and refers the small number of true joint problems that need an oral surgeon or a TMJ physician. This page explains the difference, what we treat, how, and what to expect.
Quick answer
Temporomandibular disorders (TMD) are pain and dysfunction of the jaw joints and the chewing muscles: jaw pain, clicking or locking, headaches at the temples, ear pain or fullness, and teeth that ache or wear. Most cases are muscular and are driven by clenching and grinding, often with stress, sleep problems or a bite that does not meet evenly. At South Florida Smile Spa in Pompano Beach, Dr. Berger diagnoses the type with an exam of the joints, muscles and bite, usually with a 3D cone-beam scan, and treats it conservatively: a custom occlusal splint or nightguard, Botox in the masseter and temporalis muscles for stubborn clenching, adjustment or restoration of a bite that is driving the problem, and a home program of heat, soft diet, jaw exercises and habit change. Most patients improve substantially within six to twelve weeks. Joint damage, locking that does not release, and arthritis are referred to an oral surgeon or TMJ physician.
The Symptoms
TMJ treatment in Pompano Beach: what a jaw disorder feels like
TMD symptoms wander, which is why patients see ENTs for ear pain and neurologists for headaches before anyone looks at the jaw. These are the ones that bring people to us.
- Jaw pain or stiffness. Aching in front of the ear or along the jaw, worst in the morning after a night of clenching or by evening after a day of it.
- Clicking, popping or grinding sounds. A click on opening is a displaced cushion disc in the joint; it is common, often painless, and not by itself a reason for treatment.
- Locking. A jaw that catches or will not open fully, or occasionally will not close, which means the disc is stuck and needs prompt attention.
- Headaches at the temples. The temporalis muscle fans across the side of the head; when it is overworked the result is a tension-type headache that is often misread as migraine.
- Ear symptoms. Ear pain, fullness or ringing with a normal ear exam is often referred from the joint or the muscles next to it.
- Tooth signs. Flattened, chipped or sensitive teeth, cracked fillings, and scalloped tongue edges are the fingerprints of clenching and grinding.
The American Dental Association’s page on temporomandibular joints covers the same symptoms and explains why conservative, reversible treatment comes first.
TMJ treatments: what we do here and what is referred
| Treatment | What it does | Best for | Provided at SFSS |
|---|---|---|---|
| Self-care program | Soft diet, heat, jaw rest, posture, habit awareness, stress and sleep habits | Every patient, as the foundation | Yes |
| Custom occlusal splint or nightguard | A hard acrylic appliance that separates the teeth, unloads the joints and reduces muscle activity at night | Clenching and grinding, muscle pain, morning headaches, protecting worn teeth | Yes, made from a digital scan |
| Botox in the jaw muscles | Reduces the force the masseter and temporalis can generate for three to four months | Muscle pain and headaches that a splint alone has not controlled; heavy clenchers | Yes, by Dr. Berger |
| Bite adjustment or restoration | Reshaping or rebuilding teeth so the bite meets evenly | A bite problem, a high filling or crown, or worn teeth driving the clenching | Yes |
| Jaw exercises and physical therapy | Stretching and strengthening the jaw muscles; posture work | Limited opening, muscle tightness; often with a physical therapist | Exercises here; PT referred |
| Medication | Short courses of anti-inflammatories or muscle relaxants for flare-ups | Acute pain | Yes, short term |
| Joint injections, arthrocentesis, arthroscopy | Flushing or treating the joint space itself | Locking that will not release, inflammatory joint disease | Referred to an oral surgeon |
| Joint surgery or replacement | Repairing or replacing a damaged joint | Severe degenerative joint disease; rare | Referred |
| Orthodontics or jaw surgery | Correcting a bite or jaw relationship at its root | Selected skeletal cases | Invisalign here; surgery referred |
The Process
How a TMJ problem is diagnosed and treated here
- Exam. Dr. Berger feels the joints and the chewing muscles for tenderness, measures how far and how straight the jaw opens, listens for joint sounds, and checks the teeth for wear and the bite for high spots.
- Imaging. A 3D cone-beam scan shows the bony joint and rules out arthritis, a fracture or an unusual cause; an MRI is ordered through a physician only if the disc itself needs to be seen.
- Diagnosis. Most patients are told the problem is muscular, which is good news; a smaller number have a displaced disc, and a few have joint disease. The treatment plan follows from which.
- Splint or nightguard. A digital scan is taken, and a custom hard acrylic splint is fitted a week or two later and adjusted so the bite on it is even. It is worn at night and, for heavy clenchers, part of the day.
- Botox and bite work as needed. If muscle pain persists after six to eight weeks, Botox in the masseter and temporalis is added; if a high spot or worn bite is driving the clenching, it is adjusted or restored.
- Review and maintenance. Progress is checked at six and twelve weeks. Most patients keep the splint long term and return for Botox every three to four months if it was part of the plan; anything not improving is referred.
Muscle, disc or joint: why the diagnosis matters
Three different problems hide behind the letters TMJ. Myofascial pain, by far the most common, is overworked chewing muscles: dull aching, temple headaches, stiffness, worse with stress and clenching, and the teeth often show the wear. It responds to splints, Botox, habit change and time. Disc displacement is the cushion inside the joint slipping forward, which causes clicking and sometimes locking; a click alone needs no treatment, but intermittent locking is treated promptly with a splint and exercises before it becomes permanent. Joint disease, osteoarthritis or an inflammatory arthritis, shows on the cone-beam scan as changed bone and causes grinding sounds and a bite that has shifted; it is managed with the same conservative measures plus medical treatment of the arthritis, and referred when the joint itself needs intervention. Dr. Berger tells you which you have at the first visit.
Splints and nightguards: not the same thing as a drugstore guard
A custom occlusal splint is a hard, precisely fitted acrylic appliance that covers the biting surfaces of one arch and is adjusted so every tooth meets it evenly in the position where the jaw muscles relax. That even, flat contact is what lets the muscles stand down; a soft boil-and-bite guard from the drugstore does the opposite for many clenchers, giving the muscles something to chew on and making the pain worse. Splints are made here from an iTero digital scan, fitted and adjusted at delivery, and rechecked as the muscles settle, because the bite on the splint changes as the jaw relaxes. Our nightguards page explains the designs and how to care for one.
Botox for jaw pain
When a splint and self-care have calmed the pain but not enough, or when a patient clenches through the day and cannot wear a splint at work, Botox in the masseter and temporalis muscles is the next step. It reduces the force those muscles can generate for about three to four months while leaving chewing and speech unaffected, and many patients notice the morning ache and temple headaches fading within a week or two. Dr. Berger provides it here, dosed to the muscle size and reviewed at two weeks. Our Botox page covers the treatment in detail, including the cosmetic side.
When the bite is the cause
A filling or crown that sits slightly high, teeth worn flat so the jaw over-closes, missing back teeth that overload the front, or a bite that has never met evenly can all keep the muscles bracing. These are found at the exam and on the splint, and they are fixed with a simple bite adjustment, a replacement restoration, or a plan to rebuild worn teeth, sometimes a full mouth reconstruction when the wear is extensive. Alignment problems that contribute are treated with Invisalign here; skeletal jaw relationships that need surgery are referred. Bite correction is done after the muscles have calmed on a splint, never during a flare-up, because a painful jaw does not close in its true position.
What you can do at home
For the first few weeks: soft food cut small, no gum and no chewing ice or nails, a warm compress on the muscles for ten minutes twice a day, and the rule that lips together, teeth apart is the resting position of a healthy jaw. Notice when you clench during the day, at a screen, in traffic, at the gym, and let the jaw hang. Sleep on your back or side rather than face down, keep caffeine and alcohol modest in the evening, and treat sleep problems, since fragmented sleep drives grinding; patients who snore are screened for sleep apnea, which is a common hidden cause. Gentle opening and stretching exercises are shown at the splint visit.
Cost and insurance
A TMJ exam is billed as a dental exam, and a cone-beam scan as imaging; most dental plans cover both. Occlusal splints are covered by many dental plans, often once every few years, and by some medical plans for a diagnosed TMJ disorder. Botox for jaw pain is generally not covered by dental plans; some medical plans consider it for diagnosed TMD or chronic migraine with prior authorization, and we supply the documentation. Bite adjustments and restorations are covered as the dental procedures they are. Our team verifies your benefits and gives you a written estimate before the splint is ordered.
Care in Pompano Beach
Why patients choose South Florida Smile Spa for TMJ care
- A diagnosis before a device. Muscle, disc and joint problems are told apart at the first visit, with 3D imaging when needed, so the treatment fits the cause.
- Conservative and reversible first. Splints, self-care and Botox before anything that changes the teeth, and surgery only by referral when it is truly needed.
- Splints from a digital scan. Precisely fitted hard acrylic appliances, adjusted at delivery and as the muscles settle.
- Botox by the dentist who treats the jaw. Dosed to the muscles that are actually overworking, reviewed at two weeks.
- The bite and the teeth are looked after. Worn, cracked and high teeth are found and fixed by the same dentist, in the right order.
TMJ patients come to us from Pompano Beach, Lighthouse Point, Deerfield Beach, Fort Lauderdale and Coconut Creek, many after months of headaches or ear pain that no one connected to the jaw.
Jaw pain, clicking, or headaches that start at the temples
Book a TMJ exam with Dr. Berger. You will learn whether the problem is muscle, disc or joint, and leave with a plan that starts with the simplest thing likely to work.
South Florida Smile Spa · Dr. Nicole M. Berger, DDS · 572 E McNab Rd, Suite 102, Pompano Beach, FL 33060 · (954) 785-1100
Frequently Asked Questions
What is the difference between TMJ and TMD?
TMJ is the joint itself, the temporomandibular joint in front of each ear. TMD, temporomandibular disorder, is the group of problems that cause pain or dysfunction in those joints and the chewing muscles. People say TMJ to mean both, and so does this page.
Can a dentist treat TMJ?
Yes; dentists treat most TMJ disorders, because most are caused by clenching, grinding and bite problems. Dr. Berger diagnoses the type, makes custom splints, provides Botox for the jaw muscles and corrects bite problems, and refers joint problems that need an oral surgeon or TMJ physician.
Is a clicking jaw a problem?
Not on its own. A painless click is a displaced disc in the joint and is very common; it needs no treatment. Clicking with pain, or a jaw that catches or locks, is a reason to come in promptly, because intermittent locking is much easier to treat than a jaw that has locked closed.
Will a nightguard fix my TMJ?
For muscle-type TMJ, which is most of it, a custom hard splint is the single most effective treatment and most patients improve within six to twelve weeks. A soft drugstore guard often makes clenching worse. A splint is combined with self-care and, if needed, Botox or bite correction.
Does Botox help TMJ pain?
Yes, for the muscular kind. Botox in the masseter and temporalis muscles reduces the force of clenching for three to four months, and most patients notice jaw pain and temple headaches easing within one to two weeks. It is used when a splint and self-care have not been enough, and repeated as needed.
Do I need an MRI or a scan?
A 3D cone-beam scan is taken here to check the bony joint and rule out arthritis or other causes. An MRI, which shows the disc, is ordered through a physician only when the disc position will change the treatment, which is uncommon.
When is TMJ surgery needed?
Rarely. Locking that will not release with a splint and exercises, inflammatory joint disease, and severe degenerative changes are the usual reasons, and they are referred to an oral surgeon. The great majority of TMJ disorders settle with conservative treatment.
Can stress cause TMJ?
Stress is the most common trigger, because it drives daytime clenching and night grinding, and poor sleep makes both worse. Treatment addresses the muscle overload with a splint or Botox while you work on the clenching habit, sleep and stress; snorers are screened for sleep apnea, which is a frequent hidden cause of grinding.
Do you see patients from outside Pompano Beach?
Yes. TMJ patients come from Lighthouse Point, Deerfield Beach, Fort Lauderdale, Coconut Creek and across Broward County, and splint and Botox visits are kept short. The office is at 572 E McNab Rd, Suite 102, Pompano Beach. Call (954) 785-1100 or request an appointment.