TMJ Disorder Deep Dive: Understanding Temporomandibular Joint Dysfunction, Diagnosis, and Non-Surgical Treatments

Overview

TMD, or temporomandibular joint disorder, affects a large portion of the population and centers on the cartilage disk in the jaw joint and how the bite aligns with the skull. Teeth play a crucial supporting role for the jaw, and disruptions can trigger pain, stiffness, and functional limitations in speaking and chewing. The episode frames TMD as a common, treatable condition where dental care is the primary entry point for evaluation and management.

"The teeth ultimately are the support system to the joint."

Emily Kwang hosts a clinical discussion with Justin Richard, an oral surgeon, to demystify what people experience with TMD and how clinicians approach care.

Causes and Susceptibility

Most TMJ issues relate to the cartilage pad's position within the joint. If back teeth are missing or the bite is uneven, the jaw adapts in ways that can strain ligaments and alter the cartilage’s alignment. The analogy to orthopedic alignment helps explain how unilateral tooth loss can cascade into jaw dysfunction and pain.

"If you don't have any teeth on half of your mouth, you start to develop habits with the way your jaw wants to rotate and shift to function."

Diagnosis and Imaging

Diagnosis begins with a thorough clinical exam, listening to patient reports, and comparing those findings with imaging and bone health. X-rays assess bone changes; MRI is used to evaluate the cartilage disc and synovial fluid, which nourishes and lubricates the joint. The clinician looks for reduced joint space or misalignment of the cartilage pad to confirm TMD and guide treatment decisions.

"MRI... proves it. You look at an image and you know it."

Treatment Options

Non-surgical options form the first line of care. Occlusal appliances—thick dental splints often likened to braces for the jaw—reduce joint pressure. Minimally invasive procedures such as arthrocentesis (joint lavage) and injections (for example, PRP, growth-factor concentrates) are used to reduce inflammation and promote healing. Some people receive injectable fillers in the jaw joint, though this is used cautiously and off-label in some cases. Open joint surgery is reserved for cartilage misplacement or damage in select patients and is rarely required for most TMD cases.

"The majority of TMJ issues probably don't even need surgery at all."

Early stages emphasize seeing a dentist—the mouth’s primary care provider. Self-treatment from internet appliances is discouraged due to potential harm and ineffective relief. The episode also notes the importance of education, not only for patients but also for future dental professionals.

Home Management and Education

At-home strategies include conservative measures, but the show cautions against buying at-home occlusal devices online. Clinicians stress professional assessment and tailored care plans. Education standardization across dental programs is highlighted as a critical step to ensure consistent, evidence-based TMJ care for patients in the future.

"What we got to do is standardize our TMJ education across dental education"

Conclusion and Next Steps

The discussion concludes with an emphasis on ongoing dialogue between patients and dental teams and a commitment to revisiting TMJ topics in future episodes to deepen understanding and improve care. Clinicians encourage listeners to submit questions for subsequent programs and acknowledge the role of dental professionals in preventing chronic jaw pain through informed, standardized practice.