Dr. Stewart is the leading TMJ care and TMD treatment specialist providing comprehensive, unparalleled care for patients throughout the Dallas-Fort Worth metro area, the state of Texas, and nationally. Located in Flower Mound, Texas, Dr. Stewart has been creating custom TMD solutions for 20 years. Dr. Stewart has a personal interest in helping patients who suffer from TMJ-related pain. As a student in dental school, he underwent an orthodontic procedure that damaged his bite. This one injury eventually caused severe headaches, jaw pain and problems chewing. As he sought treatment from different TMJ professionals, he became interested in the causes of TMJ dysfunction and the best way to restore patients’ chewing systems to normal function. He has pursued thousands of hours of advanced training focused on the proper diagnosis and treatment of TMJ. His experience has transformed his practice focus on the airway and chewing system as the core of the patient’s dental health and his emphasis on protecting and restoring this system as the main goal of each patient’s treatment.

What Is TMJ?

The temporomandibular joint (TMJ) is a small joint located in front of each ear where the skull and lower jaw meet. This joint allows the jaw to move and function. TMJ disorder (TMJD, also known as TMJ dysfunction or TMJ syndrome) is an umbrella term that covers any number of causes of acute and/or chronic pain related to the opening and closing of the jaw. TMJ disorder may be caused by arthritis, bruxism (teeth grinding), trauma, misalignment of the patient’s bite, displacement of the disk that is located between the jawbone and the socket, or many other issues. Many TMJ issues are related to Sleep Disordered Breathing as well.


TMD Symptoms

TMD is characterized by severe discomfort and pain, often leading to a lowered quality of life for patients. The most common symptom of TMD is facial pain which can trigger further pain throughout your upper body. The symptoms experienced by TMD patients differ from individual to individual– patients may experience a few symptoms while others may experience numerous symptoms. TMD symptoms may be temporary or may become chronic issues that last over several years. TMD can affect anyone at any age. TMJ issues are also twice as common in women than men. Women, using supplemental estrogen or oral contraceptives, have a higher risk of TMD. The symptoms of TMD can include:

  • Pain or tenderness in TMJ area, face, neck, shoulders, and in/around the ears whenever you speak, chew, or open your mouth wide
  • Pain in one or both of your jaw joints
  • Problems with trying to open your mouth wide
  • Jaws that lock or get stuck in the open or closed positions
  • Popping, clicking, or grating sounds in the TMJ when you open your mouth, close your mouth, or chew
  • Fatigue or tired feeling in facial muscles
  • Trouble chewing or experiencing a sudden uncomfortable bite
  • Swelling on the side of your face

TMJ issues and TMD can be incapacitating, making it difficult to talk or comfortably eat. Once your jaw joints are impacted, other parts of your complex chewing system are also compromised. The intricate working parts throughout your jaw naturally compensate for your affected TMJS, leading to further symptoms experienced. Facial muscles and nerves compromised by TMD often result in these symptoms:

  • Dizziness
  • Headaches and widespread facial pain
  • Hearing problems
  • Earaches or a ringing sensation in the ears
  • Jaw clenching and teeth grinding
  • Excessively worn, loose, broken, or chipped teeth
  • Sensitive teeth that react to hot, cold, and/or chewing
  • Gum recession
  • Wedge-shaped or abfractions in the teeth at the gum line
  • Eustachian tube dysfunction

With such a wide scope of cascading symptoms, TMD is often misdiagnosed causing patients to go from specialist to specialist. An estimated 10% to 15% of Americans suffer from one or more of these symptoms, making proper treatment pertinent. TMJ dysfunction is often misdiagnosed, resulting in ineffective treatment plans that fail. TMJ care is best provided by a specialized dentist like Dr. Stewart. Rather than trying to treat each individual symptom, he’ll address the underlying cause of your TMJ disorder, and treat it in a logical and definitive manner.

TMD: What Are the Causes?

It can be difficult to pinpoint the exact cause of TMD in patients, but dentists believe that symptoms arise from issues with the corresponding facial muscles or with parts of the TMJ itself. It is common for patients to have TMD due to a combination of causes and factors while some patients can attribute their TMJ discomfort to certain conditions. The known causes of TMD are:

  • Grinding or clenching your teeth– this puts significant pressure directly on TMJs
  • Heavy blows, whiplash, or other trauma that directly affect the jaw, teeth, or muscles of your head and neck
  • Movement or erosion of the cartilage disc between the ball and socket of the TMJ
  • Arthritis leading to damage of the cartilage disc
  • Chronic stress that can result in tightening facial and jaw muscles or clenching teeth
  • Genetic predisposition
  • Misalignment of your chewing system– improper bite
  • Poor posture in the upper back and neck that can lead to strain and abnormalities of facial muscle function
  • Excessive gum chewing

Evidence is clearer that many TMJ problems are associated with Sleep Breathing Disorders because of under developed upper and lower jaws. These following conditions can significantly increase your risk of developing TMD:

  • Jaw injuries
  • Arthritis
  • Chronic jaw clenching or teeth grinding
  • Certain connective tissue disease that causes issues that may compromise TMJs
  • Chronic stress that may increase jaw clenching and muscle tension
  • Genetic predisposition to pain sensitivity and increased stress responses

Any event or factor that disrupts your chewing system can potentially result in TMD. The complexity of your chewing system requires each component to work simultaneously in order to effectively and comfortably chew, speak, and swallow.

TMJ Diagnosis

Unfortunately, TMJ problems are some of the most commonly misdiagnosed illnesses out there. TMJ dysfunction can result from several different causes. For the patient to get relief from their symptoms, their individual case must be accurately diagnosed and an appropriate, customized treatment plan initiated. In our practice, Dr. Stewart uses computerized tomography (CT) scans to examine the patient’s bone and tissue structure to detect hidden problems. Computer analysis of the CT scans, in addition to analysis of the patient’s airway, ensures that we can achieve an accurate diagnosis and design a safe, effective, and individually appropriate treatment. Dr. Stewart will evaluate all components of your complex chewing system. We also use study models of your mouth, along with jaw movement simulation instruments, for a more detailed bite analysis.

TMD Treatment Plan

Dr. Stewart is honored to provide leading treatment options for our patients. We customize every treatment plan for each patient to treat each underlying cause. The first phase of TMD treatment requires using a temporary device known as an orthotic. An orthotic effectively pacifies facial pain and muscles spasms while stabilizing, and centering, the TMJ and other working components. Your muscles will be happy and you will be free of pain, your bite will then be corrected with Invisalign, traditional orthodontics, restorative dentistry, or a combination of the three.

For proper TMD diagnosis and comprehensive TMJ care, contact us today!