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TMJ / TMD Therapy
Get relief for your TMJ and headaches NOW!
Why Choose Us?
Dr. Holmes is an authority in the field of TMJ / TMD Therapy. He has 28 years of experience and has successfully treated over 9,000 TMJ/TMD/Headache patients.
We use cutting edge technology to diagnose and treat TMJ / TMD symptoms and causes. This includes MRI and 3D Diagnostic X-Ray technology.
You don't need to live in pain and discomfort.
Getting started is easy, just call us at (615) 371-8888 or click the button below to schedule a consultation.
What are TMJ / TMD Disorders?
TMJ disorders cause tenderness and pain in the TemporoMandibular Joint (TMJ) — the joint on each side of your head in front of your ears, where your lower jawbone meets your skull. This joint allows you to open/close your mouth, talk, chew and yawn.
Because many of the symptoms of this problem are not only in the joint but also cause pain in the head and neck, the condition is more accurately referred to as TMD which stands for TemporoMandibular Disorder.
TMJ / TMD disorders are caused by many different types of problems: disc displacements, uneven bites, arthritis, jaw injury/trauma, or muscle fatigue from clenching or grinding your teeth during sleep or while awake. Teeth grinding is also referred to as Bruxism.
If your jaw joint(s) make popping or clicking noises you have a TMJ problem that should be evaluated!
More information about TMJ / TMD
Dr. Dennis Holmes has successfully treated over 9,000 TMD/TMJ/Headache patients
Signs and symptoms of TMD / TMJ include but are not limited to the following:
- Pain in muscles of the head, face, jaws and neck
- Pain in the jaw joint
- No comfortable place to hold or position the jaw
- Clicking, popping or grinding of the jaw joints
- Jaw locking or sticking open or closed
- Awareness of a change in one's bite
- Crookedness of one's smile/jaw
- Abnormal wearing and attrition of one's teeth
- Unexplained dizziness
- Unexplained pain or pressure changes in the ears
Here are some answers to some of the most commonly asked questions about TMJ / TMD:
My jaw joint clicks or pops. Is this a problem and is it going to get worse?
Yes, it is a problem and it is likely to get worse unless treatment is provided to stabilize it.
I had a bite splint made for my TMJ problem, but why does it not relieve my symptoms?
It is often because an accurate diagnosis was not established prior to the splint being made. Sometimes it is because a different design or instructions for use of the splint would have been more successful. Generic or universal designs of bite splint are not recommended. If a bite splint is needed, a specific custom design should be fabricated considering your diagnosis. Also, other physical problems may be occurring that may contribute to the problem and pain. Dr. Holmes can determine why your treatment has not resolved your problem.
Is my headache or jaw pain caused by a TMJ problem, some other disorder or a combination of things?
Often time what are described or diagnosed as migraines are often cause by TMDs. Other disorders or conditions can also be a cause or factor. Only proper and thorough evaluation and testing can determine that and Dr. Holmes excels and finding answers to these questions.
Why does my bite feel uncomfortable like there is no proper spot to hold my jaw?
This is usually due to unstable jaw muscles, an internal jaw joint disorder or a combination of both.
Will getting braces fix my TMJ problem?
Sometimes orthodontic treatment can be a great option to correct a person’s bite and alignment of the teeth but it should never be used before an accurate diagnosis of the TMJ problem is established.
Do TMJ problems cause migraines?
Yes, they can. Although patients can suffer from true vascular migraines, the majority of headaches are either caused or exacerbated by TMJ problems.
Can TMJ pain be related to neck or ear pain?
Yes. Disorders of the neck and ear can refer to jaw joint and associated areas. Dr. Holmes has tests that can determine that the true source or sources of your pain.
There are many common misconceptions about TMJ / TMD:
Nothing can be done about it.
Truth - There are many wonderful and highly successful treatment options available and and Dr. Holmes is highly experienced in all of them.
The problem will eventually go away on its own.
Truth – It will not. The symptoms may temporarily diminish but without proper treatment and stabilization it will degrade over time.
The problem is completely psychological.
Truth – It is a true physical ailment. Stress can exacerbate the underlying physical problem it is not just "in your head".
Dr. Dennis Holmes has successfully treated over 9,000 TMD/TMJ/Headache patients
TMJ Disorders overview for Healthcare Providers
Dr. Holmes has treated over 9,000 patients TMD patients with 6,000 of them having severe internal TM joint disorders over his 28 years of practice. What makes his experience so rare is that he has ordered and correlated MRI scans on all 6,000 of these internal joint disorder patients. This has enabled him to provide an incredibly unique perspective and success rate for patients with this condition. Although the common recommendation of "soft diet" and "no gum chewing" may provide acute relief in some cases, with modern diagnostic tools at our disposal it is not sufficient anymore. Whether it is the initial manifestation of a problem, a patient that is unresponsive to treatment, or an acute injury Dr. Holmes has the experience necessary to treat TMJ disorders and complex dental problems and is here to help you and your patient. There is arguably no other area in dental medicine with more confusion and disagreement than TMJ disorders in not only the treatment but the diagnosis. Dr. Holmes has developed a logical, systematic and scientific approach to helping patients with this disorder.
Overview of TMJ headache pain
There are many causes of headaches and they can be very challenging problems for a clinician to diagnose and treat. TMJ problems are a major source of headaches, especially of the temporal region. If a patient presents with pain of the jaw, face, temporal, masseter, or occipital region it is often myogenic in nature and caused by a hyperactivity of these muscles due to some component of a TMJ disorder.
However, there can be many sources of pain in these area and the differential diagnoses can be a lengthy list. Cervical, dental, neurological, vascular, and auricular sources are common problems that create pain in the head. We have the ability to determine if a patient’s headache is caused by the most common source being a TMJ disorder or something else. We have the most systematic, effective, and modern diagnostic methods and treatment options available for TMJ patients.
Masticatory myalgia can mimic the location, manifestation, and intensity of true vascular migraine headaches. The important point is that the two differ in etiology but more importantly in treatment. Although masticatory muscle hyperactivity can trigger a migraine, there is unfortunately a tremendous amount of false advertising by dentists who claim to treat true migraines by the use of bite splints or TMJ therapy.
Myogenic head pain is usually caused by a discrepancy in one's dental occlusion related to their condylar position which then results in hyperactivity of the masticatory muscles. Habitual clenching and/or bruxing can also cause severe pain of the muscles of mastication and exacerbate underlying conditions.
Popping or crepitus of the TM joints represent internal derangements of the temporomandibular joints and can cause pain of the joint area itself or refer pain to regions of the head. The internal joint problem most often found is displacement of the meniscus (disc) to varying degrees. There are also various stages of condylar head pathology and this can also be a source of pain in a small percentage of patients.
Many people have some degree of damage to their temporomandibular joints that manifest as popping, clicking, or grinding noises. The noises are caused by an anterior displacement of the cartilage disc that is normally interposed between the condylar head and the glenoid fossa. The ligaments that position the disc can become stretched or torn from even a very minor injury which can then allow the TMJ disc to become displaced. The popping noise that is heard is from the disc reducing back onto the condylar head during opening or from it slipping off when closing. The direction and degree of a displacement as well as the shape and integrity of the disc determine the diagnosis, prognosis, and treatment.
All popping TMJs are not the same and are therefore not treated the same. There are 8 different classifications of internal derangements and additional subcategories. Although their signs and symptoms may appear to be the same, the treatment and prognosis of the stages are significantly different.
It is imperative that it be determined whether a disc displacement occurs at the lateral or medial pole of the condylar head before providing any type of irreversible dental treatment, including equilibration, orthodontics, prosthodontics, or jaw surgery. The prognosis of a medial pole displacement is much poorer than one at the lateral pole due to the fact that the loading of the joint occurs at the medial pole. In addition to which portion of the disc is displaced, the medial or lateral direction of the displacement is also important to know for establishing a prognosis.
Locking jaws are caused by a displaced disc that does not reduce or a subluxation. Closed locks, especially acute closed locks usually represent a more severe problem and need aggressive early intervention.
Because joint disorders are progressive, all popping joints should be properly evaluated regardless of whether they are painful. Ignoring early signs can prevent the opportunity to correct or stabilize a displacement and thus lead to a more serious problem.
Botulinum injections can be an effective treatment option for chronic myogenic head pain that is unresponsive to primary treatments. Dr. Holmes utilizes this option with remarkable success because he knows how, when, where, and how much to administer. It is important that Botox NOT be administered prior to the establishment of a TMJ diagnosis or as a primary treatment option for headache pain because most patients have an underlying occlusal or joint problem that should be corrected first to achieve the highest degree of efficacy of this costly medication.
Want to refer a patient to Brentwood Dental & TMD?
Please do. We will take great care of them!
Dr. Dennis M Holmes
9000+ Complicated TMD/TMJ/Headache Cases Successfully Treated
6000+ CEREC Crown Cases Completed
28 Years of Experience
Headaches, jaw pain, facial pain, ear pain, and uneven bites are all problems where Dr. Holmes excels in finding solutions. He will provide a thorough examination utilizing the most modern methods and equipment to determine the source of your discomfort. Once an accurate diagnosis is established then a multi-disciplinary plan of treatment will be offered to provide for you the best chance of success
Do you have questions? We are here to help you. Please call for immediate assistance.
Contact us :
5120 Virginia Way, Ste C13
Brentwood, TN 37027
Monday: 8:00 a.m. – 5:00 p.m.
Tuesday: 8:00 a.m. – 5:00 p.m.
Wednesday: 7:00 a.m. – 4:00 p.m.
Thursday: 8:00 a.m. – 5:00 p.m.