Frequent headaches, neck and jaw pain, worn teeth, and a clicking or popping jaw can all be signs of a temporomandibular disorder or TMD- often referred to as TMJ. For many patients, an untreated bite disorder can adversely affect daily quality of life.

Dr. Doyle Freano has extensive training in the diagnosis and treatment of bite disorders such as TMJ and can help patients achieve results that will not only relieve symptoms but address overall dental health. As a Dawson trained dentist, Lexington KY dentist Dr. Freano applies the principles of complete dentistry, taking a comprehensive approach to evaluating a patient’s bite. Complete dentistry goes beyond treating the symptoms of a bite disorder and seeks to identify and treat the underlying cause to restore balance to the bite.

What is TMJ

TMJ, or the temporomandibular joint, is a small joint located in front of your ears, responsible for the opening and closing of the mouth. TMJ is also commonly used to describe a temporomandibular disorder (TMD) in which the jaw joints or teeth do not fit together properly, resulting in an imbalance in the bite.

In almost all cases, a TMJ disorder will cause tooth wear and may contribute to tooth decay and/or (gum) disease.

Common Causes of TMJ Disorder

There is no single cause for TMJ dysfunction. Any number of factors or combination of factors may be to blame including:

  • Trauma to the head, neck, or face
  • Trauma to the TMJ joint or arthritis
  • Hormonal changes or imbalances
  • Malocclusion (where the jaws do not line up correctly resulting in bite problems)
  • Stress

Common TMJ Symptoms include:

  • Teeth grinding or clenching, often characterized by tooth wear
  • Headaches
  • Neck and shoulder pain
  • Limited mobility in the jaw
  • Clicking or popping when opening or closing jaw
  • Earaches

As with the causes, symptoms of TMJ disorder vary greatly between patients. TMJ symptoms often mask themselves or are similar to those of other medical conditions, making diagnosis difficult.

Treatment Options

Mouth Guard and Splint Therapy

Dr. Freano may recommend the use of a mouth guard or dental splint to alleviate specific symptoms of TMJ disorder. A mouth guard or splint is often a first step, used early in treatment and not needed as a long term solution. A dental split can be helpful to help identify a comfortable and stable bite position.

Bite Correction Therapy

When appropriate, Dr. Freano will perform occlusal equilibration – or bite correction, to bring the teeth into proper contact. This will allows the jaw to open and close in its proper position and eliminate stress on the joints and resulting pain.

This process is a series of adjustments made to the teeth which may include:

  • Removing tooth structure
  • Applying dental crowns or porcelain veneers
  • Orthodontic treatment
  • Implant dentistry


If the teeth are not in proper position, orthodontics may be needed to reposition the teeth, allowing them to fit together harmoniously. For adults who wish to avoid traditional metal braces, Dr. Freano offers Invisalign braces for more discreet and comfortable treatment.

Restorative Dentistry

In cases where teeth have been significantly worn and damaged restorative dentistry may be needed to bring the teeth back to their proper health and beauty. Dr. Freano may use dental crowns, porcelain veneers, or cosmetic bonding to restore teeth.

TMJ Treatment Video Testimonials

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