Joint, muscle, and bite together
The three systems that move your jaw are treated as one. Correcting the bite without the muscles, or the muscles without the joint, is why symptoms so often come back.
TMJ treatment in Beverly Hills · Neuromuscular dentistry
TMJ treatment that starts with the cause, not the symptom.
Jaw pain, headaches, and clicking are rarely just about the jaw. With more than 35 years focused on the temporomandibular joint, Dr. David Frey treats the bite as one connected system, so relief lasts.
Schedule A Consultation $150 TMJ consultation
When the bite is off, the whole body compensates.
TMJ disorder rarely stays in one place. These are the signs we most often trace back to the jaw.
- Headaches and migraines, often at the temples
- Jaw pain, clicking, popping, or locking
- Ear fullness, pressure, or ringing
- Neck, shoulder, and upper-back tension
- Facial pain or fatigue when chewing
- Worn, chipped, or sensitive teeth
- Clenching, grinding, and disrupted sleep
- A bite that feels off or keeps shifting
A neuromuscular approach.
Instead of chasing the ache, we find where the jaw wants to rest, then build the bite to support it.
A physiologic rest position
Using gentle relaxation of the muscles, Dr. Frey finds where your jaw truly wants to sit, then builds the bite to support that position rather than fight it.
Tested before it is permanent
A removable orthotic confirms your comfort over weeks or months. Nothing is made permanent until the relief has proven it holds.
Measured, not guessed.
Precise diagnostics let us see exactly how your bite lands and how your muscles respond, so the plan is built on evidence.
T-Scan bite analysis
A digital sensor measures exactly when and how hard each tooth meets, so the bite is corrected from data, not guesswork.
TENS and EMG
Gentle stimulation relaxes the jaw muscles to their true resting position, while EMG measures the tension behind the pain.
3D CBCT imaging
Three-dimensional imaging reveals joint position, airway, and structure that a standard X-ray cannot show.
Joint vibration analysis
The movement and health of the joint itself is recorded, so progress is tracked against real, measurable change.
What your jaw muscles are telling us.
EMG shows how tense your jaw muscles are, and guides Dr. Frey toward a bite position where they can relax.
Your path to relief.
A conservative, staged process that eases pain first and makes the result last.
Relieve and stabilize
A custom orthotic guides the jaw toward a relaxed, physiologic position. Most patients feel their pain begin to ease within the first weeks.
Confirm the position
The new bite relationship is tested and refined over time, so we know the comfort holds before anything is made permanent.
Restore for the long term
Once settled, the corrected bite is made lasting through orthodontics, restoration, or a combination, so relief no longer depends on the appliance.
Understanding TMJ, in more depth.
TMJ is short for the temporomandibular joint, the joint that moves your jaw, and the name is widely used for the painful disorder that develops when that joint is overworked or misaligned. It can lead to headaches, pain in the mouth and neck, and difficulty opening and closing the mouth. Many patients describe a popping or clicking sound when they yawn or chew, and some notice numbness in the arms, hands or fingers. Because the signs are so varied, they are often mistaken for stress, or for something other than a bite that is out of balance.
TMJ, TMD and TMJD.
All three point to the same thing: a disorder of the temporomandibular joint. TMJ is sometimes used for the joint alone. TMD usually describes a patient who has symptoms along with an imbalance between the muscles of the head and neck, the jaw joint and the bite. TMJD is used less often and simply adds the D for disorder. Whatever the name, it is a syndrome, and its most common symptoms are jaw pain and headaches.
Why the bite, the muscles and the joint cause pain.
Your bite has three components: the way your teeth come together, the muscles of mastication (the chewing muscles), and the temporomandibular joint. All three must work together for the jaw to function well. When they do not, patients often describe headaches, jaw and facial pain, ear pain, dizziness, ringing in the ears, and pain in the neck, back and shoulders.
The pain comes from ongoing strain: a misaligned jaw trying to find alignment with the muscles and the joint, or the other way around. Because you use your bite, these muscles and this joint every day, the pain can wear you down, and it can feel like something the body cannot heal on its own.
Sometimes it is the straw that breaks the camel’s back. A patient may tell us, “I had just had a dental crown when it started.” The body does everything it can to keep itself in equilibrium, and when something disrupts that balance, pain can start.
What can cause TMJ.
TMJ can be caused by a number of issues, and often more than one is at work. Some of these include:
- An unbalanced, misaligned bite, such as a deep bite, an overjet or a crossbite
- Airway issues related to poor sleep
- Tense, unhappy jaw muscles
- A compressed jaw joint that does not let the disc ride on the joint properly, which can cause popping and clicking
- Injury or trauma
- Poor posture
Our page on TMJ causes looks at each of these more closely.
Why the strain travels beyond the jaw.
The signs listed near the top of this page make more sense once you see how they connect back to the jaw:
- Neck pain. Your head weighs about 10 pounds, and your body works hard to keep it centered over your shoulders. Any imbalance can cause aches and pain.
- Facial muscle pain. Large muscles around the head and neck hold on to the jaw joint, and when they are strained they can cause pain across the face.
- Difficulty chewing. Struggling to eat and chew can point to a bite that is off, which leaves the chewing muscles unhappy.
- Snoring. Snoring, sleep apnea and low oxygen during sleep can have a TMJ related component. Learn more about sleep apnea treatment.
For a fuller picture of how TMJ can show up, see TMJ symptoms. If you are wondering what happens when the imbalance is left alone, the dangers of untreated TMJ explains it calmly and in detail.
The two phases of treatment, in detail.
Dr. Frey practices neuromuscular dentistry, which emphasizes the position of the jaw, the teeth and the surrounding tissues. Treatment is divided into two phases. Phase one works to stop your symptoms, or greatly reduce them. Phase two preserves that result.
Our philosophy is to avoid jaw surgery wherever possible. We do everything we can to treat TMJ without it, by finding a bite position that is in harmony with the muscles of the head and neck and the jaw joint, and by testing that position first in a material that is completely reversible. Our page on TMJ treatment without surgery walks through this conservative path.
Phase one: relieving the symptoms.
Phase one is a test, and it is reversible. The aim is to resolve or greatly reduce your pain without doing anything irreversible, like surgery. To get there, we look for what we call the physiologic rest position of all the muscles of the head and neck, where the muscles, the bite and the joint are in harmony, and then hold the jaw there with a bite splint.
We work backward. First we relax the muscles of the jaw, head and neck using instruments such as a TENS unit, which eases overworked muscles with tiny, relaxing electrical impulses. We can also decompress the joint with manual techniques and other devices. Electromyography (EMG) sensors then show us that the muscles really are relaxed. Once they are, the jaw joint usually decompresses and the teeth rest apart from one another. We capture exactly where the jaw sits at that moment with a soft dental molding material, and build your bite to that relaxed position.
The result is a custom orthotic, essentially a realigned bite, which you wear while your jaw muscles rehabilitate. These trial bites can be fixed, so they do not come out, or made as a removable appliance. A fixed orthotic is bonded to the tops of your existing teeth and is made to look and feel natural, so it stays discreet in everyday life.
Your muscles need time to adjust to the new bite position. As they do, many patients report that headaches, back and neck pain, ringing in the ears, dizziness and other symptoms associated with TMJ ease, and for some they fade altogether.
Phase two: making the result last.
Phase two begins once you are comfortable with your new bite and your symptoms are doing better. By then, a bite has been found that works in harmony with the muscles of the head and neck and the jaw joint, and the aim becomes holding the position your splint has established for the long term.
There are several ways to do this, and Dr. Frey will recommend one based on your situation:
- Porcelain crowns and veneers that hold the corrective bite position
- Neuromuscular orthodontics, which moves the teeth into the corrective bite position found in phase one
- A full mouth rehabilitation plan
- Long term splint therapy
- Bite adjustments
- In some cases, once your symptoms have settled, nothing further at all
Simple signs you can check at home.
If you have facial pain, migraine headaches or other symptoms, a few simple checks in front of a mirror can point toward TMJ:
- Opening your mouth. Open slowly while watching in the mirror. If your lower jaw does not move straight down and drifts subtly to one side instead, that can be a sign.
- Clicking or popping. Your jaw should open and close silently. A click or a pop is a sign the joint is not functioning properly. If your jaw used to pop and has stopped, it could be a more advanced stage, so it is still worth having checked.
- Opening fully. With the mouth fully open, most people can fit three stacked fingers vertically between their teeth. If you cannot, your jaw muscles may be under unnatural pressure.
- Resting your jaw. You find yourself always looking for somewhere to rest your lower jaw to relieve the tension.
If any of these sound familiar, a private consultation with Dr. Frey is a good place to start. Patients come to our Beverly Hills office from across Los Angeles.
The science, in Dr. Frey's words.
Why so many TMJ patients are misdiagnosed, and what a true root-cause approach looks like.
Begin with a $150 TMJ consultation.
A focused first visit with Dr. Frey to understand your symptoms and map a path to relief.
- A comprehensive symptom and bite evaluation
- A review of your history and imaging
- A clear, personalized treatment plan
Offer applies to new TMJ consultations. Ask our team for details when you schedule.
Care led by a recognized TMJ expert.
Patients travel from across Los Angeles and beyond for a conservative approach grounded in decades of focus on the jaw.
- 35+
- Years focused on the TMJ
- 30,000+
- Smiles transformed
- Non-surgical
- First approach, always
Common questions about TMJ.
Is TMJ just caused by stress?
Stress can amplify clenching and muscle tension, but it is rarely the root cause. Most TMJ disorders come from a structural or functional imbalance between the jaw joint, the muscles, and the bite.
Can TMJ go away on its own?
Mild symptoms sometimes settle on their own. Pain that lasts more than a few weeks usually points to an underlying issue worth evaluating before it compounds.
Are night guards enough to treat it?
A night guard can protect the teeth and offer short-term relief, but it rarely corrects the underlying imbalance. Lasting results usually need a more complete, bite-focused approach.
Does insurance cover TMJ treatment?
Coverage varies. Some medical and dental plans cover diagnostic imaging and initial therapy, while comprehensive bite correction is often elective. Our team will review your benefits with you at your consultation.
What is electromyography (EMG)?
EMG measures the activity in your jaw muscles. Like a Richter scale reading an earthquake, the data shows us how unhappy the muscles are, and it guides us toward a bite position where we know they are more relaxed. Low readings tell us the muscles are relaxed and the jaw is in a healthy position, so bringing them as low as possible is central to easing your pain. A TENS unit and other techniques that decompress the jaw joint help calm the muscles further.
What is a TENS machine?
TENS stands for transcutaneous electrical nerve stimulation. The device sends a gentle electrical impulse to the nerve that supplies the jaw muscles, which helps them relax. We use it to buzz the tension out of the muscles before we capture your physiologic bite position. We often compare the jaw muscles to a puppet on strings: many times the strings are tangled and need unwinding, and TENS helps unwind them.
How can TMJ affect opening my mouth?
The jaw can lock in an open or a closed position. One cause is stiff jaw muscles that go into spasm, which is called trismus. Another is the soft disc that cushions the joint between the skull and the jaw moving into a position that stops the joint from working normally and limits its movement. The good news is that techniques are available to get the jaw moving normally again.
Can I test for TMJ at home?
The simple home checks described earlier on this page can give you a sense of whether TMJ may be involved, but they are not a diagnosis. There is no substitute for a professional evaluation with a dentist who uses a 3D CT scan along with an assessment of your head and neck, your bite and the condition of your teeth.
Can TMJ be treated without surgery?
In many cases, yes. Surgery can be the right approach in certain situations, but we keep it as a last resort, for when all other non surgical methods have been exhausted. In our experience, many TMJ patients can resolve their symptoms without it. Phase one is designed as a reversible test to see whether the TMJ can be resolved, and only once the bite position is settled do we recommend lasting solutions to keep the symptoms from returning.
Can TMJ cause headaches and migraines?
It can. Pain around the head can come from a muscle imbalance between the jaw joint and the bite. Tension in the muscles of the jaw, temples and neck, along with irritation of the nerves there, can show up as tension headaches or migraines.
Why does my jaw click or pop?
Clicking or popping is a sign of imbalance between the bite and the muscles of the head and neck. The sound is the disc inside the joint shifting out of position, coming off its track, often because of misalignment or muscle tension.
Can TMJ cause ear pain or ringing?
Yes. TMJ can cause ear pain, a feeling of fullness, and ringing in the ears (tinnitus), because the jaw joint sits directly in front of the ear canal and the two share several anatomical structures, including a small ligament. When muscles or ligaments hold tight pressure there, ear symptoms can result.
What happens if TMJ is left untreated?
When the imbalance behind TMJ continues, its effects tend to build rather than fade. Pain in the jaw, teeth, ears, neck, shoulders or head can become part of everyday life. Many people with TMJ grind their teeth in their sleep, a habit known as bruxism, which over time can crack and wear the teeth and disturb sleep. Ringing in the ears or dizziness can follow, and continued pressure on a misaligned jaw can damage the cartilage of the joint, which can lead to locking. Looking at the bite early keeps these problems easier to address.
How long does TMJ treatment take?
It depends on your symptoms and how your muscles respond. In phase one, your muscles need time to adjust to the new bite position; some patients notice change early, while fuller resolution can take several months, depending on severity. The length of phase two depends on the option you choose. After your evaluation, Dr. Frey can give you a realistic sense of your own timeline.
Ready to understand your jaw pain?
Sit with Dr. Frey for a private TMJ consultation and see how a root-cause approach would work for you.