TMJ / TMD Treatment
Evaluation and management of jaw joint pain, clicking, headaches, and bite issues. Directed by Dr. Rustam DeVitre, Past President of the Northeast Craniomandibular Society.
The temporomandibular joint (TMJ) is the hinge connecting your jaw to your skull. TMD covers a range of conditions that disrupt that joint, with symptoms like clicking or popping, difficulty chewing, a stuck jaw, headaches, and pain.
Common causes of TMD
- ArthritisWear or inflammation in the jaw joint.
- InjuryTrauma to the jaw, head, or neck.
- Disc dislocationThe cushioning disc inside the TM joint shifts out of place.
- Grinding or clenchingHabitual pressure on the joint, often during sleep, that wears it down. A custom night guard can help reduce this strain.
- Improper bite (malocclusion)When the upper and lower teeth do not meet evenly.
- StressTension that contributes to clenching and muscle fatigue.
How we evaluate TMD
- Thorough examTMD is most common among women of childbearing age, and many other conditions can mimic its symptoms, so an accurate diagnosis is important. Your dentist will review your medical history and check the joints and muscles for tenderness, clicking, popping, and limited motion.
- Imaging and bite analysisWe typically take specialized X-rays of the TM joints and may take an impression of your teeth to evaluate how your bite fits together.
Treatment options
- Conservative care firstTreatment can range from self-care and non-invasive therapies to injections. We follow a step-by-step approach because non-invasive therapies are often effective at relieving symptoms.
- Bite appliancesA custom appliance or night guard can ease pressure on the joint, protect the teeth, and help reposition the bite.
- Advanced therapy when neededIn severe or persistent cases, additional therapies, including injections or surgical care, may be considered.
"If you are experiencing jaw pain, clicking, or persistent headaches, an evaluation is the best first step. We will work with you to identify the cause and recommend the most conservative treatment that can give you lasting relief."

Specialty Dentistry · Hingham Square, MA
Questions
TMJ / TMD Treatment questions, answered.
Every mouth is different. If your question is not here, call the office and we will answer it directly.
What causes TMJ pain?
- Common causes include arthritis, injury, disc dislocation, grinding or clenching, an improper bite, and stress. Because many other conditions can mimic TMD symptoms, an accurate diagnosis from an exam is important.
How is TMD diagnosed?
- Your dentist reviews your medical history and checks the jaw joints and muscles for tenderness, clicking, popping, and limited motion. Specialized X-rays and an impression of your teeth may also be used to evaluate your bite.
Do I need surgery for TMJ problems?
- Most cases start with conservative, non-invasive care such as self-care measures or a custom bite appliance. Surgical care is only considered for severe or persistent cases that do not respond to conservative treatment.
Can a night guard help with TMJ pain?
- A custom appliance or night guard can ease pressure on the joint, protect the teeth from grinding or clenching, and help reposition the bite. Dr. Rustam DeVitre can evaluate whether one is appropriate for you.
Who treats TMJ and TMD at Hingham Dentistry?
- Dr. Rustam DeVitre, Past President of the Northeast Craniomandibular Society, directs evaluation and treatment for jaw joint pain, clicking, headaches, and bite issues.
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