Temporomandibular Joint Disorders TMJ Ankara İncek – Sevgi Savaş Dental Clinic
Ankara İncek · Functional Dentistry

Temporomandibular Joint Disorders (TMJ)

We treat the source of jaw pain, clicking, locking, tinnitus and headaches with accurate diagnosis. Splint, Botox and myofascial approach.

30%Prevalence of TMJ symptoms in adults
MultidisciplinaryENT, neurology, dentistry collaboration
80%+Controlled with conservative treatment
TinnitusTMJ-related tinnitus connection
The temporomandibular joint (TMJ) is a bilateral joint connecting the lower jaw to the skull that governs all jaw movements including mouth opening and closing, chewing and speaking. TMJ disorders refer to dysfunction in this joint, the articular disc or surrounding muscles. TMJ problems manifesting as jaw pain, clicking sounds, locking, morning headaches and even tinnitus originate from teeth grinding, stress, malocclusion, trauma or missing teeth. They can be successfully controlled with conservative methods in the early stages.
◎What is TMJ? ⚠Symptoms ◇Causes ◆Diagnosis & Assessment ◈Splint Therapy ⊕Botox & Mesotherapy ✦Occlusal Treatment ①TMJ & Tinnitus ❋Lifestyle Tips

What is the Temporomandibular Joint (TMJ)?

The temporomandibular joint is a bilateral synovial joint located between the temporal bone and the mandible (lower jaw), with an articular disc at its front. This disc separates the bone surfaces during jaw movements, preventing friction.

TMJ disorders are addressed in three main categories: muscle-only (myofascial pain), joint-only (disc displacement, arthrosis) and mixed type. This distinction directly determines the treatment approach; therefore, accurate diagnosis is of critical importance.

Myofascial Pain (Muscle-Originated) Pain and tenderness in chewing muscles are predominant · No clicking or locking · Mouth opening reduced or normal · Stress and bruxism are the most frequent causes · The type that responds best to conservative treatment
Intra-Articular Disorders Disc displacement or perforation · Clicking, locking, crepitation (grinding) · Jaw deviation may be observed during opening · Radiological assessment (MRI) is important · Splint + physiotherapy is the primary option

Symptoms of TMJ Disorder

TMJ complaints are frequently misdiagnosed due to the referred nature of pain that makes identifying the source difficult. Headache is referred to a neurologist, ear pain to an ENT specialist, and jaw pain to a dentist — yet the source may be the same.

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Jaw Clicking / Crepitation

A "click" or "grinding" sound when opening and closing the mouth. The most common indicator of disc displacement.

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Jaw Locking / Restriction

Difficulty opening the mouth in the morning or sudden locking. Opening movement is restricted (normal: 40–60 mm).

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Jaw and Facial Pain

Pain in front of the ear, cheek or temple area. Increases with chewing or prolonged speaking.

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Morning Head and Jaw Pain

Muscle fatigue and temple pain in the morning due to nocturnal bruxism. Frequently mistaken for migraine.

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Ear Pain and Fullness

Due to anatomical proximity, TMJ inflammation can mimic ear pain. ENT finds no findings.

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Tinnitus (Ringing in the Ears)

TMJ muscles and the joint work together with middle ear muscles. TMJ tension can trigger tinnitus.

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Jaw Deviation (Deflection)

The jaw slides to one side when opening the mouth. It is a sign of disc displacement or muscle asymmetry.

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Tooth Sensitivity and Wear

Bruxism, which frequently accompanies TMJ disorder, causes enamel wear and sensitivity.

Causes of TMJ Disorder

  • Bruxism (teeth clenching/grinding): Excessive force on the joint and muscles is the most common cause. Unconscious forces are much higher in nocturnal bruxism.
  • Malocclusion (bite disorder): Incorrect bite causes the jaw muscles to constantly work unevenly; the load on the joint becomes unbalanced.
  • Stress and anxiety: Muscles tense involuntarily under stress; the vulnerable joint is damaged by this load.
  • Missing teeth: Especially the loss of back molar teeth destabilizes the jaw load; the joint bears excessive stress.
  • Trauma: A blow to the jaw, accidents or wide mouth opening during prolonged dental treatments can strain the articular disc.
  • Incorrect dental treatment: A filling, crown or prosthesis made at the wrong height disrupts occlusal balance and affects the TMJ.
  • Postural disorders: Head-neck muscles work in connection with jaw muscles; neck and shoulder tension contributes to TMJ complaints.

TMJ Diagnosis and Assessment

Accurate diagnosis of TMJ disorder involves a combination of medical history, clinical examination and imaging when needed. A comprehensive assessment is essential due to the referral of symptoms to other sources (migraine, ENT, neurology).

Clinical Examination

Mouth opening measurement (normal: 40–60 mm) · Jaw deviation during opening · Palpation: tenderness in masseter, temporal, pterygoid muscles · Listening for joint sounds (clicking, crepitation)

Panoramic / Cephalometric X-ray

Joint condyle morphology, bony changes and occlusal analysis are evaluated. Basic imaging; fast and accessible.

3D Tomography (CBCT)

Three-dimensional imaging of the joint condyle and fossa; detection of bone erosion and deformities. Indicated especially in advanced cases.

MRI (Magnetic Resonance Imaging)

The most accurate method for showing disc position and displacement. Applied when disc perforation or chronic locking is suspected.

Multidisciplinary Approach

ENT consultation if tinnitus is present · Neurology evaluation if headaches are intense · Physiotherapy collaboration for neck-shoulder tension · All findings are evaluated in an integrated manner

Occlusal Analysis

Wear patterns on tooth surfaces, occlusal contacts and load distribution are examined. Guides the treatment plan; shapes splint design.

Occlusal Splint Therapy

The occlusal splint (night guard / joint plate) is the primary and most evidence-based treatment option for TMJ disorders. It is a transparent, removable appliance custom-made for the upper or lower jaw.

Stabilization Splint (Michigan Splint) Flat-surface splint that equalizes all occlusal contacts · Reduces muscle activity; prevents harmful effects of teeth clenching · First choice in acute TMJ pain · Nighttime or 24-hour use determined by case · Protects teeth; distributes load on the joint
Repositioning Splint Aimed at reducing disc displacement by directing the lower jaw forward or sideways · Used short-term in acute disc locking · Risk of occlusal change with long-term use; careful management required · Supported with occlusal treatment in the next stage
Splint Does Not Stop ClenchingA splint protects the teeth and joint; however, it does not prevent the clenching behavior of the muscles. Masseter Botox or myofascial therapy combination provides much more comprehensive results for reducing muscle activity.

Masseter / Temporal Botox and Myofascial Mesotherapy Combination

Botulinum toxin (Botox) delivers extremely effective results in muscle-originated TMJ pain and bruxism-related joint loading. By selectively relaxing the masseter and temporal muscles, the force on the jaw is reduced; pain and locking are alleviated.

Masseter + Temporal Botox Masseter: Primary chewing muscle; source of TMJ loading · Temporal: Temple region; trigger of morning headaches · Synergistic effect when both are applied together · 10–15 minutes; effect lasts 4–6 months · Most comprehensive results when combined with splint
Dental Mesotherapy + Myofascial Therapy Local inflammation control with low-dose vitamin-mineral injection · Muscle tension is relieved with manual myofascial techniques · Can be planned as an alternative or complement to Botox · An integral part of our clinic's holistic approach

The combination of these two approaches is offered under one roof at our clinic, unlike most competing clinics in Ankara. Comprehensive TMJ treatment targeting both muscle-originated pain and joint loading is possible.

Occlusal (Bite) Adjustment Treatments

If one of the underlying causes of TMJ is malocclusion, managing symptoms alone is not sufficient; the cause must also be eliminated. At this stage, prosthetic and restorative treatments come into play.

TreatmentTargetDescription
Selective grinding (occlusal equilibration)Eliminating high occlusal contactsIncorrect filling or crown height is corrected; muscles relax
Filling / Crown renewalRe-establishing occlusal balanceOld or faulty restorations are brought into balance
OrthodonticsCorrecting skeletal malocclusionLong-term solution; joint loading normalizes at end of active treatment
Missing tooth replacement (implant/bridge)Balancing jaw load distributionProvides TMJ-protective effect especially in posterior edentulism
Prosthesis optimizationGum and jaw balanceIncorrectly occluding removable/fixed prosthesis directly affects TMJ

The timing of occlusal treatments is critical: structural corrections should be planned after acute pain and muscle spasm have been relieved (splint + Botox phase).

TMJ and Tinnitus Connection

The temporomandibular joint and middle ear muscles (tensor tympani, tensor veli palatini) are innervated by the same trigeminal nerve branches. Due to this anatomical connection, TMJ tension may manifest as ear fullness, ear pain and tinnitus (ringing in the ears).

How to Identify TMJ-Originated Tinnitus ENT examination normal; no hearing loss · Ringing changes with jaw movements or palpation · Ringing increases during stress and teeth clenching periods · More pronounced in the mornings; may decrease during the day · Improvement observed after splint or Botox treatment
Multidisciplinary Approach Required First, auditory cause is excluded with ENT examination · If TMJ disorder is detected, dental treatment is planned · Splint + Botox combination reduces muscle tension · Some cases fully resolve while others significantly improve · Definitive recovery cannot be guaranteed; however, conservative treatment is risk-free
Not All Tinnitus Originates from TMJTinnitus can originate from many different causes such as cochlear damage, hypertension and drug side effects. ENT specialist evaluation is always a priority. If TMJ is suspected, a multidisciplinary approach coordinated with a dentist is recommended.

Daily Life Tips for TMJ Patients

Food Choices

Avoid hard, large, crunchy foods. Cut food into small pieces; chew equally on both sides. Quit chewing gum completely.

Oral Habits

Stop biting nails, pens or lips. Change your phone-holding habit (head-neck pressure). Follow your dentist's instructions during wide yawning and long treatments.

Stress Management

Mindfulness exercises, meditation and regular sleep directly reduce muscle tension. Stress management is a sustainable part of TMJ treatment.

Posture and Ergonomics

Sitting at a computer with the jaw protruding forward constantly strains jaw muscles. Spine correction exercises and relaxing neck muscles reduce the load on the joint.

Heat and Cold Application

Cold in the acute phase (first 48–72 hours); warm moist towel for 10–15 minutes for chronic muscle tension increases muscle comfort.

Regular Check-ups

Splint fit, joint sounds and mouth opening should be evaluated every 3–6 months. If splint use is neglected, symptoms return.

Dr. Sevgi Savaş Akbaş – TMJ, Jaw Joint Treatment, Ankara İncek

Dr. Sevgi Savaş Akbaş

Dentist · TMJ · Occlusal Treatment · Masseter Botox · Ankara İncek

Dr. Sevgi Savaş Akbaş manages temporomandibular joint disorders at her Ankara İncek clinic with a multidisciplinary approach combining digital imaging, occlusal analysis, custom splint application, masseter and temporal Botox, myofascial therapy and dental mesotherapy. Comprehensive treatment planning including occlusal adjustment, missing tooth replacement and physiotherapy collaboration is offered; atypical symptoms including tinnitus are also included in the assessment.

Temporomandibular Joint Disorders (TMJ) – Frequently Asked Questions

My jaw clicks but I have no pain — is treatment necessary?
Painless clicking may be an early sign of disc displacement. Clicking alone does not always require treatment; however, if pain, locking or movement restriction is added, treatment should be planned. Assessment is recommended for early monitoring; preventing progression is much easier than treating it.
How can I tell if it is jaw pain or a migraine?
TMJ-originated headache is generally pronounced in the temples and in the mornings; it increases with chewing or prolonged speaking. Migraine is usually one-sided, accompanied by nausea, with sensitivity to light and sound. Both can coexist. Finding tenderness on palpation of jaw muscles and benefiting from splint treatment suggest TMJ.
How long does TMJ treatment take?
Mild muscle-originated TMJ can show significant improvement in 4–8 weeks with splint + Botox. Disc displacement or chronic cases require 3–6 months or longer management. TMJ is a chronic condition; "keeping it under control" rather than "end of treatment" is the goal. Regular check-ups prevent relapse.
Is a splint enough, or is Botox also necessary?
A splint protects the teeth and joint; however, it does not stop the clenching behavior of the muscles. If there is intense bruxism and pronounced muscle pain, the splint + Botox combination yields much stronger results. Myofascial therapy and mesotherapy can also be planned as complementary treatments. The decision is made after clinical examination.
Can tinnitus (ringing in the ears) originate from the jaw joint?
Yes. TMJ muscles and middle ear muscles are connected by the same nerve branches. Muscle tension can trigger tinnitus. If ENT examination is normal and jaw complaints accompany it, TMJ assessment is recommended. Tinnitus significantly improves in a considerable number of cases with splint and Botox treatment.
Can my jaw joint problem originate from my malocclusion?
Yes. Malocclusion causes the jaw muscles to work unevenly continuously and asymmetric load to accumulate on the joint. In this case, managing symptoms alone (splint, Botox) is not sufficient; the root cause must also be eliminated with orthodontics, occlusal adjustment or missing tooth replacement.
My jaw has locked — what should I do?
In acute locking, do not try to open your mouth wide in panic; muscle spasm will worsen the condition. A warm compress can be applied to the jaw. Consult a dentist or oral surgeon as soon as possible. A repositioning splint and Botox are planned for recurring locking cases.
Is TMJ surgery really necessary?
In the vast majority of cases (80%+), successful control is achieved with conservative treatments (splint, Botox, physiotherapy). Surgery is the last resort for disc perforation, severe arthrosis or cases resistant to all conservative treatments. Arthrocentesis (joint lavage), arthroscopy and open joint surgery are among the options.
Does chewing gum worsen TMJ?
Yes. Chewing gum continuously activates the masseter and temporal muscles and increases the load on the joint. Avoiding gum chewing is strongly recommended during TMJ treatment — and in the long term.
Can neck and shoulder pain be related to TMJ?
Yes. Jaw muscles are in a chain connection with neck and shoulder muscles. TMJ tension can spread to the trapezius and sternocleidomastoid muscles; conversely, neck tension can also trigger TMJ. For this reason, physiotherapy collaboration is an important part of comprehensive TMJ management.
Why Sevgi Savaş Clinic in Ankara İncek for TMJ treatment?
At our clinic, TMJ is comprehensively managed with a combination of digital imaging, occlusal analysis, custom splint, masseter and temporal Botox, myofascial therapy and dental mesotherapy. Atypical symptoms including tinnitus are addressed with multidisciplinary assessment; occlusal adjustment and missing tooth replacement are integrated into the treatment.

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