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Disorder (TMD):

Why and How Is It Treated?

Dr. Timothy E. Mickiewicz wants to end the painful symptoms from temporomandibular joint disorder (TMD) at Pacific Orofacial Pain Consultants, LLC (POPC), in Sacramento, CA, and return you to a full, productive life. He believes in patient education and empowerment when diagnosing and treating TMD. You will learn the cause of your discomfort and the available treatment options to enable the body to heal itself and enjoy long-term relief. To learn more about how Dr. Mickiewicz treats TMD, contact us today.

What is the Temporomandibular Joint (TMJ)?


Temporomandibular joint disorder (TMD) occurs when the temporomandibular joints (TMJ) are misaligned. The TMJ connects the lower jaw, named the mandible, to the temporal bone at the sides of the head. You can feel the joints by placing your fingers just in front of your ears and opening your mouth. These joints enable us to chew, speak, and yawn. They are one of the most complicated parts of the body, due to the combination of hinge and sliding motions. The TMJ is a load-bearing joint, like the knees or the hips. Multiple factors attributing to the proper alignment of the TMJ pose challenges for patients and doctors when dysfunction occurs. Dysfunction leads to pain and discomfort. TMD is more common in women than in men.

Signs and Symptoms of Temporomandibular Joint Disorder (TMD)

Patients may present with one or multiple symptoms that lead Dr. Mickiewicz to diagnose TMD. Symptoms differ for each patient and range from mild to moderate.

Symptoms may include:

  • Chronic, reoccurring headaches
  • Pain in the neck, face, jaw, shoulders, and/or lower back
  • Limited jaw motion
  • Difficulty chewing
  • Clicking and locking of the jaw joint(s)
  • Chronic ringing in the ears, or earaches

At your first visit, Dr. Mickiewicz will perform a comprehensive examination and review your medical history. A chronological and detailed medical history will help him create an effective treatment plan for you. Your medical history should include all doctors seen, treatments prescribed, and medications received for TMD or other chronic pain and/or swelling.

How Is TMD Treated?

Upon diagnosis of TMD, Dr. Mickiewicz will present you with treatment options. Our treatment plans are reasonable, conservative, and customized to each patient’s specific needs. We encourage patients to have a proactive approach to reduce risk for further damage and relieve chronic pain and discomfort.

“For our temporomandibular disorder (TMD) patients, we know it can be difficult to sort through the myriad of treatment philosophies. It’s even difficult for the average dentist, so it can be nearly impossible for patients. Fortunately, and consistent with our procedures, recent research has emphasized evidenced-based treatment approaches, and the consensus has become clear: conservative treatment is the best treatment.”

Dr. Mick

TMD is usually treated with one or more treatment methods, and the treatments take time to fully relieve symptoms.

There are a variety of treatment regimens available to improve the harmony and function of the jaw.

  • Oral Appliance – A soft, flexible (medical silicone), custom-fitted appliance eliminates teeth grinding and supports correct alignment of the jaws, decreasing pain.
  • Trigger Point Injections (TPI): –This treatment involves administering saline, local anesthesia, or corticosteroids into targeted muscles to alleviate associated pain. It is often helpful in the treatment of migraines and chronic headaches.
  • Physical Therapy – A trained therapist in TMD can provide therapy to focus on muscle and joint movements (arthrokinematics), soft tissues in the joint, the upper cervical spine on the position of the joint, posture, and the centric relation.
  • Medication – For severe pain, Dr. Mickiewicz may prescribe medications, such as muscle relaxants or antidepressants, to treat underlying causes and ease symptoms.

Patients may also apply self-care treatments at home such as:

  • Practicing techniques for relaxing and reducing stress, such as meditation or biofeedback
  • Applying cold packs or ice to painful area
  • Eating softer foods
  • Avoiding teeth grinding
  • Chewing food evenly on both sides of the mouth
  • Avoiding chewing gum and/or hard-to-chew foods
  • Avoiding biting nails
  • Using of over-the-counter pain medications or nonsteroidal anti-inflammatory drugs, such as ibuprofen, for short-term, temporary relief

For many people, discomfort from TMD goes away over time, with little or no treatment. Other patients, however, can develop significant, long-standing dysfunction and chronic pain.

I have had headache issues for the last 35 years. Every morning greeted me with a headache. I’ve been to many doctors and have had many X-rays and cat scans of my head and neck. I was treated for migraines and neck issues. Nothing worked. I went to Dr. Mickiewicz two months ago and his diagnosis was TMJ. He fitted me with an appliance and the results are amazing. I have been back twice to have him adjust the appliance as my jaw loosens and adjusts, and he is always very patient with my extra-long explanations. I wish I had known him 35 years ago. FYI – I am now waking up without headaches – it is a good start to any day. Thanks Dr. Mick!

Lily S.

I have been seeing Dr Mickiewicz for over two years and am very satisfied with his services. I have a sleep apnea problem and rarely was getting any good nights rest. My medical doctor suggested I wear a large breathing machine… so I went ahead and got one and tried it out and and had nothing but problems trying to sleep with this large breathing machine strapped to my head. Then I saw Dr Mickiewicz and he has found the simplest and most affordable solution with my custom made mouthpiece that reshapes my jaw position just while I sleep! Bingo– no more sleep issues and also no more large breathing machine to struggle with! I am very grateful for his expertise and experience with sleep issues.

Tony A.

I recently visited Dr. Mickiewicz after years of suffering from sleep apnea and no success using conventional CPAP machines. I was fitted with dental appliance in an effort to resolve the problem. Frankly, I was skeptical, but I am so pleased with the early results. I just started using the device last week and I am already seeing an improvement in the quality of my sleep. From my first contact with Dr. Mickiewicz, it was immediately apparent that his grasp of the issues surrounding sleep apnea were light years ahead of his peers. He is a true professional and I enthusiastically recommend him.

Don B.

Always a great experience at this dental office. The front office has your paperwork prepared before you arrive. Everyone is all very nice and friendly and hardworking. My teeth are thoroughly cleaned when I visit. This place is a step above the rest with the right amount of class and comfort.

Kara S.

When I went to see Dr. Mickiewicz my jaw was locking up on me because my TMJ was so bad and my doctor didn’t really know what to do for me. This man changed my life. At my first visit I couldn’t even yawn without my jaw locking in the open position. At my last visit I could yawn and even chew steak without my jaw hurting.

Jewel L.

I have spent thousands of dollars out of pocket to dentists for my TMJ problems with no lasting relief. Dr. Mickiewicz was able to give me relief after years of pain. I am also able to utilize my medical insurance for his services adding credibility to his level of service that goes beyond common dentistry. His extensive knowledge of the disorder was clear; combined with his personable disposition put me at ease. His staff also deserves mention they are true professionals with a clear constitution for compassion.

Cathleen J.

My husband and I have gone to Dr. Mickiewicz for years after a recommendation of a coworker. Kind of strange to say that going to the dentist is an enjoyable experience – but it is! After years of having tense and painful visits to other dentists in Sacramento, we have found the right DDS for us: above average in all areas. He is an excellent practitioner, listens to all symptoms and concerns, answers all questions patiently and repeats as necessary. Gives us time to make any decisions about our dental care if we are hesitant, and encourages second opinions. His chair-side manner is relaxed and personable – which helps me relax. He is stuck with us for life! Thanks Dr. Mickiewicz and staff!


Stop The Pain Now

If you are experiencing TMD symptoms, contact our offices now to set up your consultation with Dr. Mick. Let’s stop your pain today and restore the good health you deserve.