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People who are affected by TMJ/TMD suffer from malocclusion (misaligned bite). When teeth are misaligned they cannot provide support for the muscles in the face needed for chewing and swallowing, as well as the joint. These muscles are the forced into a strained position resulting in pain to the neck, face, head, shoulders, back, and condylar joint. Some patients may have had orthodontics in the past to align teeth esthetically, but not functionally.


The Temporomandibular joint (TMJ) is the most complex joint in the human body and resides right in front of each ear. The TMJ attaches the lower jaw to the skull, and is surrounded by nerves, teeth, muscles and bones. Because such an intricate network of different structures surrounds the TMJ, it can affect a person from the top of their head to the tips of their fingers.



Before, it was thought that just the joint was the culprit of all the issues, but more recent studies have shown that the facial muscles, nerves, teeth, neck and ears can be involved as well. Because of this new information, dentists are now using the term TMD instead if TMJ. This stands for Temporomandibular Disorder Syndrome. Sometimes this group of symptoms is referred to as myofascial pain dysfunction (MPD) or craniomandibular dysfunction. TMD is a chronic degenerative disease that takes years to develop.


Symptoms can include:

  • • Headaches
  • • Snoring
  • • Grinding of teeth
  • • Frequent ear infections
  • • Sleep apnea
  • • Pain in the face, neck, shoulders, teeth and jaws
  • • Clicking or popping in the jaw joints
  • • Depression
  • • Vertigo (Dizziness)
  • • Cloudiness of the ears
  • • Limited Jaw movement/Locked jaw
  • • Numbness in the hands and fingers
  • • Tinnitus (Ringing in the ears)


Women report TMD more often than men do, and cases vary in severity from mild pain to excruciating. Children are especially sensitive to TMJ and usually show early signs of frequent ear infections, biting or sucking of the fingers, snoring, grinding of the teeth, and headaches. 


Some dentists believe this condition is self-induced by stress and feel that little or no treatment will eventually cure this. This group of dentists usually prescribes a pain medication for the time the patient is in serve pain. After the spasm is over, the patient is then expected to live with mild pain until it gets severe again.

Dr. Koeppel does not belong to this group of dentists. He believes the root cause of this problem is with the occlusion (alignment) of the teeth and jaw. Misalignment causes strain on the muscles of the face and jaw.

Dr. Koeppel has trained at the leading neuromuscular center for dentistry (LVI)  and has completed a mini TMJ residency program, to learn how to correct this disease by relaxing the muscles in the face and allowing the teeth to come together properly without pain, and without the use of medication. See Dr. Koeppels Neuromuscular Dentistry Page to find out how he treats TMD patients.



Have questions about TMJ/TMD disorder? Learn more about making the right choices for treatment - call our office at (631) 318-0000 for a free consult or use our on-line Consult Request form.

Technically specific questions about TMD not addressed here can be sent to Dr. Koeppel personally by using our on-line Ask The Dentist form. He will respond to you directly with the answers you are looking for.