The temporomandibular joints are among the most complex and most consistently overlooked structures in the human body — and at New Hampshire Smile Co. in Nashua, NH, Dr. Neveu’s advanced training in TMJ disorders, functional occlusion, and airway-focused dentistry means that jaw joint health is evaluated as a meaningful clinical priority at every comprehensive exam rather than an afterthought addressed only when symptoms become severe enough to bring patients through the door specifically seeking relief. TMD treatment at our practice reflects the whole-person philosophy that defines all care here — identifying root causes rather than managing surface symptoms, and developing treatment plans designed for long-term relief rather than temporary comfort.
What Is The TMJ?
The temporomandibular joint — the TMJ — connects the lower jaw to the skull on either side of the face just in front of each ear. It is one of the most mechanically complex joints in the human body — capable of hinge movement, sliding movement, and the combination of both that normal chewing, speaking, and swallowing require. Between the ball and socket of each joint sits an articular disc that cushions and guides the joint surfaces during movement — and the health, position, and integrity of this disc is central to comfortable, functional jaw movement throughout daily life.
What Is TMD?
Temporomandibular disorder — TMD — is a broad clinical term encompassing the range of conditions affecting the temporomandibular joints, the surrounding musculature, and the related structures that collectively support jaw function. TMD is not a single condition with a single cause and a single treatment — it is a complex, multifactorial presentation that requires the comprehensive clinical evaluation and individualized treatment planning that Dr. Neveu’s advanced training uniquely supports:
- Myofascial TMD involving primarily the muscles of mastication rather than the joint structures themselves — the most common TMD presentation and the most directly influenced by bite imbalance, parafunctional habits, and stress-related clenching
- Articular TMD involving the joint structures themselves — including disc displacement, condylar changes, and joint inflammation that produce the clicking, popping, and limited range of motion that many TMD patients present with
- Combined presentations where both muscular and articular components contribute to the patient’s symptoms simultaneously
Signs & Symptoms Of TMD
TMD presents with a meaningfully diverse range of symptoms that patients frequently attribute to other causes before the jaw joint connection is identified:
- Jaw pain or soreness that is most pronounced upon waking and gradually improves as the muscles recover from nocturnal clenching activity
- Clicking, popping, or grinding sounds within the joint during opening, closing, or chewing
- Limited ability to open the mouth fully or jaw stiffness that is most pronounced in the morning or following periods of sustained clenching
- Facial muscle fatigue and tenderness concentrated in the cheeks, temples, and along the jaw
- Headaches originating at the temples that are most severe in the morning and gradually improve during the day
- Earache or a sensation of fullness in the ear without obvious ear pathology
- Neck and shoulder tension that co-occurs with jaw symptoms and reflects the muscular compensation patterns that chronic TMD consistently produces
- Tooth sensitivity and visible wear developing as the enamel is progressively removed by the grinding forces that frequently accompany TMD
Causes & Risk Factors Associated With TMD
Understanding the contributing factors that drive TMD in each individual patient is the essential first step in developing a treatment plan that addresses the source rather than simply managing symptoms:
- Bite imbalance and occlusal interferences that load the jaw joints asymmetrically or in positions of muscular strain
- Bruxism and nocturnal clenching that overload the joints and surrounding musculature with forces significantly exceeding those of normal function
- Airway dysfunction during sleep that drives jaw repositioning and increased muscle activity as the body attempts to maintain airway patency — a connection that Dr. Neveu’s airway-focused training allows her to identify and address comprehensively
- Stress and psychological factors that increase the frequency and intensity of parafunctional muscle activity
- Trauma to the jaw or joint structures that disrupts normal disc position or joint anatomy
- Hormonal factors that influence joint laxity and inflammatory response
- Prior dental treatment that altered the bite relationship without adequately considering the joint and muscular consequences
Treatment For TMD
Treatment recommendations for TMD at New Hampshire Smile Co. are always individualized — reflecting the specific type and severity of each patient’s presentation, the contributing factors identified during comprehensive evaluation, and the most appropriate sequence of intervention for that specific clinical situation:
Custom-fabricated nightguards and occlusal splints that protect the teeth and jaw joints from the forces of nocturnal grinding and clenching — distributing parafunctional forces more evenly and reducing the peak loading that the joints and surrounding musculature experience during sleep.
Precise adjustment of specific bite contacts that are concentrating excessive force on individual teeth or loading the jaw joints in positions of muscular strain — redistributing occlusal forces more evenly across the full dentition.
Injectable relaxation of the masseter muscles for patients whose muscular hyperactivity drives clenching forces that nightguard therapy alone cannot adequately reduce — providing meaningful relief from jaw tension, facial soreness, and temple headaches that bruxism-driven TMD consistently produces.
Addressing the airway dysfunction that drives nocturnal jaw repositioning and increased muscle activity in patients whose TMD symptoms are connected to sleep-disordered breathing — treating the source of the parafunctional activity rather than only its consequences.
Comprehensive restorative treatment that rebuilds the bite relationship at the correct vertical dimension and occlusal scheme for patients whose TMD is driven by or compounded by significant tooth loss, wear, or bite collapse.
Referral coordination with oral surgeons, physical therapists, sleep medicine physicians, and other specialists whose expertise complements the dental dimensions of complex TMD cases at New Hampshire Smile Co. in Nashua, NH.
Call our office or book your appointment online today.