If you are struggling with TMJ disorder, our dentists and team are conveniently located in our Puyallup office to help you find relief. Together, we can assess your condition to help you get answers about the severity of your TMD. By using a combination of techniques and technologies, we can work with you to improve the functionality of your jaw. Call (253) 845-9507 to schedule your TMJ treatment in Puyallup, Washington. Dr. Rochelle Riley looks forward to working with you.







Medication and Referral Management – A Multidisciplinary Approach

To alleviate your symptoms and discomfort, you can use muscle relaxers, preventive medications or anti-inflammatory medications.

To help you get proper treatment for your TMD, we may advise that you work in-conjunction with other qualified health care professionals, like chiropractors, physical therapists and radiologists.

Therapeutic Injections and Jaw Manipulation

To maximize your TMJ treatment results, we may use different modalities to release muscle tension and optimize the movement of the jaw.

  • Spray and Stretch is a technique that uses cold therapy on the skin to improve mobility while stretching the muscles.
  • Hot and cold therapies can be used to relax muscles and decrease inflammation.
  • Manual pressure on trigger points allows for myofascial release of spasms and tightness.
  • TENS stands for Transcutaneous Electrical Nerve Stimulation, and is used to relax the muscles, which decreases pain.
  • Manual manipulation of the jaw joint can guide the disk to its proper position.
  • Dynamic decompression and stabilization is used to guide the jaw into movements to deprogram muscle memory and then stabilize it using an intraoral device, such as an orthotic.
  • Therapeutic injections can include administering local anesthetic to create volume in the superior joint space above the disc, thereby promoting an opportunity for disc recapture.

Imaging and Neuromuscular Computer Analysis

Our team uses computerized tomography (CT) and magnetic resonance imaging (MRI) to detect anomalies and damage in both soft and hard tissues. By using these diagnostic images, we can evaluate joint position, posterior-superior joint spacing, cervical displacement and alterations.

We use the Model K7 Evaluation System and J5 Myomonitor. This computer-based system for 3D jaw tracking, can be used to surface electromyography and recording of joint sounds while the muscles are intact.

Oral Appliance Therapy

Based on the evaluation from our team and images from the computer analysis, we may recommend that you get an orthopedic repositioning appliance (oral appliance) to treat your TMD.

This device does the following:

  • Realigns the mandible to maintain the proper posture of the condyle within the mandibular fossa which is determined by the muscles, the way the teeth come together and the joint itself.
  • Re-establishes joint space by decompression of retrodiscal tissue, which causes inflammation and pain.
  • Establishes and maintains proper condyle-disc relationship that eliminates the anterior disc displacement causing the movement of the condyle into the posterior-superior position.
  • Stabilizes the bite to decrease the adverse effects on the teeth and supporting structures caused by joint pathology, clenching and grinding.

How Is This Different From a Night Guard?

Night guards are created to protect the teeth while sleeping. It allows the teeth to rub against the plastic night guard, rather than against other teeth. Orthotic devices are created to hold your jaw in position, based on the three dimensions. It is not designed to alter the bite, but after the TMJ has been healed and remodeled, you may notice a slight change to your bite.

Our team at Northwest Dental Medicine looks forward to helping you live a more comfortable life.

Our office offers medical billing for TMJ treatment. Please give us a call for more details.