Dr. Farhad Moshiri is considered an expert in diagnosis and treatment of Temporomandibular Joint Dysfunction (TMJD), having treated thousands of patients with jaw pain in over 30 years.  Dr. Farhad Moshiri was the past executive director of the Greater St. Louis Craniomandibular Society, which brought together speakers from different parts of the US and world to share their ideas on diagnosis and treatment of patients with craniofacial pain. Additionally, Dr. Moshiri has shared his expertise as a clinical professor at the University of Louisville, dedicating 28 years of teaching orthodontic residents on how to properly diagnose and treat pain patients.  Find more information regarding TMJD  below.

Symptoms of TMJD range from radiating pain in the face, jaw muscle stiffness, popping/clicking/or locking of the jaw, reduced mouth opening, headaches, neck pain, ringing in the ears (tinnitus), or a number of related symptoms. Regarding causation, there are many possible variables, ranging from hormonal causes, macrotrauma (i.e. whiplash), microtrauma (i.e. poor occlusion/bite contributing to grinding), stress (psychological or physical), postural problems, nutrition, etc.

For most people, pain in the area of the jaw joint or muscles does not signal a serious problem. Generally, discomfort from these conditions is occasional and temporary, often occuring in cycles. The pain eventually goes away with little or no treatment. Some people, however, develop significant long-term symptoms.

The area of the Temporomandibular Joint, or TMJ, is the area of the face that contributes to chewing, bite (occlusion) and jaw movement. Therefore, TMJD compromises jaw flexibility and may cause pain at rest or during common movements such as talking, chewing or yawning.

This diagram explains TMD and how it can be treated

In general, TMJD conditions fall into 3 categories:

1) Myofacial pain, the most common temporomandibular disorder, involves discomfort or pain in the muscles that control jaw function.

2) Internal derangement of the joint involves a displaced disc, dislocated jaw, or injury to the condyle.

3) Arthritis refers to a group of degenerative/inflammatory joint disorders that can affect the temporomandibular joint (idiopathic condylar resorption is a subset of this category- an autoimmune reaction where the condyles go through a resorption process).


TMJ Dysfunction Relief and Treatment

Dr. Moshiri believes in conservative management of TMJD. Our treatment philosophy combines two phases of treatment. The initial phase incorporates splint therapy, combined with intensive physical medicine modalities (i.e. chiropractor or physical/massage therapists). The second phase may involve modification of the patient’s occlusion (bite) via orthodontics (with our without jaw or joing surgery),  restorative dentistry, or any other necessary treatment depending on the patient’s needs. In the rare occasion that treatment for your TMD with Dr. Moshiri is not successful, this is an indication that your bite in not a variable in your TMD symptoms, a thus other referrals may be provided.

Outside of splint therapy and physical medicine, patients should also avoid extreme jaw movements like yawning or singing. Additionally, patients should chew softer foods and stay away from food requiring repetitive chewing or opening movements. In particular, avoid gum, biting into apples and large sub sandwiches, chewing ice, etc. Patients should also avoid keeping their mouth open for prolonged period of times (i.e. dental appointments).

This is how a TMD Relief looks like This is the TMD Relief from another angle

Download our TMD handout for more information.