Temporomandibular disease (TMD)

Temporomandibular joints (TMJ) are the hinge that connects the lower jaw to the skull. With their movement, we can perform everyday activities such as speaking and chewing. Wear and tear, injury (whiplash injury), grinding or clenching the teeth, osteoarthritis, erosions, small displacement to the TMJ, even stress may result in TMD. This causes a chronic inflammatory reaction, creating problems not only to the jaw but also to the surrounding tissues (muscles and tendons).

Symptoms include:

  • Clicking, popping, or grating sounds in the TMJ
  • Pain in the teeth
  • Pain or tenderness in the face, jaw joint area, neck, shoulders
  • Pain around the ear when chewing or speaking
  • Problems or pain when opening the mouth wide
  • Difficulty in chewing, and sometimes locking the jaw
  • Swelling and tenderness in the affected TMJ
  • A tired feeling in the face

You may also experience: toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).

Treatment options vary according to the cause of the problem:
•    Occlusal or night splint is the most common treatment and is proven to be highly effective.
•    Botox injections (muscle relaxant) can help as it relaxes the muscles and relieves the pain. The treatment is administered by Dr Joseph Georghy.
•    LLLrST (low level laser stimulation therapy) Here at North Shore Cosmetic, we have been using LLLrST since the early 1990’s.
•     Since 2013 the clinic is equipped with the latest in PRP technology. Using the Angel Whole Blood Separation System gives Dr Joseph Georghy the ability to tailor each treatment according to the patient’s needs. Research indicates the use of Platelet-Rich Plasma (PRP) in the treatment of Temporomandibular Joint (TMJ) Osteoarthritis (TMJ-OA) may enhance the regeneration of bone in TMJ-OA (*1,2,3).


1.    X.D. Wang, J.N. Zhang, Y.H. Gan, and Y.H. Zhou (2015). ‘Current Understanding of Pathogenesis and Treatment of TMJ Osteoarthritis.’ J Dent Res. 94(5):666-73.
2.    Machon V, Rehorová M, Šedý J, Foltán R (2013). ‘Platelet-Rich Plasma in Temporomandibular Joint Osteoarthritis Therapy: A 3-Month Follow-Up Pilot Study’. J Arthritis 2:112. doi:10.4172/2167-7921.1000112In conclusion, the use of PRP is an effective treatment option for early TMJ OA.
3.    Ayman F. Hegab, Hossam Eldin Ali, PhD, Mohamed Elmasry, PhD, Mustafa G. Khallaf (2015). ‘Platelet-Rich Plasma Injection as an Effective Treatment for Temporomandibular Joint Osteoarthritis’. Journal of Oral and Maxillofacial Surgery 73(9).
Please note: ‘Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.’