Philadelphia, Main Line, and Ardmore, Pennsylvania Cosmetic Dentistry

Millions of people have TMD and suffer from its painful or uncomfortable symptoms without knowing what causes those symptoms. How can this be addressed? Temporomandibular Joint Disorder (TMD) is an unbalanced bite. Persistent pain in the jaw and face can have a negative effect on many aspects of your life, and TMD symptoms can affect many areas of your body. They may not at first seem to be connected with each other or with your bite.


The temporomandibular joint (TMJ) connects your lower jaw to the rest of the skull, including the upper jaw. It functions like a ball-and-socket mechanism, giving your mouth and jaw the range of motion to open, close, and move side to side when performing actions like:

  • Eating
  • Speaking
  • Yawning

TMD, meanwhile, stands for temporomandibular disorder. This is the general name for issues affecting the health and function of the joint and connected muscles in the face. The exact cause of TMD is unknown, but possible risk factors include:

  • Grinding or clenching the teeth
  • Injury or repetitive stress to the side of the mouth, which could dislocate the joint
  • Medical conditions that inflame joints, such as arthritis

Though the TMJ is a structure in the body and TMD is a disorder affecting the joint, you might hear some neuromuscular dentists use the term interchangeably.

What is TMD?

Temporomandibular joint disorder (TMD)TMJ Philadelphia | Jaw Pain Ardmore PA | Neuromuscular Dentistry occurs when you have an unbalanced or misaligned bite. When your jaw joints are not at rest, they can put strain on the surrounding nerves, tendons, and tissues in your face and neck, causing painful TMD symptoms.

Dr. Lindsey Marshall has been trained in the diagnosis and treatment of TMD, and has graduated from the Las Vegas Institute for Advanced Dental Studies (LVI), the world’s premier school for post-graduate dental training. She has completed rigorous theoretical and hands-on training in neuromuscular dentistry and uses state-of-the-art technology for practicing it.

The Puzzle of TMD

Many people who suffer from TMD may become so used to its discomfort that they don’t think to seek any treatment. If they suffer chronic TMD headaches, they may mistake them for migraines and seek pain relief from a physician.

It is a good idea to speak to your physician and make sure than your symptoms do not have a medical cause. Then, contact Dr. Marshall to see if they might have a dental cause.

The muscles, nerves, tendons and bones of your face and mouth are designed to work together for effective biting and chewing, and for a comfortable resting position when not in action. The lower jaw pivots in a ball-and-socket joint just in front of each ear.

The jaw joints are delicate in that they can be rather easily thrown out of alignment. If this happens, the jaw muscles must strain to hold even a resting bite position, leading to chronic discomfort and other symptoms.

Common Causes of TMD

TMD can be caused or influenced by a number of different factors, including:

  • An injury to the jaw
  • Tooth grinding
  • Teeth clenching
  • Osteoarthritis
  • Rheumatoid arthritis
  • Bad dental work

TMD can be treated and repaired through neuromuscular dentistry. If you are suffering from symptoms of TMD, Dr. Lindsey Marshall will evaluate your bite and the position of your jaw joints to determine whether or not you have TMD. If you do, she will develop a treatment plan to relieve your pain and correct your jaw’s position.
Treating Your TMD

Dr. Marshall offers several different TMD treatment options, including:

  • Muscle relaxation with a TENS unit – This device provides immediate relief from jaw pain, while allowing your jaw joints to relax into their ideal position for diagnostics to be taken.
  • Restorative procedures – Restorative dental work can help correct minor bite problems. Dental crowns, inlays and onlays, and tooth bonding can all be used to improve the way your bite fits together.
  • Oral splints or mouthguards – These can be worn while you are asleep to gently hold your jaw in proper alignment, retraining your facial muscles in the process.
  • Invisalign® – If your TMD is caused by mild to moderate malocclusion, Invisalign® can straighten your teeth and bring you relief.

When to Seek Treatment for TMJ Disorder

If you regularly experience the following symptoms, you might be suffering from dysfunction of the TMJ:

  • Clicking or popping sounds in the jaw
  • Migraine headaches
  • Pain in the jaw, face, neck, shoulders, or upper back
  • Limited mobility of the mouth

An estimated 10 million Americans suffer from some form of TMJ disorder. To alleviate the discomfort that can accompany TMD, it’s important to visit a neuromuscular dentist who can assess the health and function of your jaw and recommend treatment options.

Dr. Lindsey Marshall is an experienced neuromuscular dentist in the Philadelphia area. Having received training from the Las Vegas Institute for Advanced Dental Studies (better known simply as LVI), she regularly diagnoses and develops custom treatment plans for TMD sufferers.

TMD Diagnosis

After a thorough dental examination, Dr. Marshall will use specialized technology to measure and record:

  • Jaw muscle activity
  • Jaw movements
  • Jaw joint sounds

She may use a TENS unit (Transcutaneous Electrical Nerve Stimulation) to administer low level stimulus to the jaw muscles in order to relax them. It may be the first time in many years that your jaw muscles have assumed their correct, relaxed position, and the pain relief can be tremendous. When Dr. Marshall determines your relaxed jaw position, your TMD treatment will focus on making that position permanent.

TMD Treatment

To permanently relax your jaw position and movement, the jaw muscles need to be re-trained and the factors that have been maintaining the misalignment must be removed. Your treatment plan will be entirely customized. It may include:

  • Use of a custom-made orthotic that you can wear at night to hold the lower jaw in its correct position and prevent tooth grinding or jaw clenching
  • Periodic pain relief using the TENS unit – in some cases, TMD sufferers will purchase their own TENS unit for home use
  • Dental work to correct malocclusion – this may include porcelain crowns to give a new shape and size to a particular tooth, or Invisalign to re-align many teeth. Replacement of old fillings that are interfering with how your upper and lower teeth meet might also be necessary
  • Referral for orthodontic work if you have severely misaligned teeth that cannot be remedied with Invisalign
  • Referral for physical therapy or chiropractic work if your neck vertebrae have become misaligned and are causing persistent neck, back, or shoulder pain

Before any treatment is begun, Dr. Marshall will discuss your TMD and dental status with you and give you a printout from our K-7 Evaluation System that presents the data clearly. She will explain the best treatment options and answer your questions, making sure that you understand and agree with your eventual treatment plan.

For information on how we can help with financing, please see the Affordability page.

Dr. Marshall can restore your correct jaw position and bite, enhancing your smile in the process, and relieve you of the chronic discomfort and pain of misaligned jaw joints. The first step is to contact our neuromuscular dentistry office at (610) 649-0696 for a private consultation with Dr. Marshall. We serve the Philadelphia, Main Line, and Ardmore, Pennsylvania area and we hope to work with you soon.

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