Home / TMJ & Facial Pain
Head and neck pain
Headaches, a clicking jaw,
and teeth that keep
breaking.
Often these are not three problems. They are one problem wearing three disguises — a bite and a jaw joint that are not working together, and a set of muscles doing overtime to compensate.
Why people come here
- Surgery and the finished teeth done by one dentist, under one roof
- Clinical Director of the Resnik Implant Institute — 7,000+ CE hours since 1982
- Relaxation and sedation options for anxious patients
- A written, itemized plan before anything is scheduled
Why a dentist
The joint, the muscles and the bite are one system.
Dr. Robinette practices comprehensive dentistry — treating the oral cavity in relation to a patient’s overall health — and places a strong emphasis on head and neck pain. A large share of his more than 7,000 hours of continuing education since 1982 has gone into exactly this territory.
The temporomandibular joint is the only joint in the body whose position is partly dictated by how a set of teeth meet. When the bite and the joint disagree, the muscles arbitrate — and muscles that arbitrate all night are the reason people wake up with headaches and a sore face.
Signs that bring people in
- Waking with a headache, a tight jaw or sore temples
- Clicking, popping or catching when you open
- Teeth that are chipping, cracking or wearing flat
- Pain in front of the ear that spreads into the neck and shoulders
- A bite that has never felt settled since previous dental work
- Being told you grind, by a partner or by your own enamel
How it is worked up
Assessment before appliances.
History
When it hurts, what makes it worse, what you have already tried, and what changed before it started.
Visit oneExamination
Joint sounds and range of motion, muscle palpation, wear patterns on the teeth and how the bite actually closes.
Same visitImaging and records
Photographs, imaging and models as the case requires, so the bite can be studied off the patient.
As neededA staged plan
Usually reversible measures first — an appliance, muscle therapy, habit change — before anything permanent is done to teeth.
Written downWhat treatment looks like
Reversible first, always.
Custom appliance therapy
A hard, precisely adjusted appliance — not a boil-and-bite guard — that changes how the muscles and joint load overnight.
Bite refinement
Where specific interferences are identified, careful adjustment can settle a bite that has been fighting itself.
Restoring worn teeth
Once symptoms are stable, teeth that have been ground flat can be rebuilt to a height the joint agrees with.
Referral when needed
Some facial pain is not dental. If the examination points elsewhere, you get told so and pointed to the right specialist.
Sleep overlap
Grinding and airway problems travel together more often than people realize, which is why the sleep questions get asked here too.
Review
Appliance therapy is reviewed and adjusted rather than issued and forgotten.
Questions
TMJ, answered.
Is a night guard from the drugstore good enough?
It protects enamel and that is not nothing. But a soft, unadjusted guard can make muscle pain worse in some people, because it gives them something to chew on all night. A custom appliance is adjusted to a specific bite relationship, which is the part that does the work.
Will I need my teeth rebuilt?
Not necessarily, and not first. The sequence is to settle the symptoms with reversible treatment, confirm the improvement holds, and only then decide whether anything permanent is worth doing.
Do you treat the joint surgically?
No. Surgical management of the joint belongs with an oral and maxillofacial surgeon, and cases that need it are referred.
Start with an exam and a straight answer.
A consultation includes an examination, imaging and a written, itemized plan. If implants are not the right treatment for you, Dr. Robinette will say so and tell you what is.