Temporomandibular Joint Disorder (TMJ)
You are not alone! Did you know that more than 15% of American adults suffer from chronic facial pain; such as jaw pain, jaw popping, locked jaw, difficulty chewing, headaches, or earaches? Dr. Gregg Hillery in Concord can help you with the most appropriate and conservative treatments for your TMD/TMJ pain. Call us today at 603-224-2555 or complete the form and we will contact you shortly.
What is TMD/TMJ?
Problems with your jaw, jaw pain, and the muscles in your face that control it are known as temporomandibular disorders (TMD). Referring to the specific temporomandibular joint (TMJ), is the hinge joint that connects the lower jaw to the bone of the skull. This joint is located immediately in front of the ear on each side of the head. The muscles attached to the jaw allow the jaw an incredible amount of movement, such as side to side and up and down.
This flexibility allows us to chew, talk, and yawn. Each TMJ has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and rotate or glide. Any problem that prevents this complex system of muscles, ligaments, discs, and bones from working properly may result in a painful TMJ disorder.
About Us
Dr. Gregg Hillery graduated from the University of Pittsburgh School of Dental Medicine in June of 1987. He had been a resident of New Jersey but decided to finish his undergraduate degree in Behavioral Neuroscience and dental degree in the city of his birth, Pittsburgh, Pennsylvania.
Dr. Hillery practiced dentistry in New Jersey and Pennsylvania before moving to New Hampshire in June of 1998. He is a member of the American Dental Association which includes the New Hampshire branch and the Concord Dental Society. He has attended many continuing education courses throughout the years. He likes to supplement his knowledge by reading dental journals and newsletters to stay current with new technology and procedures.
Dr. Hillery’s interests include outdoor activities and travel. He enjoys spending time with his wife and his son, and searching for family and cultural events to attend.
Kelly has been in the dental field for over 36 years in the capacity of dental assistant. Working with Dr. Hillery since 1998, she feels very fortunate to have a career that she has loved and still has the desire to be part of a team that provides excellent dental care. Making patients feel cared for and comfortable, in a sometimes-stressful environment, is her favorite part of her job. Her faith and family have always been the most important parts of her life. Now that her children are grown, she has more time to spend working out (to try and stay ahead of mother nature), cooking and enjoying her entire family, especially her triplet grandsons and granddaughter.
Dawn graduated from Franklin Pierce College in 1986 with a B.S. in Business Management with a minor in accounting and from NHTI in 2001 with a degree in dental hygiene. She is board certified in the administration of local anesthetic. She joined our team in 2007. Dawn is passionate about her career as a Dental Hygienist. Educating patients on how to help them improve their oral and overall health is of the utmost importance to her. Dawn enjoys meeting new patients every day and making dental appointments a positive experience for them as well as taking care of their dental needs. In her spare time, she enjoys hiking, kayaking and spending time with her family.
Lauren earned a Bachelor’s Degree in Business from Saint Anselm College prior to entering the dental field. She then went on to become a Registered Dental Hygienist with a certification in local anesthesia administration. She graduated from NHTI in 2009 with a degree in Dental Hygiene and joined Dr. Hillery’s team that same year. Lauren’s favorite part of her job is building relationships with her patients while educating them on the importance of oral hygiene and disease prevention. Her main goal is to give each patient a positive experience in the dental chair by taking time to perform a comfortable and thorough hygiene visit. When she is not in the office, Lauren enjoys spending time with her two young children, husband and friends.
Melissa joined our team August of 2013. She graduated from Keene State College in 2009 with a B.S. in Biology and a Minor in Management. She received her Associates in Dental Hygiene from NHTI in Concord, NH in 2012. She previously was a dental assistant for over 6 years while working to receive her degrees. She has worked in both general and specialty practices where she has had extensive experience in soft tissue periodontal treatment. She is certified to administer local anesthesia and subgingival soft tissue treatment in periodontal pockets. Melissa continues to take courses in all aspects of oral dental care so as to ensure our patients achieve a lifetime of healthy smiles. Melissa lives in Concord, NH and in her free time enjoys cooking, exercising, being outdoors and playing with her rescue dog, RemDog and her fiancée.
Beverly has been in the Dental industry for over 40 years as both a Dental Assistant and Office/Patient Coordinator. Bev takes pride in making our patients feel comfortable with any scheduling, insurance, or dental concerns they may have. Her widespread knowledge of the dental field allows her to provide patients with excellent, personalized care and service to make their visits as comfortable and pleasant as possible. In her free time, she volunteers at Concord Hospital and CRVNA Hospice offering Reiki for her patients. Her spare time is filled with photography, cycling and hiking around our beautiful state.
Wendy joined our team in October 2015. She has been in the dental office administration field since 1998. She is a transplant from Massachusetts who fell in love with New Hampshire after spending many summers here. She loves being able to help patients understand their dental needs and how their dental insurance works. Her priority is helping them maximize their dental benefits. She enjoys spending time with her husband, son, and dog. She enjoys making custom signs in her spare time. Her favorite activity is attending her son’s sports games especially baseball.
Treatment Options
What treatment options do I have?
Keep in mind that for most people, discomfort from TMD/TMJ will eventually go away whether treated or not and our office encourages simple self-care non-invasive practices. If more treatment is needed, it should be conservative and reversible. Dr. Gregg Hillery avoids, if at all possible, treatments that cause permanent changes in the bite or jaw. If irreversible treatments are recommended, we encourage you to gather all the information you need to make an informed best decision and even to get a second opinion. Pain clinics in hospitals and universities are a good source of advice and second opinions for temporomandibular disorders.
Non-Invasive treatment options include:
- Using a dental articulator, Dr. Gregg Hillery will analyze your bite on an instrument that simulates the way your jaw works
- Bite correction with T-Scan computer-bite sensors which digitally map your bite so we know precisely how your teeth bite, from the high spots to the low spots
- Bite Splint Therapy- If we determine that there is a cause/effect relationship between the incorrect bite of the teeth and TMJ/muscle symptoms, a bite splint could be recommended. A hard acrylic therapeutic device is fabricated to fit snugly over either your upper or lower teeth creating an artificial biting surface that alleviates undue stress and force, providing for better joint and muscle function and comfort. As you wear the splint, your bite on it will change, requiring additional adjustments to the splint. The goal is to alleviate the signs and symptoms of TMJ disorders, as well as stabilize your bite on the splint.
- Inflamyar – a compound of various natural plant-based products for the treatment of Inflammation, Arthritis, Muscle Pain, Bursitis, Sprains, Bruises, and Sports Injuries. We use this with low-level laser therapy to help with sore temporomandibular joints and muscles
- Eating soft foods
- Try to avoid extreme jaw movements, like yawning and gum chewing
- Avoid biting your nails
- Applying warm compresses to the area of pain
- Muscle stretching and relaxation exercises to perform at home
- If you have the habit of teeth grinding, Dr. Gregg Hillery can fit you with a therapeutic splint that fits over your upper and lower teeth like a mouth sports guard. The splint is designed to ease muscle tension by reducing clenching or teeth grinding at night
More invasive treatment options include:
- A bite adjustment to correctly engineer your bite. It is a precise procedure that is always done first on models of your mouth. And before that procedure is done, a bite splint may be prescribed to relax the muscles and allow the joints to stabilize first.
- Cortisone shots can help relieve inflammation and pain
- Fixing an uneven bite by adjusting or reshaping some teeth
- Orthodontic treatment may also be recommended
- Jaw joint replacement surgery to replace the jaw joint with an artificial implant
What are the chronic symptoms of TMD/TMJ?
- Facial pain or tenderness, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or yawn
- Limited ability to open the mouth wide
- Jaw popping
- Jaws that get “stuck” or “locked” in the open or closed-mouth position
- Clicking, popping, or grating sounds in the joint when the mouth is opened or closed
- Tired feeling in the face or neck
- Difficulty chewing
- Sudden uncomfortable feeling when biting
- Swelling on the side of the face
- Toothaches
- Consistent headaches or neck aches
- Dizziness
- Earaches
- Hearing problems
- Upper shoulder pain
- Ringing in the ears
- More women experience TMD/TMJ pain than men and is most often seen in people between 20 and 40 years of age.
What are potential causes of TMD/TMJ?
- Trauma or injury such as whiplash
- Bruxism, or teeth grinding
- Clenching
- Osteoarthritis
- Rheumatoid Arthritis
- Dislocation
- Tooth and jaw alignment
How is TMD/TMJ diagnosed?
At present, there is no widely accepted, standard test to correctly identify TMD/TMJ. Because the exact causes and symptoms are not clear, diagnosing temporomandibular disorders can be confusing especially because other dental conditions, such as a toothache or sinus problems, can cause similar symptoms.
The Delta Dental Plans Association says that in about 90% of the cases, your description of symptoms, combined with a simple physical examination of the face and jaw by Dr. Gregg Hillery provides useful information for diagnosing temporomandibular disorders. During an examination, we perform orthopedic types of tests on the TMJ such as palpation (pressing various areas), auscultation (listening while the jaw moves), range of motion tests, and loading or joint compression tests.
These allow us to assess the current status of joint form and function. If you have joint pain, we will determine exactly which structure(s) are involved in order to make a diagnosis. We will also palpate the muscles of the head and neck area to determine if they may be a source of pain. Dr. Gregg Hillery in Concord may also take x-rays and make a cast of your teeth to see how your bite fits together, or specialized x-rays of the TM joints will be taken.
Complimentary Consultation
After a personal consultation and exam, Dr. Gregg Hillery can suggest the most appropriate therapy based on the suspected cause of your TMD/TMJ pain. Call us today 603-224-2555 to schedule an appointment in Concord or complete the form for a complimentary consultation at Gregg Hillery DMD
Call 603-224-2555 NOW to schedule your Complimentary Consultation or fill in the following form and we will contact you as soon as possible.
Everyone one from the secretaries to the hygienists, and doctor are very friendly and welcoming. Completely non-judgemental, and they were able to get me in for a cleaning in addition to a screening when I was just scheduled for a screening. 12/10 would recommend. - Christopher M.
Can’t I award them 10 stars? Seriously the best! Smart. Professional. Fair. Kind. Gentle. Superbly qualified. - Mario C.
I am a Veteran and the VA referred me to Dr. Hillery since he is in the network of seeing veteran patients. He performed an extraction for me and I am extremely grateful for his expertise! He was kind and gentle with my care. He even called me personally yesterday to make sure all was well. I would like to thank him and his staff for making my visit pleasant, although I had to have a tooth removed :) I look forward to my future visits to his office and will recommend Dr. Hillery to anyone who needs dental work. - Donna H.
Dr. Hillery and the staff are wonderful! - Angela F.