Chomiak Dental Associates | How Do I Correct TMD? in Connellsville

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How Do I Correct TMD?    

Neuromuscular Treatment  (<Click for Video) 

Because of the complex interaction of the TMJ with the nerves and muscles of the head, neck and face, proper diagnosis and treatment requires a dentist with special training in the area of TMD and craniofacial pain.  Dr. Chomiak has undergone a mini-residency in TMD and Craniofacial Pain, completed extensive training in neuromuscular dentistry, JVA Interpretation, K-7 Interpretation, Therapeutic Botox Trigger Point Injections, and Roccobodo TMD manipulation and physical therapy.  Dr. Chomiak is a member of the American Academy of Craniofacial Pain.  His training places him as one of the leading specialists in Western Pennsylvania.


The treatment is dependent on the specific nature of the disorder and the amount of time the patient has experienced the condition.  The neuromuscular dentist will perform a variety of tests to help understand the specific nature of each patient’s problems.  It is important to understand that this is an orthopedic correction that allows nerve decompression, healing and more normal function of the muscular and neurologic systems. This is not about a jaw or tooth problem alone, but rather a piece of a complex medical problem.  Dentists who use neuromuscular techniques are uniquely qualified to correct and work with both the craniomandibular disorders and the related medical issues.

Diagnosing Neuromuscular Problems  (< Click for Video) 

An exam, medical and dental history, CT-scan, and a simple, painless, 5 minute test known as Joint Vibration Analysis (JVA) is all that is necessary to screen for TMD. The JVA picks up sounds coming from the joint separating the frequencies to give us a specific signature to indicate if the joint is normal or damaged (pathologic).  It gives us a general idea as to the location, severity and prognosis of the problem.  Once determined, we can establish the most conservative and best treatment approach for that patient.

Most cases involve a clicking sound or joint pain because the disc has become displaced or out of its normal position. The movement of the jaw during opening allows the disc to reassume its normal position (recapture) creating a click.  If the ligament supporting the disc is only slightly stretched, simple treatment with muscular TENSING and a splint worn on the lower teeth allows the TMJ to resume its natural movement and allows the disc to heal.

In more advanced cases where the joint has been irreversibly damaged and there is an inability to recapture the disc to its normal position, the treatment goal is to position the lower jaw (condyle) where it can function without causing further damage to the joint and allow the patient to live without the continuum of symptoms.  Sometimes new fibrous tissue will replace the damaged disc (pseudo disc).

If the problems are more complex involving not only the joint, but muscles and nerves of the head, neck and face, or the disc is locked out and not able to be recaptured, then more specific testing may be necessary to determine the origin of the problem and the prognosis. In such cases a CAT-Scan, if not already done, of the TMJ, performed in the office, may be necessary.  If there is dysfunctional muscle activity and abnormal jaw movements, a K-7 Neuromuscular Jaw Tracking Computer with EMG’s and Sonography is sometimes necessary to diagnose and treat the issues in conjunction with the orthotic (splint).  Depending on the severity and stage of progression, other treatment modalities may be added.  Sometimes a team approach may be necessary including physicians, chiropractors, and physical therapists to help expedite treatment.

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