TMJ Disorders | Alexandria VA | DC

TMJ DiagramDid you know that one in every four Americans has a TMJ disorder (Temporomandibular Jaw Joint Disorder or TMD) with either mild to severe symptoms? Unfortunately, ignoring a TMJ disorder doesn’t make it go away. In fact, some of the more serious cases can require surgery, but only 1-2% of the time. We all have two TMJs (temporomandibular joints) – one on each side of our head in front of the ears. They allow the jaw to open and close, move side to side, forward and backward. Unlike other joints of the body, these joints generally move in unison. When one or both aren’t functioning properly, it is referred to as “dysfunction”. This is commonly caused by the displacement of the cartilage (disc).

The jaw joint is comprised of parts: 2 bones, the mandible (jawbone) and the temporal bone (located at the side of your skull). The joint is positioned immediately in front of the ear canal. These bones are attached to each other by ligaments, tendons and muscles which all play a vital role in controlling movements and positioning of the jaw. A small fibrous cartilage pad (also known as a disc) acts as a friction absorber, preventing the bones from rubbing on each other. They also insure a smooth functioning joint. The neck and shoulder muscles can become tense and painful as a result of TMD problems. Many structural problems of the skeleton can involve and aggravate or cause TMD.

Here is a list of other symptoms that may mean you have TMD:

  • Loss of balance
  • Ringing in the ears (tinnitus)
  • Ear pain
  • Throat pain
  • Vertigo
  • Facial asymmetry
  • Headaches
  • Ringing, throbbing or stuffiness in the ears
  • Sleep difficulties
  • Teeth that do not meet properly
  • Difficulty chewing or swallowing
  • Neck or back pain
  • Tingling or numbness in arms
  • Teeth sensitive to cold or touch
  • Unexplained loose teeth
  • Clenching or grinding teeth/jaws
  • Face pain
  • Dizziness
  • Pain or pressure behind eyes
  • Shoulder stiffness
  • Limited movement or locking of the jaws
  • Clicking or grating jaw joint sounds
  • Forward head posture / ears are toward front of the shoulders when standing at a comfortable rest position
hands man holding ear
It is hard to believe so many symptoms can be related to TMD. That’s why it can be difficult to diagnose and treat because the problem often crosses over into several different specialties in medicine and dentistry. People who suffer from this disorder have typically visited many different health care professionals — all of whom may have a piece of the puzzle. Dr. Singer is educated, experienced and has the proper instrumentation to diagnose and treat TMD.  If you need referrals to other health care professionals such as chiropractors, physical therapists, acupuncturists, ENTs, and doctors in naturopathic and integrative medicine, Dr. Singer can guide where best to get treatment in each individual case.
Fill out our Contact Form or call us at Alexandria Office Phone Number 703-239-6475 if you have any questions or to schedule an appointment with Dr. Singer today!


There are many factors that can cause Temporomandibular Disorders (TMD). Those factors include, but are not limited to:


postureThe posture and bite are intimately related. Picture a postural chain with the feet at one end and the teeth at the other. When the upper and lower teeth are closed together, each tooth actually forms a skeletal relationship with its opposing tooth. In turn, this bite determines and position of your jaw and the position of your head on your spine. Poor posture places unnecessary wear and tear on the joints. It can also cause the muscles to suffer. Symptoms that are specific to a poorly postured bite include:

  • Numbing or tingling sensation in one hand
  • Pain in the jaw, head, neck, shoulders, back
  • Difficulty clearing the ears
  • One shoulder being higher than the other
  • Altered gait

When your posture is incorrect, you may notice pant legs that must be hemmed to different lengths or shoe heels that wear out unevenly. The majority of people carry their head too far forward. This places tremendous strain on the muscles of the shoulders, back, neck and head. Because the average human head weighs 15 pounds, with each inch the head is held forward it adds 15 more pounds. Further, the shoulders roll forward and the jaw is pulled back. Treatment for poor posture is normally treated with physical therapy. Therapists stretch muscles which have become shortened over time. When your bite is involved with a postural problem the TMJ dentist must correct with a properly fabricated orthotic so muscles, bones and teeth can function without strain and tension.

Work on your posture when standing, driving, walking and sitting. Catch a glimpse of yourself in a mirror or reflection in a window to see if you are practicing good posture.

Bruxism (Teeth Grinding)

What is Bruxism?
Bruxism (the medical name for teeth grinding) is the grinding of teeth on a regular basis, typically in one’s sleep.

What Causes Bruxism?
A number of different factors cause bruxism, including:

  • Abnormal bite
  • Missing or crooked teeth
  • Stress or anxiety
  • Sleep breathing issues, including sleep apnea

How is Teeth Grinding Harmful?
Serious teeth grinding can cause fracturing, loosening or loss of teeth. Additionally, bruxism is very damaging to the teeth and jaw joints, causing (or worsening) TMJ disorders and even resulting in hearing loss. Bruxism also causes fatigue and pain to the facial muscles.

What are Symptoms of Bruxism?
Symptoms of bruxism include:

  • A dull, constant headache
  • Sore jaw
  • Abnormalities in the teeth such as recession and/or abfractions (as seen below in the image)


An abfraction is an angular notch at the gum line. When one tooth makes contact before the rest, it causes too much stress on that tooth and it begins to flex. Abfractions are caused by one of two things: 1)Chronic heavy forces on teeth, produced by clenching or grinding the teeth (bruxing).         2) Normal forces on teeth which are improperly aligned (malocclusion/bad bite)

How is Bruxism Diagnosed?
Because teeth grinding frequently occurs during sleep, many people are not aware that they grind their teeth. If you experience any of the symptoms above and suspect you may be grinding your teeth, call our office for a consultation with TMJ dentist, Dr. Singer.

How is Bruxism Treated?
TMJ & Sleep Therapy Centre can fit you with an orthotic to protect your teeth when you sleep.

Stress management and relaxation techniques can help alleviate stress-induced bruxism.

Learn About the the Diagnosis & Treatment of TMJ

Fill out our Contact Form or call us at Alexandria Office Phone Number 703-239-6475 if you have any questions or to schedule an appointment with Dr. Singer today!

Statement regarding amalgam/silver fillings from the US Food and Drug Administration: FDA has reviewed the best available scientific evidence to determine whether the low levels of mercury vapor associated with dental amalgam fillings are a cause for concern. Based on this evidence, FDA considers dental amalgam fillings safe for adults and children ages 6 and above. The weight of credible scientific evidence reviewed by FDA does not establish an association between dental amalgam use and adverse health effects in the general population. Clinical studies in adults and children ages 6 and above have found no link between dental amalgam fillings and health problems.
Statement from the American Dental Association: Another conclusion of the report stated that, aside from rare instances of local side effects of allergic reactions, “the small amount of mercury released from amalgam restorations, especially during placement and removal, has not been shown to cause any … adverse health effects.”