TMJ can be caused by many factors and has a wide variety of symptoms.

Unbalanced Bite

When your teeth are misaligned and you suffer from a bad bite, there isn't enough muscle support in your face required for chewing and swallowing. These muscles are then forced into a strained position which means you'll experience discomfort throughout your face, head, arms, shoulders and back. The over-worked muscles result in pain that can show up in the form of migraines, headaches, earaches, muscles tenderness, facial discomfort, a sore jaw and a variety of other symptoms.

The stress and strain on yoru jaw from an imbalanced bite can impact the way your mouth functions. It can prevent you from fully opening your mouth which then limits your swallowing, eating, chewing and even talking. A bad bite can also wear down your teeth and drastically impact your facial appearance. Your lips change shape. Wrinkles and creases form and deepen on the sides of your nose and around your mouth. And your lower lip starts to roll out and jowls begin to appear.

How did I acquire this bad bite?

Your bad bite and unaligned jaw could be the results of one or more issues:

  • allergies as a child
  • thumb sucking or other oral habits
  • previous dentistry that has worn out or broken down
  • the shifting of teeth due to tooth loss
  • result of accident or trauma

Improve your looks AND your health

Dr. Khullar is specifically trained in neuromuscular dentistry. By examining your bite and determining where and how your jaw joints should be fitting together, he can determine what issues your bad bite is causing and suggest the proper treatment to get you back on track. This not only creates a beautiful and healthy smile but a properly functioning and fine-tuned body as well. You benefit on every level.


Bruxism is a condition characterized by the grinding of the teeth and the clenching of the jaw, and occurs in most people at some point in their lives. Though this clenching and grinding can occur either during the day or at night, bruxism is one of the most common known sleep disorders and causes most of its damage during sleeping hours.

The clenching and grinding which accompanies bruxism happens because of a faulty chewing reflex. This reflex is turned off in non-sufferers when you are sleeping. For sufferers, deep sleep, or even naps, cause the reflex nerve control center in the brain to turn off, and the reflex pathways to become active.

The causes of bruxism

Typically, the front 6 upper and lower teeth grind against each other laterally. This side to side action puts undue strain on the medial pterygoid muscles and the temporomandibular joints. Earache, depression, headaches, eating disorders and anxiety are amongst the most common symptoms of bruxism; which often accompanies chronic stress, Alzheimer’s disease and alcohol abuse.

Bruxism is frequently misdiagnosed or not diagnosed at all, because it is only one of several potential causes of tooth wear. Dr. Khullar can tell the difference between bruxing wear and wear caused by overly aggressive brushing, acidic soft drinks and abrasive foods.

A BiteStrip® is an economical device used to diagnose bruxism at home. The device itself is a small electromyography which senses and monitors any activity in the jaw muscles during sleep. The frequency and severity of the condition can then be assessed and the best treatment plan can be formulated.

Why get treatment

Here are some of the main reasons why bruxism should be promptly treated:

Bruxism is one of the leading causes of gum recession and tooth loss; firstly because it damages the soft tissue directly, and secondly because it leads to loose teeth and deep pockets where bacteria can colonize and destroy the supporting bone.

The abnormal wear patterns on the occlusal (chewing) surfaces can lead to fractures in the teeth, which may require restorative treatment.

In severe and chronic cases, bruxing can eventually lead to painful arthritis in the temporomandibular (TMJ) joints (the joints that allow the jaw to open smoothly).

The grinding associated with bruxism can eventually shorten and blunt the teeth. This can lead to muscle pain in the myofascial region and debilitating headaches.

Treatment options

There is no single cure for bruxism, though a variety of helpful devices and tools are available through Dentalways. An acrylic mouth guard can be designed from tooth impressions to minimize the abrasive action of tooth surfaces during normal sleep. Mouth guards should be worn on a long-term basis to help prevent tooth damage, damage to the temporomandibular joint and help to stabilize the occlusion.

Other methods of treatment through TMJ dentist Dr. Khullar include relaxation exercises, stress management education and biofeedback mechanisms. When the bruxing is under control, there are a variety of dental procedures such as crowns, gum grafts and crown lengthening that can restore a pleasant aesthetic appearance to the smile.

TMJ Migraines & Headaches

The pain is so excruciating and constant, you don't even remember living without headaches. It's such a part of your everyday life, you have come to accept it as normal. The truth is, if you are suffering from chronic headaches and migraines and even facial pain and soreness in your neck, shoulders and back, TMD could be at the root of it all.

When your TMJ (temporomandibular joint) is out of alignment, the muscles supporting your face, head and neck are constantly stressed. Everything you do causes additional strain on those muscles. Even when you are relaxing, the muscles aren't in their innate position and excess stress is constantly added. All this extra strain on your muscles in your head, face, and neck can lead to headaches, TMJ migraines and soreness and irritation in all those connected muscles.

So these headaches could be dental related?

Tension headaches can result when your muscles are constantly strained or squeezed. TMJ headaches can also be caused by a build-up of blood pressure. When the muscles in your head, face and neck are strained, blood is prevented from flowing to the right places. Then your body attempts to correct the problem by sending more blood to the area, which increases blood pressure. This feeling of pressure around the head (called a vascular headache) can be remarkably painful.

Because they are often so painful, severe and frequent, TMJ headaches are often misdiagnosed as migraines. Migraine headaches are mainly on one side of your head and are usually accompanied with visual disturbances and extreme sensitivity to light. The treatment for migraine headaches is much different from TMJ headaches so it’s crucial to see a TMJ dentist, like Dr. Khullar, to make a proper diagnosis.

Find out what's causing your pain

Dr. Khullar will work with you to diagnose your headaches. As part of the diagnosis, he'll relax your jaw muscles with a set of electrodes that deliver mild stimulation, contracting and relaxing the muscles until they relax. This might just be the first time these muscles have fully relaxed in many years and your pain will disappear along with the muscle tension.

Facial Pain / Pain behind the Eyes

Facial pain can be extremely uncomfortable and limiting, even making it a challenge to talk and to eat. It can be some of the worst pain you can experience. Because of it's proximity to the brain, we feel it more deeply than pain in other areas of our body. It hurts to eat, to talk and, because of it, you’re miserable.

Your teeth help you talk, breathe, kiss, eat, drink and swallow. You chew with them, bite with them, brush them, grind them, floss them and generally (unbeknown to you) abuse them. When you have a lopsided jaw (or a 'bad bite'), the wear and tear on your teeth is considerably more severe and rapid. The erosion on your teeth can lead to uneven tooth wear, loss of range of motion in your jaw, gum recession and an assortment of other symptoms – all connected to TMJ.

If your cheeks are constantly inflamed, your face hurts to touch, your jaw feels bruised and the area by your ear is sore, there's a good chance a bad bite is to blame. But the good news is Dr. Khullar can help alleviate your pain and discomfort with neuromuscular dentistry.

This pain I'm experiencing is dental?

Your neck, head and face have nerves, muscles and joints that communicate with one another. If a nerve in your neck is aggravated, the pain travels up your nerve and you are left with pain in your face. Your TMJ affects all the muscles, specifically those in your head, neck, face, shoulders and back. It makes perfect sense then, if you suffer from TMD, you will feel the effects in your face and jaw.

Some of the questions we often ask to determine if your pain is caused by a problem with your TMJ are:

  • When you bite down, do you experience pain?
  • Does your mouth only open “so” far?
  • When you chew, do you hear popping or clicking?
  • Have you had friends or family comment on how loud your jaw popped?

If you've answered yes to any of these, visit Dr. Khullar as soon as possible.

A healthy TMJ is quiet. When you eat, chew, swallow, sing, talk and brush your teeth, you wouldn't notice anything unusual if you have a healthy TMJ. You'd have no pain or discomfort in your jaw, face or neck. Your muscles should work in harmony, letting you open and close your mouth both smoothly and silently.

If you notice a constant popping, clicking or snapping when you perform the most basic function, something isn’t right. Clicking, popping and pain are indicators that your jaw joint is unstable. When your jaw joint is unstable, the ripple effect will cause severe and often times debilitating pain in your jaw and your face.

So, what's happening?

To keep the joints from rubbing together, you have a disc of cartilage inside of your jaw joint. When this disc isn't in proper place, your joints end up rubbing together, causing the clicking and popping sound you hear. At times its loud enough to be heard by other people.

When your jaw isn't aligned and being properly supported, it limits your range of motion. You are eating and suddenly you can’t open your mouth wide enough. When you talk or yawn, you feel like your jaw needs support. If you suffer from TMD, the ability to open your mouth widely can be limited and painful.

TMJ Jaw & Tooth Pain

When you suffer from jaw pain, it can be extremely uncomfortable, making it hard to eat and talk. Your face can feel tender, your jaw can constantly click or pop and your teeth feel like they are under continuous pressure. It hurts to eat, to talk and it leaves you writhing in pain, wondering what the heck is happening.

Just like anything you use repeatedly and everyday, there is going to be substantial wear and tear. The same theory applies to your teeth. You use them repeatedly, day-in and day-out. Virtually everything you do requires the use of your teeth. Talking, breathing, kissing, eating, drinking, swallowing, chewing, biting, grinding, brushing, flossing... your teeth and jaw are needed for things you don't even think of.

When you have a misaligned jaw or a "bad bite", diagnosed by Dr. Khullar in Little Rock, the wear and tear on your teeth is considerably more rapid. The attrition can lead to uneven tooth wear, loss of range of jaw motion, gum recession and various other symptoms. All of these are connected to your TMJ.

In this war of muscle versus tooth, three things may happen:

  1. If your muscles win, you have rapid tooth wear
  2. If your teeth win, you will have muscle tension and stress along with headaches and other TMD problems
  3. Or worse: you will experience a combination of both

Jaw misalignment and teeth wear (which can be treated by Little Rock's Dentalways) can affect how your face function and it can change the appearance of your face. When your jaw isn't where it should be, you will experience pain and inflammation in your jaw, teeth and surrounding areas. Additionally, it creates deterioration of your teeth, causing them to look ground down and worn.

TMJ Ear Pain, Ringing & Congestion

You've been to see a doctor, complaining of ringing and whistling in the ears. They shone a light in there, asked you what you'd been experiencing, yet nothing has been diagnosed. You know that ringing sound is real and you also know that you’re sometimes hit with waves of dizziness so strong, you are forced to hold on to something.

Ear congestion, unrelenting earaches, vertigo, dizziness, ringing or whistling in the ears… these can all be traced back to your TMJ. And TMJ dentist Dr. Khullar can diagnose exactly what's going on and provide the proper treatment in his Dentalways office.

What's going on with me?

The over-activity of your jaw joint contributes to hypersensitivity in your ear canal, resulting in a number of different outcomes and symptoms.

To get technical for a moment, your ear has two important muscles: the tensor tympani (this attaches to the ear drum, stabilizing it from the excess vibration caused by loud sounds) and the tensor levi palatini (this attaches to the Eustachian tube helping to equalizing pressure within the inner ear. This is what “unplugs” your ears when you suck on a hard candy or chew gum when you take off or land in an airplane).

When your jaw is unaligned and you have a bad bite, your muscles become over-stimulated. This over-stimulation leads to symptoms related to your ears. The jaw area is a complex network of nerves and muscles. When your bite is misaligned - muscles and nerves throughout the head, including the ears, can be affected. The most common and noticeable affect is relentless ringing or whistling in the ears. It can also lead to:

  • dizziness
  • vertigo
  • ear pain or discomfort (earaches)
  • impaired or restricted hearing
  • congested or stuffy feeling in your ears
  • sinus pain

No more ringing, dizziness or ear congestion

When your bite is restored to the position it was intended, the symptoms associated in your ears (caused by the bad bite disappear). By stabilizing and realigning your jaw, TMJ dentist Dr. Khullar, can relieve the discomfort and irritation you've been experiencing so your ears are finally free and clear at last.

TMJ Neck & Shoulder Pain

Your neck, shoulder and back muscles work together as a team. Seldom does a single muscle work without other muscles in the team joining in. Often times, when your muscles are being overworked, they will unknowingly recruit other muscles to help pick up the slack. This is known as muscle recruitment. TMJ dentist, Dr. Khullar can explain this in greater detail in his Little Rock office, Dentalways.

When your muscles are strained, it takes a toll on your posture. With the head centered, the spinal column is straight, but muscle tension can shift the head away from the center. To compensate for this, the spine beings to buckle and postural distortion develops as the shoulders nad hips begin to tip.

When turning your head, chewing, talking and breathing, all the muscles of your head and neck work together, in unison. When a specific muscle is over-used, it naturally affects the muscles that hold up your head and those that support the neck and shoulder. When one muscles is strained and tired, it recruits other muscles which results in unbalance, which, ultimately, results in pain.

The bones in the neck work intimately with the muscles that control talking, biting, breathing, chewing and head posture. Tight, sore, contracted muscles in your jaw will tilt the shoulder and head, causing over-compensation of the shoulder, neck and back muscles.

Bye-bye neck and shoulder pain

Dr. Khullar is specifically trained in neuromuscular dentistry. By examining your bite and determining where and how your jaw joints should be fitting together, he can suggest the proper treatment and eliminate the pain and soreness affecting your neck and shoulder. He'll not just create a beautiful and healthy smile but a properly functioning and fine-tuned body as well.

TMJ & Bad Posture

You can hear your mother's voice ringing in your ears. "Stand up straight dear or you'll wreck your posture". While you did your best to follow her advice, there might be a good reason you still appear to be slouching. If you have TMD, a bad bite or a misaligned jaw, your posture problems could be a directly related.

TMJ plays with your posture

If you have a bad bite, you will have a jaw that's misaligned. Because of this, you end up with stressed and strained muscles in the jaw, contributing to a stiff upper body. In turn, this can affect your posture, and may make it difficult or even impossible for you to stand up straight.

When your jaw is out of alignment, the lower and upper teeth don't meet where they are supposed to. The misaligned jaw muscles have to work extra hard to do the job they were meant to do. As the months, or years, go by, inflammation builds up and results in your back, neck and shoulders becoming stiff. You are constantly adjusting to the strained muscles and as a result, your whole body goes out of alignment. This may be the cause of your neck, back and shoulder pain - contributing to bad posture.

If you have a lopsided bite, then the muscle activity and tension will also be unbalanced. When those muscles are over-used it impacts and ‘tugs’ the muscles that hold up your head, resulting in a forward facing posture. It starts with a ‘tug’ on your head, which ‘tugs' at your posture, resulting in a slouching appearance. You look like you aren't standing or sitting straight as there's a slight roundness in your neck, shoulders and back. The domino effect begins cascading down your entire body and can manipulate the positioning of your shoulder and your hips. In a lot of cases its so severe, one shoulder or hip is visibly higher than the other.

When your entire body is not aligned properly, you'll find yourself gradually more lethargic and tired throughout your day. Your sense of balance, control and strength will be reduced and even the simple things will require more effort on your end.

Improve your smile, improve your posture

Dr. Khullar is specifically trained in neuromuscular dentistry and can suggest the proper treatment to fix your bite. This will eliminate pain and soreness and allow you to stand tall and proud for the first time in quite some time.

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