BDS, MDS (OMS), FRACDS (Aus), FAMS
Dr Seah Tian Ee is an Oral & Maxillofacial Surgeon whose clinical interests include rhinoplasty, orthognathic surgery, surgical and non-surgical facial aesthetic procedures, the treatment of temporomandibular joint disorders, and oral and maxillofacial pathology. He also performs routine oral surgical procedures, such as wisdom tooth removal and dental implant placement.
If you experience jaw pain, clicking sounds, facial pain, difficulty chewing, or jaw locking, you may be dealing with a temporomandibular joint disorder. At TES Clinic for Face & Jaw, Dr Seah Tian Ee provides assessment and treatment for TMJ disorders in Singapore, including conservative treatment options and surgical management where appropriate.
The temporomandibular joint (TMJ) is a sliding hinge that connects your jawbone to your skull. There are two joints, one on each side of your jaw. The parts of the bone in the joint are covered with cartilage and are separated by a small shock-absorbing disk within the sliding hinge which allows the jaw to open smoothly.
We may prescribe medication to relieve pain such as:
You may also need to wear a mouth guard (occlusal appliance) inserted in between the upper and lower jaw to provide a cushion between the upper and lower teeth and reduce pressure on the joint.
Botulinum Toxin injections into the muscles used to chewing may also be necessary to help relieve muscle spasm and pain. It temporarily reduces the strength of the masseter muscles (or chewing muscles) and prevents them from being overworked. As a result, it helps to provide pain relief, as well as alleviate other symptoms affecting the TMJs throughout its duration.
Learn more about Botulinum Toxin Injection for TMJ.
If the pain does not resolve with more-conservative treatments and it appears to be caused by a structural problem in the joint, we may suggest a joint washout (arthrocentesis) to remove the inflammatory mediators, a scope or open-joint surgery (arthrotomy) to repair the joint.
At the first consultation appointment, we will look at the range of motion of your jaw, discuss symptoms, and feel around for sore spots that elicit pain.
We may also need more information like:
Temporomandibular joint disorders (TMD) — can cause pain if the joints are damaged or the muscles in the area are sore.
The joints may be damaged when:
The muscles may be sore when:
In some cases, however, the cause of TMJ disorders isn’t clear.
At TES Clinic, our treatment approach typically begins with diagnosis and conservative care before considering procedure-based or surgical options, where clinically appropriate.
Our doctor will assess jaw movement, identify pain points, and evaluate symptoms to understand better how your temporomandibular joint is functioning. We will also review your dental condition and medical history.
Imaging may be recommended in certain cases to examine the jaw joint and surrounding structures in greater detail. This may include dental X-rays, CT scans, or MRI.
TMJ disorder treatment may begin with conservative management, such as pain relief medication to reduce pain or inflammation. A mouthguard may also be recommended where appropriate.
For patients with muscle-related TMJ pain, injection-based treatments such as botulinum toxin injections may be considered to help relax overactive jaw muscles and reduce tension. Procedures such as arthrocentesis (TMJ washout) and intracapsular injections may be required. Surgical treatment or arthroscopy may be considered if the condition is linked to structural issues within the temporomandibular joint or if symptoms persist and significantly affect daily function.
If your jaw symptoms are painful and persistent, affecting your daily activities such as eating, speaking, or sleeping, consider seeking a consultation with a TMJ specialist:
There are three main types of TMJ disorders, and a patient may experience only one or more of these disorders at the same time.
• Internal Derangement of the Joint
A structural symptom that involves the progressive slipping or displacement of the articular disc within the temporomandibular joint, caused by bruxism, previous trauma to the joint or lower jaw, a dislocated jaw, displaced TMJ disc, or lower jaw injury. This may result in a locked jaw.
• Degenerative Joint Disease
Degeneration and/or inflammation of the joint. This may be due to inflammation in the synovial fluid (fluid in the joint), in the capsule surrounding the joint, osteoarthritis, rheumatoid arthritis and may result in a perforated TMJ disc.
• Myofascial Pain Disorder
Characterized by pain or discomfort in the muscles surrounding the jaw joint. The pain may be in the jaw or may present as headaches. This may be the result of abnormal muscular function, daytime clenching or nocturnal grinding (bruxism).
It depends on the cause and severity of the disorder. For TMJ disorders caused by stress, the symptoms may clear up and may never return once the individual addresses their stress and anxiety. However, professional treatment is needed to treat TMJ disorders caused by a combination of teeth grinding and arthritis, locked jaw, chronic and acute pain.
Yes, TMJ may cause chronic pain in the face, jaw, neck and shoulders and in or around the ear, as well as headaches and neck aches. This happens because the temporomandibular joint is close to the inner ear, and muscle tension from jaw issues can affect surrounding areas.
To confirm a TMJ disorder, a doctor will review the patient’s symptoms and perform clinical examination of the relevant muscles and TMJ, intraoral examination and may run several tests, including a clench test, X-rays, CT scan or MRI scan.
TMJ refers to the temporomandibular joint itself, while Temporomandibular Disorders (TMDs) are a group of conditions that cause pain and dysfunction in the TMJ and muscles that control jaw movement.
TMJ disorders can involve the jaw muscles, the temporomandibular joint or structural changes within the joint. As an Oral & Maxillofacial Surgeon, Dr Seah Tian Ee provides assessment and treats temporomandibular joint disorders, including conditions associated with persistent jaw pain, jaw clicking, restricted mouth opening and jaw locking, from conservative management to procedure-based or surgical treatment where required.
Jaw dislocation is a condition in which the lower jawbone shifts or becomes dislodged from one or both sides of the temporomandibular joint (TMJ).
An uneven or asymmetrical jaw is a condition where both sides of the jawbone do not match. One of the obvious signs of an asymmetrical jaw is an imbalanced appearance. This condition not only affects your facial symmetry but may also cause functional impairments that affect your ability to talk and chew food.
A misaligned jaw can cause issues with breathing, chewing, speaking and temporomandibular joint dysfunction. Double jaw surgery may offer a long-term solution to correct jaw issues that may not be addressed with braces alone.
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