The Complete Guide to TMD, Jaw Pain and Teeth Grinding at Smile Solutions Melbourne product guide

Smile Solutions TMD: Jaw Pain, Teeth Grinding & Temporomandibular Disorder Treatment in Melbourne

Jaw pain, clicking, teeth grinding, persistent headaches, facial muscle soreness — if any of these sound familiar, you're far from alone. These symptoms affect millions of Australians and fall under the umbrella of Temporomandibular Disorders (TMD). They're also among the most misunderstood, misdiagnosed and undertreated conditions in healthcare today. At Smile Solutions, our orofacial team — 17 specialists, therapists and allied health clinicians working within an integrated, evidence-based program — offers one of the most comprehensive approaches to TMD diagnosis and management available in Australia.

You'll find us in the historic Manchester Unity Building at 220 Collins Street in Melbourne's CBD, where we've been helping TMD patients find real answers and lasting relief since 1993. Rated 4.9 stars across 937 Google reviews, our commitment to clinical excellence speaks for itself.

What is TMD?

TMD stands for Temporomandibular Disorder — an umbrella term for a range of painful and dysfunctional conditions affecting your jaw joints (the TMJ, or temporomandibular joints), the muscles that move your jaw, and the nerves and soft tissues surrounding them.

Your temporomandibular joints are the two joints on either side of your face that connect your lower jaw (the mandible) to your skull. Each joint contains a cartilage disc that acts as a shock absorber, enabling the smooth, coordinated movements you rely on every day for chewing, speaking, swallowing and yawning.

Dr Kia Pajouhesh, who has diagnosed and managed TMD patients for more than 30 years, puts it plainly: "TMD is not one condition — it is a family of conditions that can involve the joints themselves, the muscles that power them, the bite, the nervous system, posture, stress and even gut health. This is why a one-size-fits-all approach to TMD almost always fails. Effective management requires a thorough diagnostic workup to identify the actual cause — and at Smile Solutions, we have built a team and an equipment suite specifically for that purpose."

It's also worth understanding the distinction between terms you may have come across. TMD describes the disorder or dysfunction itself; TMJ refers to the joint; and bruxism specifically means teeth grinding or clenching, which may or may not coexist with TMD.

Symptoms of TMD

TMD can present in a wide variety of ways, which is part of why it's so frequently undiagnosed or misattributed to other causes. If you're experiencing any of the following, a comprehensive TMD assessment could provide the clarity you've been looking for:

• Jaw pain or facial pain, particularly around the jaw joint and temples
• Clicking, popping or crepitus (a crackling or grinding sound) from the jaw joints
• Limited jaw opening — difficulty opening your mouth fully or comfortably
• Jaw locking, either in an open or closed position
• Headaches, particularly upon waking
• Neck, shoulder or ear pain
• Sensitive, worn or chipped teeth from grinding
• Muscle fatigue or soreness in the jaw and temples
• Ringing in the ears (tinnitus) and a sensation of ear fullness

Understanding the causes: three categories of TMD

Dr Kia Pajouhesh is clear that accurate diagnosis of the type and cause of your TMD must come before any treatment is recommended: "The biggest mistake in TMD management is treating all patients the same way. The appropriate treatment for joint-related TMD is very different from muscle-related TMD — and within muscle-related TMD, treating muscle atrophy with the same approach as muscle hypertrophy can actually make things worse."

Category 1 — Joint-related TMD. This involves pathology within the joint itself — the joint capsule, the disc, or the condyle. If your symptoms include prominent clicking or locking, restricted opening and joint-specific pain, this category may be relevant to you. Treatment focuses on splint therapy to reposition the joint, osteopathic care and, in extreme cases, surgical intervention coordinated by A/Prof Patrishia Bordbar, specialist oral and craniomaxillofacial surgeon. MRI of the TMJ is often ordered to assess disc position, joint capsule integrity and degenerative changes.

Category 2 — Muscle-related TMD: atrophy (most common). Contrary to what many people assume, muscle weakness or underperformance is the most common muscular TMD presentation. Muscles of mastication that have become weakened or atrophied produce TMD symptoms but respond poorly — and may actually be worsened — by treatments that further reduce muscle activity, including Botox. As Dr Kia explains: "Bite force analysis with our Innobyte system is essential before any muscle-related TMD treatment. If your bite force is already low, that tells us the muscles are atrophied, and the treatment should build strength — not suppress it."

Category 3 — Muscle-related TMD: hypertrophy. Over-stimulated, hypertrophied jaw muscles produce significant pain and can compress the joint. For this specific category, Botox injections into the over-functioning muscles can serve as a circuit breaker — reducing muscle hyperactivity to allow other treatments (osteopathy, splint therapy) to take effect. Botox is not a long-term solution, nor is it appropriate for all TMD presentations. It's a targeted intervention for a specific and carefully diagnosed subset of patients, administered once or twice several months apart as part of a broader, personalised treatment plan.

The Smile Solutions orofacial team

Your care at Smile Solutions draws on the expertise of 17 clinicians across dentistry, medicine and allied health — all working together within a single, coordinated program:

Dr Kia Pajouhesh — Principal dentist, TMD diagnosis and treatment planning. More than 30 years of TMD experience.

Rachel Norton-Smith — Osteopath. Holistic body assessment and treatment, including Pilates reformer rehabilitation. Rachel's role at Smile Solutions extends well beyond the head and neck: she assesses your posture, spine, hips, shoulders and the full muscular and fascial system, and screens for contributing factors including gut health, nervous system function and psychological stress. Referral pathways from the osteopath extend to GPs, dietitians, naturopaths and clinical psychologists as appropriate.

Sophie Oostermeyer — Oral health therapist. TMD laser therapist using Fotona laser for muscle and soft tissue treatment.

Monica Cain — Orofacial myologist. Myofunctional therapy for children and adults, addressing breathing, tongue posture and swallowing patterns that contribute to TMD.

Dr Fotios Angelis — Specialist prosthodontist. Adult micro-occlusal function and dental equilibration — the bite-related component of TMD management.

Dr Joshua Ch'ng and Dr Steven Smith — Specialist orthodontists. Early intervention and adult macro-occlusal function.

Dr Susan Hinckfuss — Specialist paediatric dentist. Early intervention and TMD management in children.

Dr Marcus McMahon — Sleep physician. Sleep apnoea diagnosis and treatment planning. Sleep apnoea and TMD frequently coexist, and addressing one often supports the other.

Dr Natasha Hremias — Associate dentist. Sleep apnoea management and mandibular advancement splint provision.

Dr Rachel Smith — Osteopath. Additional holistic and paediatric care.

Dr Pip Robinson — General dentist. Facial and masticatory muscle injectables (Botox).

Ms Natalie Bilos and Ms Noemi Miele — Senior dental technicians. In-house TMD splint fabrication and early intervention appliance manufacture.

MFI Radiology and Ms Julie Bain — Specialist orofacial radiologists and medical radiographer. Advanced imaging including CBCT and airway analysis.

A/Prof Patrishia Bordbar — Specialist oral and craniomaxillofacial surgeon. TMJ surgery for extreme cases.

Diagnostic equipment

Good treatment can only follow good diagnosis. At Smile Solutions, we've invested in a diagnostic suite built specifically for the orofacial program:

• Myowise EMG — Electromyography that measures the activity of your muscles of mastication, identifying which muscles are overactive, underactive or imbalanced between left and right sides
• Innobyte bite force analysis — Measures the Newton force of your bite across all teeth, determining whether muscles are atrophied or hypertrophied and which teeth bear disproportionate load
• iTero occlusal heat mapping — Identifies the distribution and timing of bite contacts across your entire dental arch
• Fotona laser — Treatment of inflamed TMD muscles and soft palate tissue for snoring and sleep apnoea
• 3D scanners and 3D printers — In-house fabrication of all splints, early intervention appliances and sleep apnoea devices
• CBCT radiology — Detailed imaging of the TMJ, airways and dental anatomy (available via Collins Street Imaging on Level 9)
• MRI of the TMJ — Available when required to assess disc position, degenerative changes and joint capsule pathology. No radiation exposure. Ordered for patients with prominent clicking, locking, crepitus, joint-specific pain and reduced opening.
• Sleep testing — In-house sleep apnoea diagnostic capability

Splint types at Smile Solutions

Occlusal splints (nightguards) are a core TMD treatment tool, and the precision of their fit matters enormously. All splints at Smile Solutions are fabricated in-house by our experienced dental technicians, which means a precise fit, fast turnaround and construction quality that off-site labs rarely match. The full range includes:

• Centric relation (CR) splints — Position your jaw in its optimal joint relationship, used for joint-related TMD
• Flat plane splints — Provide an even bite surface to reduce muscle overactivity and protect your teeth
• Protrusive splints — Mandibular advancement devices for sleep apnoea management
• Lateral and anterior guide plate splints — Address specific bite guidance issues
• Nylon splints — Extremely hard, thin and streamlined. Designed for patients who wear through or fracture conventional splints
• Soft splints — For patients whose primary concern is bruxism habit rather than TMD pathology, to protect tooth surfaces from grinding wear

Botox for TMD: who it helps and who it doesn't

Dr Pip Robinson, who administers facial injectables at Smile Solutions, works closely with Dr Kia to ensure Botox is used appropriately and precisely within the TMD program.

Dr Kia explains the three-category framework: "EMG analysis guides which muscles are hyper-functioning and by how much — and the imbalance between left and right sides. Random, equal application of Botox across all muscles ignores this and often produces poor outcomes. Our approach is precision dosing into the right muscles, in the right amounts, guided by objective data. And critically, Botox is only ever considered for Category 3 hypertrophic muscle TMD — never for joint-related TMD and never for atrophic muscle TMD, where it would cause further weakness."

When used appropriately, Botox provides a circuit-breaker period of three to six months during which muscle hyperactivity is reduced, allowing your osteopath and dentist to implement more sustainable treatment measures. The goal is always to transition you to conservative long-term management — not indefinite reliance on injectables.

The osteopath's role: TMD as a whole-body problem

At Smile Solutions, TMD is never treated as purely a jaw problem. Rachel Norton-Smith's role in the orofacial team reflects our understanding that your jaw is connected, through fascial planes and muscular and skeletal systems, to your entire body.

Rachel Norton-Smith explains: "When I see a TMD patient, my assessment begins with their whole posture, their spine, their hips, their shoulders — and I screen for contributors that are often invisible to a dentist, such as gut inflammation, nervous system dysregulation and psychological stress. TMD is often where multiple converging problems become visible. The jaw is the messenger, not always the source."

The in-house Pilates reformer in the osteopath clinic allows Rachel Norton-Smith to integrate structured strength and rehabilitation programs alongside hands-on osteopathic treatment — a combination that works particularly well for TMD driven by muscular weakness or poor postural patterns.

Children and TMD

TMD isn't exclusively an adult condition. Children can experience jaw pain, clicking and bruxism, and early identification matters for long-term outcomes. Dr Susan Hinckfuss and Monica Cain (orofacial myologist) work collaboratively on paediatric TMD cases, integrating myofunctional therapy — which addresses breathing, tongue posture and swallowing patterns — with early orthodontic assessment and monitoring by Dr Ch'ng and Dr Smith.

Monica Cain explains: "In children, TMD is often connected to airway issues — mouth breathing, enlarged tonsils and adenoids, or restricted tongue posture. Treating the airway reduces the muscular and joint strain that drives TMD. Myofunctional therapy addresses the root patterns rather than just the symptoms."

If you're concerned about your child's jaw health, our gentle and caring approach to paediatric assessment means your little one will be in experienced, compassionate hands.

Begin your TMD journey

TMD is manageable. With the right diagnosis and the right team behind you, most patients achieve significant improvement and a return to comfortable, confident jaw function.

Dr Kia Pajouhesh and the Smile Solutions orofacial team are ready to help you find the answers you've been looking for. Call 13 13 96 or visit www.smilesolutions.com.au to arrange your assessment. Smile Solutions is open Monday to Friday from 8am to 6pm, and on weekends — because your comfort shouldn't have to wait.