TMJ Treatment and Jaw Pain Dentist in Shreveport, Louisiana

What is TMJ and what are the symptoms?

The temporomandibular joints (TMJ) are the hinges that connect the lower jaw, or mandible, to the skull just in front of each ear. When this joint and the muscles around it are not functioning properly, it's called a TMJ disorder. Over 350 different conditions fall under the umbrella of TMJ disorders. Common symptoms include jaw pain, morning headaches, neck or shoulder tension, clicking or popping when opening the mouth, locked jaw, teeth grinding (bruxism), worn or chipped teeth, ringing in the ears (tinnitus), and disrupted sleep. Many patients have lived with these symptoms for years without realizing they are related to a treatable jaw-joint problem.

How is TMJ treated at Kerst & Caskey Family Dentistry?

Dr. Jeffrey Kerst takes a conservative, non-surgical approach to TMJ treatment, drawing on advanced training in occlusion from LSU School of Dentistry and The Pankey Institute. After a comprehensive evaluation including occlusal analysis, digital imaging, and bite assessment, treatment may include one or more of the following: custom-fabricated night guards to reduce grinding and joint strain during sleep; occlusal appliances (also called splints or orthotics) worn during the day or night to reposition the jaw and relieve muscle tension; bite adjustment (occlusal equilibration), a precise reshaping of the biting surfaces of teeth to allow the jaw to close in a balanced position; and same-day acute care for patients in active pain including temporary appliances or other immediate relief options at the first visit. Most patients are managed successfully with conservative care, and surgery is rarely needed. However, in a small number of instances, if all other options are exhausted, surgical intervention may be necessary.

What if conservative treatment doesn't work?

A small number of TMJ cases involve structural joint damage, advanced arthritis, or complex pain that doesn't respond to conservative care. When this happens, Dr. Kerst refers patients to an oral and maxillofacial surgeon, neurologist, or orofacial pain specialist for advanced imaging and care. Kerst & Caskey continues to coordinate with the patient throughout this process to ensure continuity and follow-up. Surgical referral is uncommon, and the majority of patients improve significantly with appliance therapy, bite adjustment, or orthodontic treatment alone.

Can dental appliances treat sleep apnea?

For patients diagnosed with mild-to-moderate obstructive sleep apnea who cannot tolerate CPAP therapy, Dr. Jeffrey Kerst and Dr. Gary Caskey fit custom mandibular advancement oral appliances. These appliances gently reposition the lower jaw forward during sleep, opening the airway and reducing apnea events. Oral appliance therapy is endorsed by the American Academy of Sleep Medicine as a first-line treatment for mild-to-moderate obstructive sleep apnea and as an alternative for patients with severe sleep apnea who are CPAP-intolerant. A sleep study and diagnosis from a physician are required before fitting an appliance. Some risks include the possibility of moving teeth. We are fortunate to have an in-office ABO board-certified orthodontist who can help us fit custom appliances to reduce the risk of teeth being moved

How do we diagnose TMJ problems?

Accurate diagnosis is the foundation of successful TMJ treatment. Every TMJ evaluation at Kerst & Caskey includes:

Comprehensive clinical examination. Muscle palpation, range-of-motion measurement, joint auscultation, and functional loading tests based on the diagnostic protocols taught in the Pankey Institute's TMD & Orofacial Pain Focus curriculum.

Occlusal analysis. Evaluation of how your teeth come together and function through their full range of movement — because occlusion (bite) is the root cause of most TMJ symptoms.

BioJVA (Joint Vibration Analysis). A non-invasive, computerized screening tool that measures vibration patterns in the temporomandibular joints during opening and closing. Manufactured by BioRESEARCH Associates and used with the BioPAK software platform, BioJVA takes less than five minutes and produces an objective, repeatable record of TMJ function. Different joint conditions produce different vibration signatures, which helps identify what may be happening inside the joint before recommending advanced imaging.

In-office CBCT (Cone Beam CT) imaging. When 3D imaging of the joint structure is indicated, we capture it in-office using Cone Beam Computed Tomography. CBCT delivers detailed 3D visualization of the temporomandibular joint bone anatomy at significantly lower radiation exposure than a traditional medical CT scan, and results are available the same day.

Photography and records. Digital photography and records for baseline comparison and treatment monitoring over time.

For most patients, this diagnostic workup can be completed in a single 60–90 minute appointment. If the findings warrant advanced imaging beyond CBCT - such as MRI for soft-tissue disc evaluation - we coordinate the referral and continue to manage your case.

Frequently Asked Questions About TMJ Treatment

What is BioJVA and why do you use it?

BioJVA (Joint Vibration Analysis) is a non-invasive, computerized screening tool manufactured by BioRESEARCH Associates. Small sensors placed over each temporomandibular joint measure vibration patterns while you open and close your jaw. The test takes less than five minutes and produces an objective, repeatable record of TMJ function. Because different joint conditions produce different vibration patterns, BioJVA helps identify whether a joint is likely functioning normally or whether more detailed imaging may be warranted. Very few general dental practices in Louisiana own this technology.

Do I need a referral to see Dr. Kerst for TMJ?

No. Kerst & Caskey accepts TMJ patients directly. Call (318) 865-1600 to schedule a TMJ evaluation. If you've already had imaging or a previous TMJ workup with another provider, bring those records to the first visit.

Do you have a CBCT scanner in your office?

Yes. Kerst & Caskey uses in-office CBCT (Cone Beam Computed Tomography) for 3D imaging of the temporomandibular joint bone anatomy, dental implants, and complex restorative planning. CBCT delivers detailed 3D images at significantly lower radiation exposure than a traditional medical CT scan, and images are available the same day.

Do I need an MRI to diagnose TMJ?

Not for most patients. A thorough clinical exam, occlusal analysis, BioJVA screening, and — when needed — CBCT imaging are sufficient to guide treatment for the majority of TMJ cases. MRI is the gold-standard imaging for the soft-tissue disc inside the joint and may be recommended when disc-displacement or soft-tissue pathology is suspected. When MRI is indicated, Dr. Kerst coordinates the referral and continues to manage the case.

How long does it take to feel relief from TMJ treatment?

Many patients feel significant symptom relief within the first few weeks of wearing a properly fitted occlusal appliance, particularly relief from morning headaches and jaw soreness. Full resolution of chronic TMJ patterns often takes several months and may involve appliance adjustments along the way. Acute pain can frequently be reduced at the first visit with a temporary appliance or other immediate intervention.

Will my medical insurance cover TMJ treatment?

TMJ coverage varies widely between medical and dental plans. Some medical insurance plans cover TMJ evaluations and appliances; some dental plans cover the appliance only. Kerst & Caskey is out-of-network and fee-for-service, but the office files claims on your behalf with both medical and dental insurance when TMJ treatment may be a covered benefit.

Is TMJ surgery ever necessary?

Surgery is rarely needed. The overwhelming majority of TMJ patients respond well to conservative, non-surgical treatment including night guards, occlusal appliances, and bite adjustment. When surgery is indicated for structural joint damage, Dr. Kerst refers to an oral and maxillofacial surgeon and continues to coordinate care.

Can a night guard fix my TMJ?

A custom night guard fitted by a dentist trained in occlusion is one of the most effective TMJ treatments available, particularly for patients whose primary symptoms involve nighttime grinding and morning headaches. Over-the-counter night guards from drugstores are not equivalent. They're typically too thick, are not fitted to your bite, and can sometimes worsen TMJ symptoms by introducing an imbalanced occlusion and training your muscles to bite more, instead of less, while you sleep. These appliances can also worsen symptoms of sleep apnea and create an airway obstruction that leave you feeling tired and groggy.

If you're experiencing jaw pain, morning headaches, or grinding-related symptoms, schedule a comprehensive TMJ evaluation with Dr. Jeffrey Kerst at Kerst & Caskey Family Dentistry. The exam includes occlusal analysis, digital imaging, and a discussion of conservative treatment options tailored to your case.