TMJ & TMD Treatment in Hillsboro — Relief from Jaw Pain, Headaches, and Clicking

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TMJ & TMD Treatment in Hillsboro — Relief from Jaw Pain, Headaches, and Clicking

If you wake up with sore jaws, get tension headaches that start near the temples, hear clicking or popping when you open your mouth, or have had your jaw lock open or closed — those are signs of a temporomandibular joint disorder (TMJ/TMD). At East Wind Dental Care in Hillsboro, Dr. Merat Ostovar diagnoses TMD and treats the majority of cases conservatively with custom night guards, occlusal splints, and behavior modification. Surgery is rarely needed and only used as a last resort. To schedule a TMJ evaluation, call (503) 614-0198.

What Is TMJ/TMD?

The temporomandibular joint (TMJ) is the hinge that connects your lower jaw to your skull, just in front of each ear. You have one on each side. They are the most-used joints in the body — every time you talk, chew, swallow, or yawn.

A temporomandibular disorder (TMD) is the term for any dysfunction of that joint, the surrounding muscles, the cartilage disc inside the joint, or the way your bite distributes force. The Academy of General Dentistry (AGD) groups TMD into three broad categories: muscle-driven (myofascial pain), joint-disc disorders (internal derangement), and joint-surface disorders (osteoarthritis or inflammatory arthritis). Most patients we see have a combination of more than one driver.

“I tell every TMJ patient: a custom night guard does not ‘cure’ TMD — it interrupts the cycle. Most jaw pain in adults is muscular, driven by night-time clenching, daytime stress holding, or a bite that loads one side harder than the other. Once you stop reinforcing the pattern, the muscles calm down, the headaches fade, and the joint stops getting hammered. Surgery should be the absolute last option, not the first.” — Dr. Merat Ostovar, DMD, FAGD

What Are the Symptoms of TMJ/TMD?

TMD symptoms vary by patient, but the most common patterns are:

• Jaw pain or soreness — especially in the morning, or after long periods of talking or chewing
• Tension headaches — typically starting at the temples or behind the eyes, sometimes radiating to the back of the neck
• Clicking, popping, or grinding sounds when opening or closing the mouth
• Limited opening — difficulty opening wide, or jaw “catching” before it opens fully
• Locked jaw — the jaw locks open or closed and will not move; this requires prompt evaluation
• Ear symptoms — ear pressure, ringing, or pain in front of the ear with no infection
• Facial muscle fatigue — sore cheeks, sore temples, or a tired feeling in the jaw after meals
• Tooth wear — flat spots, chipped edges, or sensitive teeth from grinding (bruxism)
• Neck and shoulder tension — the muscles that move the jaw connect into the cervical chain

If your jaw locks open or closed and will not return to position, or if jaw pain is accompanied by swelling, fever, or trouble swallowing, call (503) 614-0198 the same day. Those are signs that need prompt assessment.

What Causes TMJ/TMD?

In our Hillsboro practice, the most common drivers we see are:

• Bruxism (clenching and grinding) — usually at night, often without the patient knowing. The single most common driver of muscular TMD.
• Stress and posture — daytime jaw clenching, screen-time forward-head posture, and shoulder tension all funnel into the jaw muscles. Common in Intel Ronler Acres / Jones Farm campus engineers, Nike WHQ, and the broader Hillsboro tech sector where deadlines and long meetings stack up.
• Bite imbalance (malocclusion) — when teeth meet unevenly, one joint takes more force than the other and breaks down faster
• Trauma — a blow to the jaw, a sports injury, or whiplash from a car accident
• Arthritis — osteoarthritis or rheumatoid arthritis affecting the joint surfaces
• Recent dental work that changed the bite — a high crown or filling can trigger TMD symptoms within days
• Genetics — some people are simply more prone to disc displacement and joint laxity

Most cases involve more than one of these. Treatment works best when it addresses the dominant drivers, not just the symptoms.

How Do You Diagnose TMJ/TMD?

A TMJ evaluation at East Wind Dental Care includes:

• Symptom history — when symptoms started, how often they occur, what makes them better or worse, sleep patterns, stress patterns
• Clinical examination — palpating the joint and the muscles of mastication, listening for joint sounds, measuring opening range and lateral movement, evaluating bite and occlusion
• Wear pattern analysis — flat spots, chipped enamel, scalloped tongue edges, and cheek-line indentations all tell us about night-time clenching
• Imaging when indicated — panoramic X-rays for joint and bone overview; CBCT (3D cone-beam) imaging for joint-disc concerns; MRI referral when soft-tissue evaluation is needed

The exam takes about 45 minutes. Dr. Ostovar then walks you through what is driving the symptoms and which treatment path makes sense.

What Are the Conservative Treatment Options?

About 90% of TMD cases respond to non-invasive treatment. The first-line options are:

Custom Night Guard

A custom-fitted upper or lower night guard is the most common and most effective single treatment for muscular TMD. It works by separating the teeth so the muscles cannot fully clench, distributing bite forces evenly across all teeth instead of concentrating force on a few, and protecting the enamel from grinding wear.

A custom night guard is fabricated from impressions or a digital scan of your teeth, milled or pressed in dental acrylic, and adjusted to your bite. It is not the same as a drugstore boil-and-bite — those are too soft, fit poorly, and can actually make grinding worse. Cost: $400–$700.

Occlusal Orthotic Splint

For patients with more advanced TMD — disc displacement, joint pain on opening, or failed night-guard therapy — an orthotic splint is a more substantial appliance designed to reposition the jaw into a less-stressed position while the joint heals. It is typically worn full-time for several months, then weaned to nighttime only. Cost: $1,500–$3,000.

Behavior Modification and Self-Care

• Awareness training — learning to keep the teeth apart during the day (“lips together, teeth apart”)
• Soft-food diet during flares — avoiding tough meats, chewy bread, hard nuts, and ice
• Heat for chronic stiffness, ice for acute flares — both reduce muscle pain
• Jaw stretches and exercises — Dr. Ostovar can prescribe a basic protocol
• Stress management — meditation, yoga, sleep hygiene; counseling when stress is the dominant driver
• Posture correction — especially for desk workers; forward-head posture loads the jaw muscles continuously

Physical Therapy

For cases involving neck and shoulder muscle involvement, we coordinate with local Hillsboro and Beaverton physical therapists who specialize in craniofacial pain and TMD. PT typically runs 4–8 sessions over 6–10 weeks.

Trigger Point Injections

For patients with persistent muscle trigger points, lidocaine injection therapy can break the muscle-spasm cycle. We also offer BOTOX masseter injections in-house for TMJ muscle hyperactivity; complex cases or patients preferring a specialty setting we refer to Aloha Dental Specialty Center in Aloha. Cost: $300–$600 per session for trigger-point injections; BOTOX pricing varies by units.

What Are the Advanced and Surgical Options?

Surgery is rarely needed for TMD and is reserved for the small minority of patients with structural joint damage — disc perforation, severe arthritis, ankylosis — that does not respond to conservative care.

When surgery is appropriate, Dr. Ostovar refers to an oral and maxillofacial surgeon for evaluation. Procedures range from minimally invasive (arthrocentesis — joint lavage) to arthroscopy (small-instrument joint surgery) to open-joint surgery in the most severe cases. The American Academy of Dental Sleep Medicine (AADSM) and AGD both emphasize that conservative therapy is first-line and surgical referral is appropriate only after non-surgical options have failed.

If you arrive having been told you need TMJ surgery, Dr. Ostovar will give you an honest second opinion before you commit.

Am I a Candidate for TMJ/TMD Treatment?

You may benefit from a TMJ evaluation at East Wind Dental Care if you:

• Wake up with jaw soreness, headaches, or facial pain most mornings
• Notice clicking, popping, or grinding sounds when you open and close
• Grind or clench your teeth during sleep (a partner or family member may have noticed)
• Have difficulty opening your mouth fully, or your jaw “catches” before opening
• Have chronic headaches or ear pain with no clear medical cause
• Work in a high-stress environment where tension accumulates in the jaw and neck
• Have recently had dental work that changed your bite
• Have visible tooth wear, chipped enamel, or sensitive teeth

Conservative treatment works well for most patients. A custom night guard alone resolves or significantly reduces symptoms for the majority of mild-to-moderate TMD cases.

How Much Does TMJ/TMD Treatment Cost in Hillsboro?

| Treatment | Typical Cost |
|—|—|
| Initial TMJ evaluation and exam | $150–$250 |
| Diagnostic imaging (panoramic or CBCT) | $100–$350 |
| Custom night guard | $400–$700 |
| Occlusal orthotic splint | $1,500–$3,000 |
| Trigger point injections (per session) | $300–$600 |
| Physical therapy coordination | No additional charge from our office |
| Surgical consultation (referral) | $200–$350 |

Insurance, Membership, and Financing

Most dental insurance plans cover TMJ/TMD treatment when there is documented clinical need — especially diagnostic imaging, custom night guards, and physical therapy referrals. We accept Delta Dental, Moda, Cigna, Aetna, MetLife, and Guardian and verify benefits before treatment.

For patients without insurance:

• VIP Membership Plan — $299/year for adults, $199/year for children. 15% off all treatment, no annual maximums, no waiting periods, and 100% of payments accumulate as credit toward future treatment if not used. Details on the VIP Membership page.
• CareCredit — 0% interest for up to 24 months on qualifying balances
• Sunbit — instant approval, no hard credit pull
• Cherry Health — flexible monthly payment plans

Jaw pain disrupts sleep, work, and quality of life. Cost should not be the reason you stay in pain. Call (503) 614-0198 to discuss your situation and get a personalized estimate.

What Is the Treatment Timeline?

Recovery and improvement timelines vary by treatment:

Conservative treatment (night guard, behavior modification):

• Weeks 1–2: Adjusting to the appliance. Some patients notice reduced morning jaw pain almost immediately; others take 2–3 weeks.
• Weeks 3–6: Most patients report meaningful reduction in clicking, headaches, and facial tension as muscle inflammation settles.
• Months 2–3: Continued improvement. Physical therapy or jaw exercises if part of your plan.
• Month 4+: Many patients reach a stable, comfortable baseline. Night guard use continues long-term to prevent relapse.

Trigger point injections: Relief within 3–7 days. Repeat every 3–4 months as needed.

Post-surgical recovery (rare cases): 2 weeks to 3 months depending on procedure complexity.

If you are not improving on schedule, we adjust the plan. You should not have to suffer in silence while waiting for a generic protocol to work.

Serving TMJ Patients Throughout the Hillsboro Area

Dr. Ostovar treats TMJ/TMD patients from across west Portland metro:

• Hillsboro and the NE Cornell Road corridor
• Orenco Station and the MAX Blue Line area
• Tanasbourne and the Streets of Tanasbourne
• Aloha and TV Highway
• Beaverton and Cedar Hills
• South Hillsboro and Reed’s Crossing
• Rock Creek and AmberGlen
• Cornelius and Forest Grove
• Intel professionals at Ronler Acres and Jones Farm campuses, Nike WHQ employees

Stop Living With Jaw Pain

A custom night guard alone resolves the majority of TMD cases. Call (503) 614-0198 for an evaluation.

Call (503) 614-0198

What Patients Say

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Rated 4.9 / 5 across 300+ Google reviews — read what Hillsboro patients say about TMJ/TMD treatment.

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Related Services at East Wind Dental Care

• Night Guards — Custom night guards for jaw protection
• Sleep Apnea Treatment — Sleep apnea oral appliance therapy
• Dental Exams — Comprehensive exam with TMJ evaluation
• Crowns & Bridges — Restoring teeth worn from clenching
• Cosmetic Dentistry — Cosmetic restoration after grinding damage
• Preventive Care — Full preventive care program

Areas We Serve

East Wind Dental Care welcomes patients from across Washington County and the west Portland metro area: Hillsboro, Orenco Station, Tanasbourne, Aloha, Beaverton, South Hillsboro, Rock Creek, AmberGlen, Cornelius, Forest Grove, North Plains, and Banks.

Frequently Asked Questions — TMJ Treatment Hillsboro

What is the best treatment for TMJ?

There is no single “best” — the right treatment depends on what’s driving the pain. For muscle-driven TMD (the majority of cases I see in Hillsboro), the first-line treatment is a custom occlusal splint — either an NTI (small front-tooth-only appliance) or a full-coverage hard splint — paired with stress management and a soft diet during flares. For joint-disc problems we add bite analysis with T-Scan and sometimes physical therapy referral. For myofascial trigger points unresponsive to conservative care we use trigger-point injections. We offer BOTOX masseter injections in-house for TMJ muscle hyperactivity; complex cases, patients with multiple trigger points, or patients preferring a specialty setting we refer to Aloha Dental Specialty Center in Aloha. Most TMJ patients tell us they expected surgery and are relieved when I tell them surgery is the absolute last resort.

Can a dentist help with TMJ?

Yes — for the muscle and bite components, a general dentist with TMJ training is usually the right starting point. We do the bite analysis (we use T-Scan for digital occlusal mapping), the splint fabrication, and the conservative management. When the issue is myofascial-driven and conservative care isn’t enough, we refer to physical therapy. When the issue is internal joint disc displacement that isn’t responding, we refer to an oral and maxillofacial surgeon for arthrocentesis or arthroscopy. Open-joint TMJ surgery is genuinely rare.

How long does TMJ treatment take?

Most patients feel meaningful improvement within 6-8 weeks of consistent splint use. The muscles need time to stop being inflamed, and the bite has to settle into the new pattern the appliance creates. The first 2 weeks you’re adjusting; weeks 3-6 the morning soreness fades; by month 3 most patients have reached a stable baseline. Splint use continues long-term to prevent relapse — TMJ is more like managed asthma than a one-and-done fix.

Does insurance cover TMJ treatment?

Often, yes — when there’s documented clinical need. Most major dental plans cover diagnostic exams, imaging, and custom occlusal splints at 50% when documented as medically necessary for bruxism or TMD. Some plans classify TMJ as a medical condition and require billing through medical insurance instead — those usually have higher deductibles but better total coverage. We verify both dental and medical benefits before treatment and provide a written estimate.

What does a TMJ flare-up feel like?

Most TMJ patients tell us a flare starts with morning jaw soreness or temple-area headache, escalates over 24-48 hours into a full ache that radiates from in front of the ear down into the neck, and sometimes locks the jaw so opening past two finger-widths becomes painful. The clicking gets louder. Chewing crunchy food or yawning makes it sharply worse. Triggers we see most often: a stressful work week (Intel deadline crunches, Nike product launches), a recent crown that changed the bite by even 0.1mm, or a long dental procedure that overstretched the joint.

Can TMJ go away on its own?

Mild flares sometimes resolve on their own with a few days of rest, soft food, and ibuprofen. But chronic or recurring symptoms — repeated morning jaw pain, regular tension headaches, persistent clicking — usually don’t go away without treatment because the underlying driver (nighttime clenching, daytime stress holding, bite imbalance) is still there. The longer TMD is untreated, the more likely it is to cause tooth wear, joint changes, and chronic muscle pain that take longer to reverse once you do treat them.

What is the new treatment for TMJ in 2026?

Three things have moved the needle in the last few years. First, T-Scan digital occlusal analysis — instead of marking paper to find a high spot we map bite force in real time and find the load imbalance instantly. Second, BOTOX masseter injections in-house for patients whose muscle hypertrophy is the main driver — relief lasts 3-4 months per round. We refer complex cases or patients preferring a specialty setting to Aloha Dental Specialty Center in Aloha. Third, increased use of trigger-point injections (lidocaine plus low-dose anesthetic) for myofascial pain that didn’t respond to splint alone. We use all three when the case calls for it. Surgical TMJ care has changed less.

Can a Hillsboro dentist diagnose TMJ in one visit?

Usually yes — the initial TMJ evaluation here runs about 45 minutes and includes the symptom history, palpation of the joint and the muscles of mastication, range-of-motion measurement, T-Scan bite analysis, and panoramic X-ray when indicated. By the end of that visit you have a working diagnosis and a treatment plan. The exception is suspected internal disc displacement, which sometimes needs MRI imaging to confirm — that adds a second visit after we get the imaging back.

What sleeping position helps TMJ pain?

Back sleeping with a supportive cervical pillow is the kindest position for the jaw — neutral neck alignment, no asymmetric pressure on the joint. Side sleeping is acceptable if you use a pillow thick enough to keep your neck level (so the jaw isn’t being pushed sideways into the pillow). Stomach sleeping is the worst — the jaw is rotated to one side all night and the cervical extension feeds the masseter. If you’re a stomach sleeper, that habit alone can keep TMJ symptoms going even with a perfect splint.

When should I see a specialist instead of a general dentist for TMJ?

Start with a general dentist who has TMJ experience — most cases are muscle and bite driven and resolve with conservative care a general dentist can manage. Move to a specialist (orofacial pain physician or oral & maxillofacial surgeon) when: symptoms haven’t improved after 3 months of consistent splint therapy, imaging shows joint pathology like arthritis or disc perforation, the jaw locks repeatedly, or a previous TMJ surgery has failed. I refer maybe 5-10% of TMJ patients out of our Hillsboro office — the other 90% we manage in-house.

From Our Dental Library

• TMJ Pain or Migraine — How to Tell the Difference — symptom comparison and when to see whom
• When to See a Dentist for Jaw Pain — red flags and self-care first steps
• Why Your Jaw Hurts in the Morning — bruxism patterns and what they mean

Visit Our Hillsboro Office

Office Location: 7546 NE Shaleen St, Hillsboro, OR 97124
Phone: (503) 614-0198
Hours: Mon/Wed/Fri 8–5 | Tue 7–6 | Thu 7–5 | Sat 7–12 | Sun Closed

Reviewed by Dr. Merat Ostovar, DMD, FAGD | East Wind Dental Care, Hillsboro, OR | Last medically reviewed: 2026-05-05 | Book a consultation

> Dr. Ostovar leads East Wind Dental Care in Hillsboro, which has served the community since 2006. He holds Fellowship in the Academy of General Dentistry (FAGD), a credential held by fewer than 7% of general dentists in the U.S.

Written by Dr. Merat Ostovar, DMD

Doctor of Dental Medicine | 15+ Years Experience

Last updated: May 14, 2026