Rock Valley Dental

1302 10th Street

Rock Valley, IA 51247

(712) 476-2749


Temporomandibular disorder (TMD) is the name given to a multitude of problems with jaw movement and pain in and around the jaw joint, and head and neck. TMJ (Temporomandibular Joint) and/or TMD generally don’t start as an acute condition. The symptoms can be caused by many different types of problems, including arthritis, jaw injury, muscle fatigue from clenching or grinding your teeth. New research has determined TMJ is seldom independent of airway and breathing problems. Often the causes of TMD are multifactorial and complicated.


  • Facial pain, ear or jaw pain
  • Swelling over the joint
  • headaches
  • Facial pain/ear pain/jaw pain
  • Clicking/popping of the jaw joint
  • Locking of the jaw open or closed
  • The feeling that only one or a few teeth are touching while biting together
  • Difficulty and or pain with chewing
  • Chipped or worn teeth
  • Sleep disordered breathing/ night bruxism
  • Tinnitus or ringing of the ears

Most people become conscious of their symptoms, ranging from annoying aches to debilitating headaches/migraines or neck, shoulder or back pain, only after they start impacting their quality of life.Conditions inside your mouth and airways change over time, and when they affect your bite, they can cause TMD.

Dr. Koth’s extensive training at the Pankey institute, ACORN group, and with the AADSM is based on non-surgical treatment of TMD to bring the jaw and bite back into alignment for long-term relief. Sometimes, restoring jaw alignment can be as basic as repairing a chipped tooth or replacing a missing tooth or a worn-out crown or filling. Other times treatment may indicate an occlusal splint or oral appliance. Occlusal Appliances are custom-designed and fabricated to reduce stress on your jaw, and they can only be prescribed after a thorough clinical examination. Occlusal Appliances allow muscles to function optimally and/or overcome issues affecting your bite. When the treatment works as designed for your condition, it can help the lower jaw reposition properly into its socket and thereby reduce or eliminate pain.

In most cases, there may be an airway/sleep component that is causing your TMJ.  These cases are often associated with bruxism and or clenching. Dr. Koth has screening measures that will best help determine if factor needs to be addressed in order to resolve your TMD and improve your overall health.

Tooth Clenching, Tooth Grinding, Bruxism and TMJ Pain are caused by:

  1. Airway Restrictions caused by a small mouth, small nasal passageways and crowded tongue and tonsil spaces.

  2. An incorrect bite

  3. ….Stress and poor work conditions are major contributing or exacerbating factors, but they do not cause TMJ symptoms or pain alone.

Specialized Physical Therapy and/ or Myofunctional Therapy are often a critical yet conservative factor in management of TMD/TMJ. Over worked muscles or alignment problems with the neck and cranial bones can have cascading effects on the TMJ system, and physical therapy can identify and treat these imbalances. Myofunctional therapy restores the correct tone and position of the musculature of the oral cavity. This is because your tongue and surrounding facial muscles directly influence TMJ positioning. You can read more about this service under our Myofunctional Therapy Tab on our website. Whatever your multidisciplinary needs, at Rock Valley Dental we have an integrated team ready to help you.

After our outcomes have been met, and our clinical examination finds no structural disorders in the joint and Occlusal-Appliance therapy or another intervention is successful, we can then restore occlusal equilibrium if necessary. This treatment involves selective reshaping of the biting surfaces of the teeth so that the jaw can close properly. This solution will eliminate the need for a splint to hold the jaw in alignment. Once the jaw can close properly, the body has a greater chance of healing itself. Sometimes orthodontics will also be employed to help joint, muscles and teeth work in harmony.

In most cases, conservative treatment leads to successful outcomes for our patients. At Rock Valley Dental we offer an informative, integrative approach to TMD treatment and we will help you understand the reason for your TMD and help you achieve pain-free results. Our goal is to empower you to take control of your care and treatment outcomes. If you would like to learn more about TMJ disorder, its causes and dental treatment methods, set up an appointment with Dr. Koth and the team at Rock Valley Dental.

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Rock Valley Dental


8:00 AM-4:00 PM


8:00 AM-4:00 PM


8:00 AM-4:00 PM


8:00 AM-4:00 PM