Advanced Education and Training

Dr. Grimshaw has been awarded a Fellowship with the renowned Las Vegas Institute for Advanced Dental Studies, where she has received special training for treating disorders of the temporomandibular joint. She uses neuromuscular dentistry in a comprehensive way to treat TMJ disorders and correct bite alignment.

Neuromuscular Dentistry and TMJ Treatment

Dr. Grimshaw uses neuromuscular dentistry, a holistic approach to dental care by moving beyond just the teeth and gums to also focus on the relationship between the muscles, nerves and joints of the upper and lower jaw.

The goal of neuromuscular dentistry is to create a harmonious balance in the entire mouth to achieve an aligned bite. A balanced bite keeps the jaw joints and muscles moving smoothly and helps eliminate or eradicate the symptoms of a TMJ disorder.

Our Process for Diagnosing and Treating TMJ disorders

TMJ dentist Dr. Grimshaw checking patient for jaw pain

Comprehensive exam and consultation

Dr. Grimshaw will examine the muscles of your head, neck and jaw.

The initial step in determining if you are experiencing problems with your jaw joint is a consultation with Dr. Grimshaw. She will review your medical and dental history, ask what symptoms you have and whether you have been involved in an accident.

Dr. Grimshaw will conduct an examination of the muscles in the head and neck to check for signs of pain, tenderness and stiffness. During the comprehensive oral exam, she will look for broken teeth and bony outgrowths on your jawbone. She will also take an impression of your mouth in its current position.

TENS (Transcutaneous Electrical Nerve Stimulation)

Dr. Grimshaw uses a TENS unit to relax muscles and relieve pain.

After your examination, Dr. Grimshaw uses transcutaneous electrical nerve stimulation to control overactive nerves, relax muscles and stimulate the production of endorphins for effective pain relief.

Electrodes are strategically placed around the jaw area, and a painless, low-level current gently stimulates nerve pathways with a massaging sensation. This not only relieves pain, it allows Dr. Grimshaw to understand the jaw’s motion free from compensating behaviors your jaw may be using to make up for misalignment.

Dr. Grimshaw discussing tmj treatment with Aberdeen patient
TMJ dentist Dr. Mandy Grimshaw performing treatment procedures on patient

State-of-the-art diagnostics

The K7 Evaluation System uses three separate components for comprehensive testing of jaw joint movement.

After TENS therapy, Dr. Grimshaw uses the K7 system to determine if your jaw muscles are fully relaxed.

This comprehensive diagnostic tool is used to evaluate your bite (the way your teeth meet), and the way your jaw functions while opening and closing your mouth.

The K7 system record sounds and movements, as well as measure the tension in your chewing muscles.

When your muscles are relaxed and your bite is in alignment, Dr. Grimshaw takes an additional impression of your teeth for comparison and to send to the lab that fabricates orthotic appliances used in TMJ treatment.

Treating TMJ Disorders

Intermediate orthotic therapy

The first step in treatment is the use of a custom-fitted orthotic device, (also known as a “realignment appliance”) that helps to keep your jaw properly aligned. Orthotic therapy is an intermediate step, with patients wearing the appliance for three to six months until their bite is comfortable.

Solutions to provide long-term pain relief

To correct your bite permanently, Dr. Grimshaw may use crowns, veneers, braces, or clear straightening to correct the way your teeth come together and provide relief from headaches and painful TMD.

Typical Symptoms of a TMJ Disorder

TMJ problems can be hard to diagnose because they can cause so many different symptoms. Typical symptoms of TMJ problems, known as TMD (TMJ Disorder) are:

  • Jaw pain
  • Tooth pain
  • Excessive or uneven tooth wear
  • Jaw sounds like clicking, popping, or grinding
  • Limited jaw motion
  • Locked jaw
  • Chewing difficulties
  • Headaches
  • Neck aches
  • Earaches
  • Ringing in the ears (tinnitus)
  • Vertigo or dizziness
  • Ear fullness
  • Upper shoulder pain
  • Facial pain

There are many different types of TMJ disorders, and not all manifest with the same symptoms. Don’t dismiss TMJ problems just because you don’t have all the symptoms. If you have two or three symptoms, it’s time to talk to a dentist trained in neuromuscular dentistry like Dr. Grimshaw.

Headaches, neck aches, and toothaches are common signs of TMJ.

Causes of TMJ Problems

Just as TMJ can have many symptoms, it can also have many causes. Some of the causes that have been linked to TMJ disorders include:

  • Misaligned bite (malocclusion). Your teeth, joints, and muscles all have to be in harmony for the joint to function properly. When the teeth don’t come together harmoniously, it can cause problems elsewhere in the system, including stressed muscles and misaligned joints.
  • Teeth clenching and grinding (Bruxism). Teeth grinding can be a response to misaligned teeth, or it can be a habite. It might also occur at night. Some night-time teeth grinding is linked to sleep apnea.
  • Stress. People experiencing a great amount of stress can get into the habit of tightening their facial and jaw muscles or clench their teeth.
  • Trauma and injury. If your jaw was injured, you might develop TMJ disorders, either directly from the injury or secondarily from your compensation habits during recovery. You don’t need to get a blow to the jaw to injure it. Whiplash from car accidents can also trigger TMJ disorders.
  • Dislocation of the joint from the socket. This can occur as a result of trauma, but it’s also possible to dislocate your jaw with normal daily activities. Yawning is a common cause of TMJ disorders that bring people to the emergency room.
  • Referred pain. Referred pain is when pain in one part of the body feels like it’s in another part, such as when a heart attack feels like arm or jaw pain. This doesn’t explain TMJ disorders, but it does explain some of their far-reaching symptoms.

$99 New Patient Special Offer Exam, X-rays and Consultation

If you are experiencing pain in your neck, head and/or jaw, please schedule an appointment to meet with Dr. Grimshaw and find out if a badly aligned bite is causing your troubles.

This special offer includes the following:

  • Comprehensive oral exam
  • 3D Dental CT Scan
  • Full-mouth digital X-rays
  • Full series of digital photos
  • CT of head and airway
  • Extraoral head and neck exam
  • Oral cancer screening
  • Periodontal exam
  • Restorative exam (check for decay in existing crowns, fillings, bridges)
  • Check for bite alignment and TMJ issues
  • Get your questions answered

(A $331 Value)

To make an appointment, call (910) 692-4450 or click here to request an appointment online.


Photo of George after completing his TMJ treatment with Dr. Grimshaw.“I was referred to Mandy Grimshaw by an ENT physician. After several procedures to alleviate sinus, neck and ear pain, the physician suggested that the root cause may be TMJ.

“Over my lifetime I’ve been to several different dentists. Each dentist would note the wear on my teeth from the grinding/clenching, but Dr. Grimshaw was the first to use a proven procedure to demonstrate and correct the misalignment of my jaw. It’s so refreshing to find a dentist that can handle the routine dental care as well as conditions that are not readily evident.

“I’m sleeping better at night, and the headaches are gone. I wish I had done this years ago. Thank you, Dr. Grimshaw.”


To make an appointment, call (910) 692-4450 or click here to request an appointment online.