If you constantly struggle with jaw pain, neck discomfort, or debilitating headaches, the small temporomandibular joint (TMJ) that enables your mouth to open and close might be the culprit. This joint is tiny, but it’s more complex than any other joint in your body.

TMJ is usually trouble-free, and you don’t even realize it exists. But when things are not right, you may experience discomfort that is hard to ignore while talking, eating, or yawning. If left untreated, it can make you feel dizzy, give you headaches and migraines, cause ear, neck, shoulder, and back pain, and even send pain shooting down your arms.

Only a quarter of those with this condition seek professional help for their symptoms. Stop letting TMJ disorder disrupt your life and enable Moonlight Sleep REMedies to help you get back to feeling healthy again, without pain. Dr. Mika Miyamoto, DMD will take a comprehensive approach to treating TMJ pain beyond the obvious symptoms.

How We Treat TMJ Disorders (TMJ/TMD)

Before recommending a treatment, we must understand what is causing issues in your TMJ. It could be arthritis, poor head posture, an injury, joint and muscle fatigue, and injury from worn-out dentition and/or not-so-ideal dental work, or it could be simply a stress-induced clenching and grinding. Dr. Miyamoto starts with a thorough physical examination to see how well your jaw and neck can move and take a good look at how you hold yourself.

Once she identifies the full scope of the problem, she comes up with a treatment plan to get rid of the pain NOW but also make sure it doesn’t come back. But your treatment goes beyond what happens in our office; we work with your primary care physician, orthodontist, and other care providers to improve your health and sustain the results for a lifetime.


Photobiomodulation Therapy by Fotona Laser®


Low-level laser therapy (LLLT), recently named photobiomodulation therapy (PBMT), which has been indicated to have bio-stimulating and analgesic effects without making a thermal response, is considered a conservative and non-invasive way to improve function and reduce symptoms in TMD patients. If a patient comes into our office with severe pain, in our office, this is the ideal first line of treatment to reduce the pain right away before we offer the traditional Botox injections to weaken the muscle to reduce the pain. Dr. Miyamoto uses her Fotona Laser® to apply the laser on your painful TMJ and surrounding area for a short time. You will feel a warm sensation when the laser is applied, but never hot. You will definitely feel better right after the treatment, and the symptoms keep getting better over time within the next 24 hours.

Muscle Deprogrammer Oral Appliance

Muscle Deprogrammer Oral appliance is also called anterior deprogrammer or Spear Deprogrammer (named after Dr. Frank Spear). It is a mouth piece that you can wear day or night time to relax the muscles of your jaw that is causing TMJ disorder. This is another non-invasive way to treat TMJ disorder associated with the tense muscles.

BOTOX® Injection

BOTOX® has been used for TMJ treatment by dentists for a long time. BOTOX® is used to treat facial muscles around TMJ that cause jaw tension resulting in pain. When injected into specific facial muscles affected with soreness and discomfort, BOTOX® relieves TMJ and jaw tension by weakening the muscles for many patients. The injections often eliminate headaches resulting from teeth grinding, and in cases of severe stress, BOTOX® can even minimize lockjaw. Unlike PRF injection, BOTOX® does not repair the damages caused by TMJ disorder or treat the root cause of the disorder. If BOTOX® injection does not calm down the pain of TMJ, then we may assume that you have an issue with the joint itself. In that case, you may move forward with PRF(Platelet-Rich Fibrin) treatment.

PRF Treatment

Think of Platelet-Rich Fibrin (PRF) as a super-healing gel that is derived from your own blood. When we spin your blood in a centrifuge, it separates into different layers, and one of those layers is packed with platelets and growth factors. These are the body’s natural healing elements. PRF is one such layer, and it’s packed with regenerative components from your own body.

What Can Be Treated With PRF Injection?

PRF can be injected in weakened or injured joints, ligaments, and tendons. Arthritic joints and sports injuries can be treated with PRF injection. It can also be used as a treatment method for ACL tears, iliotibial band syndrome, plantar fasciitis, rotator cuff tears, shin splints, and tennis elbow. In the same manner, when we inject PRF into the injured TMJ area, it reduces the inflammation and encourages healing and recovery.

How Many Treatment Sessions Are Needed?

Most patients only need 1-3 treatment sessions, and each set is spaced approximately 2-3 months. However, others may require more than three PRF injections depending on their conditions and how they respond to the medication. There is no limit to the number of sessions the patients can have. The risks and side effects of the treatment won’t change no matter how many sessions they go through.

Here is how PRF procedure works:

Blood Draw

Just like getting a blood test, a small amount of your blood is drawn (generally from your arm). After cleaning and prepping the area, we use a small needle to draw a vial or two of your blood, usually from the inside of your elbow. It may feel like a sharp pinch, but it’s over before you know it.


The vial of your blood is placed in a special centrifuge, which is essentially a machine that spins really fast. This causes the blood to separate into layers based on the density of the components: red blood cells at the bottom, PRF in the middle, and plasma on top. The PRF layer is what we are after; it settles in the middle and is rich in platelets, white blood cells, and growth factors.


The final step is applying the PRF to the TMJ area through an injection. The PRF is carefully drawn into a syringe from the middle layer of the centrifuged blood. Then, using a fine needle, it’s injected directly into the affected area around your TMJ. This process might take a few minutes, depending on the extent of the treated area. The injection itself is quick.

What to Expect After the Treatment

Right after the injection, you might experience some soreness or swelling in the injected area. This is normal and part of the body’s response to the PRF injections. It’s mild for most patients and can be managed with over-the-counter pain relievers. Applying ice packs in short intervals (about 15-20 minutes on, then off) can also help reduce swelling.

In the days following the injection, any initial swelling or discomfort should start to diminish. You may find that you can return to regular activities within a day or two. However, it is important to avoid strenuous activities or heavy jaw movements that might stress the TMJ area for a short period. We will give you specific guidelines based on the extent of your treatment.

While the short-term recovery is quite quick, the true benefits of PRF injections come through over the longer term as the platelets and growth factors within the PRF stimulate regeneration in the TMJ area. This process doesn’t happen overnight. You might start to notice improvements in TMJ symptoms, such as pain reduction, increased mobility, or decreased clicking noises, within a few weeks. Still, the full effects of the treatment may take several months to manifest.

Dr. Miyamoto may recommend follow-up appointments to monitor your progress and determine if additional injections are needed. The number of PRF injections required can vary based on the severity of your TMJ disorder and how well your body responds to them.

Use the Healing Power of PRF Therapy for TMJ Relief

Using PRF is a relatively new approach, but it is gaining traction because it is all-natural (coming from your own body), and taps into the body’s innate ability to heal itself FAST. Since it’s drawn from your own blood, the risk of rejection or allergic reactions is virtually non-existent.

If home remedies or BOTOX® Injection for TMJ pain have not worked for you, and you don’t want to undergo more aggressive treatments (like surgery), contact the team at Moonlight Sleep REMedies. The dedicated staff at our office in Portland, OR, can set up a consultation to determine whether PRF might be the solution you need.