• Richard D. Downs, D.D.S

  • Aaron J. Rauen, D.D.S

  • Jack E. Osterhaus, D.D.S

(563) 556-8388

Bad Bite/Headaches

If pain is dictating the quality of your life, this information can change your life forever!

TMJ is just one of the symptoms of a Neuromuscular disorder. Others are Migraines, frequent headaches, facial pain, neck, shoulder and back pain, unexplained loose, sensitive or painful teeth, worn or cracked teeth and/or crowns, jaw pain, clicking or popping of the jaw joints, numbness in fingers or arms, depression, vertigo, and ringing in the ears. Most people who are needlessly suffering have no idea that these symptoms can be stemming from their mouth! A misaligned bite which is preventing their jaw joints, muscles and teeth to be working harmoniously together is physically stressful enough to do this. Through miraculous advances in detecting Neuromuscular disorders, patients who thought they were doomed to live like this forever, are being cured everyday!!!

Neuromuscular Dentistry focuses on dental pain related to a misaligned bite. When a misaligned bite causes your jaw muscles to work too hard to align your teeth, jaw and muscle tension are the result. Other health problems, such as Temporomandibular Joint Disorder (TMD), are also likely.

What causes TMD?

TMD is a common and painful condition of the jaw and surrounding facial muscles originating with the Temporomandibular Joint (TMJ). This joint connects your lower jaw to the temporal bone of your skull and controls jaw movement, talking, chewing and yawning. When problems with this joint occur, the result is TMD, a condition that can become quite painful if left untreated.

Through their extensive training in Neuromuscular Dentistry, dentists like Dr. Downs and Dr. Rauen work with the hard and soft tissues, muscles and nerves of your jaw to return your jaw to optimal positioning for the greatest symptom relief.

At Abbadent Family & Cosmetic Dentistry, we use a variety of advanced dentistry techniques combined with state-of-the-art technology to achieve your best jaw position, including:

  • Orthotic bite positioning
  • Porcelain bonding
  • Orthodontics
  • Full-mouth reconstruction

Is your head, neck, jaw and/or facial pain caused by TMD? There's only one way to find out and find relief. Contact us today to schedule your neuromuscular dentistry consultation.

TMJ Symptoms

Symptoms of TMJ/TMD may include but are not limited to:

  • Head and face problems
    • Headaches and migraines
    • Neck pain
    • Jaw pain and soreness
    • Jaw or neck stiffness
    • Facial pain
    • Forehead pain
    • Cluster headaches
    • Sinus-like headaches
    • Scalp tenderness
    • Mouth, face, cheek, or chin pain
    • Dizziness or vertigo
    • Tongue pain
  • Tooth and gum problems
    • Premature tooth wear
    • Tooth loss
    • Teeth clenching
    • Teeth grinding
    • Tooth pain
    • Tooth sensitivity
  • Jaw problems
    • Limited opening of the jaw
    • Locking of the jaw
    • Clicking or popping of the jaw joints
    • Uneven alignment of upper and lower teeth when jaw is closed
    • Uncontrollable jaw movement
  • Ear problems
    • Ringing in the ears
    • Hissing or buzzing in the ears
    • Clogged ears
    • Hearing problems
    • Ear pain or soreness
  • Eye problems
    • Pain
    • Blurred vision
    • Bloodshot eyes
    • Increased eye pressure
    • Light sensitivity
    • Watery eyes
  • Throat problems
    • Swallowing problems
    • Tightness in the throat
    • Sore throat
    • Voice fluctuations
    • Laryngitis
  • Other problems
    • Neck or shoulder pain
    • Back pain
    • Tingling or numbness in the arms or hands

If you are experiencing one or more of these symptoms, you may want to see a skilled neuromuscular dentist. Dr. Downs and Dr. Rauen diagnose and treat TMJ/TMD.  Contact us today for your free neuromuscular dentistry consultation.

The Science Behind the Bite

Biting and chewing are such routine actions, and most people rarely think about the complex mechanism that makes these processes work so effortless.  Just moving the jaw up and down seems simple, but the process of mastication (chewing) requires nerves, muscles, joints, bones, and teeth to interact seamlessly.  When they do not work together, a painful, chronic condition as TMD (temporomandibular joint disorder) can develop, which causes a whole host of pain, sometimes debilitating symptoms.

Mechanics of Motion

A group of four muscles - the tensor tympani, tensor veli palatini, mylohyoid, and the digastrics - raise the lower jaw (mandible) up to the upper dental arch (maxilla). The mandible moves up and back aided by the temporomandibular joint, often called the TMJ.

The TMJ is one of the most complex joints in our body, which is why dentists not trained in neuromuscular dentistry may not accurately diagnose TMD (teporomandibular joint dysfunction).  Iowa Dentists, Dr. Downs and Dr. Rauen, are experienced in diagnosing and treating TMD (temporomandibular joint disorder) and will not overlook any potential TMJ problems.

The top and bottom rows of teeth fit together when the muscles and TMJ do their job. Usually, it feels like our two rows of teeth match perfectly.  Actually, most people have some degree of malocclusion, a misalignment of the teeth generally called underbite or overbite.

Small Problems Become Big Problems

Many patients and some dentists may not worry about malocclusion or consider it a serious issue.  However, misaligned teeth force facial muscles into a stressed position, which can eventually cause TMD.  Most often with TMD, the articular disc has become displaced, allowing painful bone-to-bone contact.

TMD can cause a broad range of symptoms.  Even though the issue begins with the teeth and jaw, pain can spread to other regions of the face, head, neck, and shoulders through the trigeminal nerve.  The trigeminal nerve activates facial movements like chewing, but it is also responsible for carrying pain signals from all parts of the head and face.

TMD should only be treated by a trained neuromuscular dentist like Dr. Richard Downs and Dr. Aaron Rauen, who serve the Tri-State area.  If you have chronic headaches, muscle pain, or other symptoms, please contact our office right away @ 563.556.8388.

TMD Diagnosis

Treating TMD is no easy task. The nerves, muscles, joints, teeth and supporting oral structures must all be thoroughly evaluated for an individual diagnosis of the cause of your TMD, and to determine the best course of treatment.

Fortunately, advances in dental technology now allow Dr. Downs and Dr. Rauen to more accurately measure and determine your most comfortable jaw position, and to outline a customized course of treatment to achieve your goal of pain relief.

The TMD Examination

At Abbadent Family & Cosmetic Dentistry, our evaluation begins with your comprehensive medical and dental history.

Other features of the initial evaluation include:

  • Radiographic examination (X-rays)
  • Muscle palpation
  • Posture analysis
  • Photographs
  • Computerized technology

State-of-the-art dental technology plays an important part in your TMD diagnosis. Abbadent Family & Cosmetic Dentistry offers the very latest technology for a fast, accurate and thorough diagnosis, 

TENS - Transcutaneous Electrical Neuromuscular Stimulation

The MyoMonitor is an ultra low frequency TENS unit that delivers a mild electrical impulse to the muscles. This positively affects the muscles with relaxation, increases blood flow, and removes toxins, to coax muscles back to their most comfortable length and position.

If you think TMD may be the cause of your pain, contact us.

TMD Aches & Migraine Headaches

Migraines are different from normal headaches. They come with strong, throbbing pain in part of the head, nausea, vomiting, and sensitivity to light and sound. This combination of symptoms can be extremely painful and interfere with quality of life. Because migraines typically affect the visual center of the brain, they can be preceded by visual disturbances such as an aura.

Insomnia, anxiety, stress, and overexposure to light can all trigger migraine but are not the ultimate cause. The root causes of migraines probably involve a combination of blood vessel issues and heredity, but scientists are not all in agreement. Three times as many women as men suffer from migraines, but the reason for this is not well understood.

TMJ - Another Migraine Factor

Many migraine sufferers are not aware that their migraines may be caused by TMD (temporomandibular joint disorder). They may not know that a problem involving the teeth and jaw could cause such intense pain. Also, primary physicians do not always consider TMD as a possible cause of migraines since they usually are not trained in neuromuscular dentistry.

TMD is a medical condition caused by malocclusion (misaligned teeth/bite), which strains the TMJs (temporomandibular joints) that link the jaw with the cranium. TMJ misalignment or dysfunction is a serious issue, and can cause migraine-type headaches. This is because the trigeminal nerve, responsible for jaw movement, also transmits pain from nerves throughout the head and neck.

Other TMD symptoms include:

  • Pain in the back, neck, or face
  • Tingling or numbness in the arms or hands
  • Jaw pain, stiffness, soreness
  • Dizziness or vertigo

If you have frequent migraines or other symptoms, you may have TMD. Dr. Richard Downs and Dr. Aaron Rauen are neuromuscular dentists trained at the Las Vegas Institute for Advanced Dental Studies (LVI), and they can tell you if your headaches are the result of TMD.

Treating TMD

Abbadent Family & Cosmetic Dentistry uses high-tech diagnostic equipment that helps provide definitive answers about whether TMD is causing your headaches. After a diagnosis of TMD, they will develop with you a treatment plan to relieve your pain and return you to a life without migraines.

Dr. Richard Downs and Dr. Aaron Rauen diagnose and treat TMD patients in Dubuque and the surrounding Tri-state area. To find out if your migraines, headaches, or other symptoms are caused by TMD, please contact Abbadent Family & Cosmetic Dentistry to schedule a free neuromuscular evaluation.

Why is the treatment Needed?

If TMJ/TMD is left untreated, symptoms can worsen and extend far beyond the jaw and mouth area. Your dental health can be negatively affected in the form of tooth loss and even your overall health can be affected.

Neuromuscular treatment helps those suffering from TMJ/TMD find the ideal at-rest jaw position. Through the use of medication, orthotic devices, and dental improvements, you may be able to permanently restore a well-aligned bite and avoid the symptoms of neuromuscular dysfunction.

Learn more about TMJ/TMD and the benefits of experienced neuromuscular therapy. Call us at 563.556.8388 or email today for your free bite evaluation.


At Abbadent Family & Cosmetic Dentistry, our highly skilled neuromuscular dentistry team takes the time to thoroughly evaluate your symptoms and examine your jaw joint system using high-tech diagnostic equipment. Once you are diagnosed with TMJ/TMD, our doctors will use their findings to develop a personalized neuromuscular therapy plan to restore your bite and give you relief from your symptoms.

A diagnosis of TMJ/TMD means you have a dysfunction in the jaw joint and jaw muscle areas. Your neuromuscular dentist will study the relationship between your teeth, jaw muscles, and your jaw movements, to understand the dysfunction and formulate a strategy for improvement. Treatment may involve repositioning the jaw into its most comfortable posture and supporting it with an oral appliance.  Once comfort is attained, more permanent support is attained through Orthodontics or restorative procedures.

Each individual has unique jaw joint dysfunction, and a combination of therapies may be recommended for permanent correction. The goal of treatment is to alleviate pain, soreness and other symptoms and to improve the function of the jaw joint.

Treatments for TMJ/TMD may include:

  • TENS electrical stimulation
  • EMG measurements of Facial Muscles
  • Cosmetic Dentistry
  • Oral appliances
  • Medication
  • Physical therapy
  • Lifestyle recommendations

TMJ/TMD treatment is affordable! Visit our affordable financing page to learn more.


Why are TMJ and related problems so hard to diagnose?
First of all, the majority of dental providers in this country are not trained in neuromuscular diagnosis and treatment. While the causes may include tooth grinding, physical injury, or genetic defects, only specially trained neuromuscular dentists are taught to recognize indications of bite problems.
Because neck pain, migraine headaches, and tooth problems can be rooted in a number of other causes, general dentists and family doctors may ignore the possibility that TMJ is the culprit. In other instances, dentists or doctors may recognize a bite problem, but are at a loss for how to find its cause.
The development of impressive diagnostic technology has helped neuromuscular dentistry become less of a mystery in practices committed to finding TMJ answers and offering state-of-the-art diagnosis and treatment.

Can you make headaches and other symptoms disappear?
While temporary relief of TMJ symptoms is sought initially, the goal of our neuromuscular dentists is to identify the root of the problem and treat it for permanent relief. There are no guarantees that your symptoms are in fact caused by TMJ, or that our treatment options will be successful. However, our dentists at Abbadent Family & Cosmetic Dentistry have an extremely high rate of success in the treatment of TMJ.

What treatments will alleviate my TMJ pain and discomfort?
Treatments can range from simple to invasive, depending on your level of bite imbalance and your individual needs. Some patients can resolve their bite problems with basic physical therapy or lifestyle changes, while others may need the help of an oral appliance, medication, orthodontics or restorative dentistry.

Is neuromuscular dentistry treatment affordable?
At Abbadent Family & Cosmetic Dentistry, we strive to make neuromuscular dentistry affordable to all patients. While diagnosis and treatment costs will vary substantially based on the case, our financial counselors work with you to create a payment plan you are completely comfortable with. Read more about our affordable financing options.

Why should I choose a neuromuscular dentist?
TMJ is a relatively common problem that hasn't received enough attention in media and medical circles. A highly trained neuromuscular dentist can recognize the sometimes subtle and diverse signs of this syndrome. Dr. Downs and Dr. Rauen are trained to diagnose it and can restore the misaligned bite and help you find relief from neuromuscular symptoms like migraine headaches, jaw pain, and neck soreness. Neuromuscular techniques are also used to restore proper jaw posture before cosmetic or restorative dental procedures when necessary.

Call us today at 563.556.8388 or email Abbadent Family & Cosmetic Dentistry today for your free personal neuromuscular or cosmetic dentistry consultation.

Headache/Migraine Treatment

Migraine headaches are a common symptom of temporomandibular joint disorder (TMJ/TMD), a condition in which a misaligned bite causes dysfunction of the jaw joints. Anyone who's ever experienced a migraine headache knows that the pain can be extremely debilitating and disruptive.

While any doctor may be able to prescribe medication to lighten or eliminate the pain of migraine headaches, medication is a temporary solution designed to control the symptom instead of finding and eliminating the cause.

At Abbadent Family & Cosmetic Dentistry, our neuromuscular dentistry team has done substantial work in the areas of research, diagnosis, and treatment of TMJ/TMD. In treating patients for the root cause of their headaches (neuromuscular dysfunction), we've been able to help many achieve relief from migraine headaches and other symptoms of TMJ/TMD.

If you are experiencing recurring migraine headaches, schedule a free neuromuscular evaluation with our TMJ/TMD dentistry team.

After a highly technical diagnostic process, your dentist will be able to determine if a link exists between the function of your jaw joints and your migraine headaches. Once a link is established and a thorough diagnosis is made, our neuromuscular team will create a personalized treatment plan to realign your bite and alleviate your TMJ/TMD symptoms.
Treatment for migraine headaches may include the use of functional jaw orthopedics, medication, lifestyle changes, orthodontics or restorative procedures. Learn more about neuromuscular treatment.

You may be able to minimize or eliminate migraine headaches. Call us today at 563.556.8388 or email Abbadent Family & Cosemtic Dentistry today for your free TMJ/TMD evaluation.

Treating TMD w/TENS

After your evaluation at Abbadent Family & Cosmetic Dentistry, you may receive a diagnosis of TMD (temporomandibular joint disorder). The painful symptoms of TMD can worsen over time, so we will work with you right away to develop a plan to treat them. One option for TMD treatment is TENS therapy. TENS stands for Transcutaneous [through the skin] Electrical Nerve Stimulation.

One function of TENS is to relieve the pain caused by TMD. TENS therapy also reduces hyperactivity in your jaw and facial muscles caused by TMD-related strain on those muscles. With the hyperactivity reduced, our neuromuscular dentists can determine your jaw's most natural position.

What does TENS feel like?

In TENS therapy, the dentist will attach adhesive electrode patches around your jaw. Then, the TENS machine sends regular, minute pulses of electricity to the nerves beneath your skin. Most people describe the electric pulse as a tapping on their cheeks. Treatments take about an hour, during which you can read, nap, or do a crossword. The facial muscles expand and contract alternately in a relaxing way, making TENS almost like a facial massage using electricity.

How does it work?

TENS unit blocks pain by increasing the levels of endorphins, the body's natural painkillers, in the affected area. Endorphins block pain messages from travelling along nerves to reach the brain. Because of its effects on endorphins, TENS is effective for other conditions that cause chronic pain, such as arthritis.

TENS can not only help diagnose TMD but TENS is also beneficial for treating TMD because it dampens the hyperactivity in the jaw and facial muscles that prevents the jaw bone from resting in its proper position. This allows the dentist to find that proper position, and determine the TMD treatment needed. Once our dentists know your ideal resting jaw position, he or she can figure out how to adjust for optimum occlusion, (the best fit for your upper and lower teeth).

Is TENS right for me?

Our staff and neuromuscular dentist at Abbadent Family & Cosmetic Dentistry are equipped to properly diagnose and treat TMD. If you've received a diagnosis of TMD, we will educate and advise you so that we can choose a treatment strategy together.

Dr. Downs and Dr. Rauen are trained neuromuscular dentists serving Dubuque & the Tri-State area. For more information about TMD treatment or TENS therapy, please contact Abbadent Family & Cosmetic Dentistry via our website book online tool or call us today 563.556.8388.