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Temporomandibular Joint Disorder in the Pediatric Population

Lori Steinley, PT, MS

June 18, 2012



Do you ever have pediatric patients with symptoms of TMD?


Yes I do.  With my craniosacral background, I am starting to wonder if something is happening in labor and delivery as I have seen babies with these symptoms.  This is more craniosacral in nature.  I do not know if the use of more vacuum suction or other techniques in delivery can cause these issues in pediatric patients. 

Labor and delivery is not the only thing that could cause these issues.  I would love to screen these pediatric patients before they get braces.  I treat my own children.  I treated my daughter before she received braces.  I am not against braces, but I want to try to get the muscles and mechanics back to normal before changing the teeth permanently.  I have not seen a lot of pediatric patients, but I have noticed the female patients are getting younger, between 14 and 16.  I have also seen some 12-year-olds.  I would not see patients younger than this as the child’s teeth may not have come in.  This is conservative treatment and there is nothing wrong with checking the mechanics of pediatric patients. 

On a side bar, children who were in a NICU or intubated previously should be checked because their jaw muscles often are very tight.  The lateral pterygoid should be checked.  In babies who cannot suck or nurse, it is possible there is an issue with the lateral pterygoid.  I have treated inside some babies’ mouths to see if it would improve their feeding.  I had an orthodontist in one of my craniosacral classes that said he thinks he would be out of business or have a greatly reduced patient population if physical therapists checked children with issues first.  So not only do I work with dentists, but I target pediatric physicians as well and offer conservative treatment for children in need. 

lori steinley

Lori Steinley, PT, MS

Lori Steinley, PT, MS is a 1988 graduate of the College of St. Scholastica in Duluth, MN with a Bachelor of Arts degree in physical therapy.  She is a 1994 graduate of St. Cloud State University with a Master of Science in Exercise Physiology.  Lori has spent the majority of her clinical practice in outpatient orthopedics with an emphasis on the neck, back, TMJ and headaches.  She began working with patients with temporomandibular disorders in 1992 and has over 250 continuing education hours of instruction in assessment/treatment of the head/neck region. Lori is also a physician assistant, graduating from the University of North Dakota in Grade Forks, North Dakota, Magna Cum Laude, May 2014. She continues to maintain her physical therapy degree but is presently working as a physician assistant in Urology, primarily with pelvic pain patients.   

Related Courses

Temporomandibular Joint-Anatomy/Physiology
Presented by Lori Steinley, PT, MS
Recorded Webinar


Lori Steinley, PT, MS
Course: #1071Level: Intermediate2 Hours
  'Instructor was concise and thorough with information'   Read Reviews
This course is designed to familiarize participants with the anatomy/physiology of the temporomandibular joint.

Temporomandibular Joint-Physical Therapy Assessment and Treatment
Presented by Lori Steinley, PT, MS
Recorded Webinar


Lori Steinley, PT, MS
Course: #1072Level: Intermediate2 Hours
  'Personal education'   Read Reviews
Please note: This course is also offered in a series of recordings titled "The Temporomandibular Joint", course 1416.

This course is designed to instruct participants in the physical therapy assessment and treatment of the temporomandibular joint-including discussion of modalities, manual techniques and home exercises.

Keys For Success: Strategies for Working With Teens and Young Adults With Autism Spectrum Disorders
Presented by Melissa Tovin, PT, MA, PhD, PCS
Recorded Webinar


Melissa Tovin, PT, MA, PhD, PCS
Course: #2588Level: Intermediate2 Hours
  'Great job of explaining why PT is important in this population, and very nice amount of compassion from a PT/parent of ASD child'   Read Reviews
Individuals with ASD often struggle with sensory processing disorder, dyspraxia, overweight and obesity, social-communication impairments, anxiety, and impaired cognition and executive functioning, all of which persist into adulthood and can interfere with independent living, paid employment, quality of life, and community participation. This course will explore current knowledge on the impact of ASD throughout the lifespan, discuss the role of physical therapy in serving this population, and identify resources and strategies to empower patients and families for successful transitions to adulthood. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Series: The Pediatric Hand
Presented by Valeri Calhoun, MS, OTR/L, CHT
Recorded Webinar


Valeri Calhoun, MS, OTR/L, CHT
Course: #3371Level: Intermediate2 Hours
  'Presenter is very knowledgeable and organized in her presentation, great use of pictures'   Read Reviews
Part I: This course will outline the evaluation and treatment principles for the pediatric orthopedic hand patient, including the traumatic hand injured patient, and how it differs from the adult hand population. This course will provide specific evaluation techniques along with treatment ideas. Part II: This presentation will build on the foundational information provided in Part I. It provides the learner with specific information on the evaluation and treatment of the congenital hand patient and the unique challenges this brings to clinicians. Explore functional issues unique to this population and interventions that may assist in improving their abilities.

Please note: This course series is comprised of the following individual recordings: #2533 and #2599.

This course is part of the “Hand and Upper Extremity Review Series.”

Contemporary Guidelines for Exercise and Diabetes: Application to Physical Therapy Cases
Presented by Gina Pariser, PT, LDE, PhD
Recorded Webinar


Gina Pariser, PT, LDE, PhD
Course: #3387Level: Introductory2 Hours
  'A lot of great information plus resources to help keep up-to-date'   Read Reviews
Physical activity is established as an important therapy in the prevention and management of diabetes and diabetes-related health comorbidities. This course reviews new guidelines related to physical activity for improving glucose control and cardiovascular health in people with Type 1 and Type 2 diabetes and highlights ways to apply these guidelines in different physical therapy cases. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.