with Dr. Priya Mistry and TMJ Physical Therapist Josh Dillingham
In this episode of The Unclenched Podcast, Dr. Priya Mistry dives into a rich, multidisciplinary conversation on improving TMJ outcomes through collaboration, education, and full-body awareness. Joined by physical therapist Josh Dillingham, the episode highlights key strategies that dentists and patients alike can use to get to the root of chronic jaw pain—and move toward lasting relief.
Expanding the Practice: Phase Two Reconstruction In-House
To streamline care and improve patient outcomes, Dr. Mistry is expanding her practice by bringing on an associate who specializes in Phase Two full-mouth reconstruction. This addition will allow patients to receive comprehensive, bite-stabilizing treatment under one roof, rather than being referred out for the next stage of care. As Dr. Mistry explained, this expansion is about more than convenience—it’s about continuity, expertise, and long-term success.
Championing DTR Therapy Despite Resistance
Dr. Mistry remains a strong advocate for Disclusion Time Reduction (DTR)—a valuable yet often misunderstood treatment that helps reduce muscle hyperactivity and relieve jaw pain. Despite encountering some resistance from fellow dentists hesitant to adopt new techniques, she encourages persistent education and dialogue. DTR may not be mainstream yet, but Dr. Mistry believes its benefits speak for themselves, especially for patients suffering from persistent, unexplained discomfort.
The Power of Collaboration: Dentistry & Physical Therapy
This episode featured insight from TMJ-focused physical therapist Josh Dillingham, who works closely with dentists to support patients through complex, chronic pain cases. Josh emphasized that TMJ issues rarely exist in isolation. Postural imbalances, cervical spine dysfunction, and airway challenges can all play a role in jaw instability. By approaching treatment with a collaborative, whole-body lens, practitioners can create more durable and meaningful results for their patients.
A standout example shared was a patient named Fallon—someone who required a multifaceted approach involving orthodontics, physical therapy, and postural reconditioning to see lasting improvements in comfort and function.
The Posture-Jaw Connection: A “Vicious Circle”
One of the episode’s most compelling discussions centered on forward head posture—a common issue in today’s tech-heavy world. Josh explained that many people unknowingly push their heads forward to improve airflow, especially if airway obstructions are present. This posture, while compensatory, causes the jaw to retract, putting additional strain on the TMJs and contributing to a cycle of dysfunction.
The takeaway? If the jaw is to heal, posture must be part of the conversation.
What to Look for in a TMJ-Focused Physical Therapist
For patients considering physical therapy as part of their TMJ treatment, Josh offered practical advice. Look for PTs who:
- Offer one-on-one sessions
- Are trained in cranial-facial therapy (CCT)
- Hold certifications such as COMT (Certified Orthopedic Manual Therapist)
- Conduct whole-body assessments, including standing posture, range of motion, and sitting alignment
These clinicians are more likely to understand the intricacies of TMJ and how the jaw fits into the bigger musculoskeletal picture.
Safe Exercises That Support TMJ Health
Josh also shared simple, gentle exercises that can help alleviate tension and improve posture when done correctly. His recommendations included Rocabado’s “Big Three”:
- The “fish exercise”
- Gentle neck retraction
- Light head tipping
He emphasized that these movements should feel comfortable—if they worsen symptoms, they should be stopped immediately. Additionally, for people with desk jobs, Josh advised moving every 15 minutes and walking every hour to avoid postural stagnation.
Final Thoughts: TMJ Treatment Shouldn’t Be Siloed
Dr. Mistry’s commitment to full-body healing is clear. TMJ dysfunction is rarely just a jaw problem—it’s often a symptom of systemic imbalances, from posture to muscle tone to bite function. By integrating dental care with skilled physical therapy, and by continuing to educate others about emerging treatments like DTR, Dr. Mistry and her team are redefining what it means to truly heal.
Dr. Priya Mistry is a TMJ-focused dentist in Vancouver, WA, known for her collaborative, non-invasive approach to treating jaw disorders. Through her practice, TMJ Dental Doc, and her podcast, The Unclenched Podcast, she continues to bring education, compassion, and cutting-edge care to patients everywhere.
