When jaw joint discs are misaligned, TMJ disorder (TMD) can result, causing inflammation and radiating pain throughout the head, neck, or even body. But this isn’t the only oral health issue with far-reaching effects. Gum disease promotes systemic inflammation too, making routine dental care essential for more than just your smile. By staying proactive with dental appointments, you can reduce the impact of these conditions. Dentists treating TMJ disorders often ask: Which matters more, relieving jaw pain or tackling gum health? Perhaps it’s time to consider a comprehensive approach to protect your overall health.

As we all know, teeth rely on the bone and gums for their support system. However, without good support for the teeth, a TMD appliance will not work as well. Remember the appliance is held on by attaching to the teeth. It is critical that the gums and teeth are checked and the patient continues with their regular checkup. Absolutely! Then, as any good debater would argue, the TM joints are really critical to good health and if the articular discs within the jaw joints are displaced, the pain this causes can be debilitating. The displaced discs can cause headaches, vertigo, visual problems, sleep disordered breathing, and even tremors. TMJ disorder is so poorly understood that it often is ignored until one day when the pain is so great that the patient can barely function. Not so much with periodontal issues- most periodontal patients are able to function just fine with their gum and bone problems. Does this make the TMJ issues more important? Maybe.

The stability of your jaw and its function heavily rely on the health of the periodontium—the bone, gums, and teeth. These structures ensure that the condyle, or jawbone, stays correctly positioned in its socket. When your teeth are healthy, they provide essential vertical support to keep the TM joints functioning smoothly. However, losing teeth, such as bicuspids, can result in the jawbone collapsing deeper into the joint due to the loss of support. Additionally, gum disease can make teeth unsteady, tipping them side to side. This instability causes the condyle to shift deeper into the socket, often displacing the protective disc. Without the disc, the risk of painful bone-on-bone contact increases, which can lead to TMJ disorder. Symptoms such as head and neck pain frequently accompany this condition. To prevent these problems, maintaining good periodontal health is critical, it’s the foundation of a stable and pain-free jaw!

So, what is a patient to do when they have both periodontal and TMJ problems? Is there a way to tell which problem is worse? Sometimes an MRI of TM joints can solve that little question. The MRI will show how badly the articular discs are displaced. If the discs are displaced and in bad shape, that person is experiencing serious symptoms like headaches, neck pain, vertigo, etc., then treating the jaw first and foremost might be a good approach. By working on the debilitating pain factors first, then periodontal treatment will go easier. Ideally this approach will likely be more effective. Another reason why the TMD issues might be more important is when the bite is collapsed, then there is extreme pressure on the teeth and that person might be grinding or clenching their teeth. This huge pressure on the teeth will cause gum recession and bone loss due to the extraordinary pressure that grinding/clenching puts on the teeth. So, for this reason, dealing with the TMJ component as the primary problem makes a whole lot of sense. It will only help with the periodontal issues. This is why it is important to understand the big picture – is it BOTH TMD and periodontal or is it just one or the other that needs attention first.

Treating TMD and gum disease requires team effort. Working with a TMJ specialist and a periodontist together ultimately gets the best results. The connection between jaw joints and periodontal health is significant and addressing them separately may lead to unresolved issues. Understanding the complexity of these conditions is crucial. Since everything in the mouth is interconnected, managing both simultaneously ensures a more effective and holistic approach to overall oral health.

The post Is There a Link Between Gum Disease and TMD? first appeared on Sleep & TMJ Therapy.

Imagine if you had four bicuspid teeth pulled out for braces, like so many people have done over the years. This will often cause the face to retract – come backward – and you end up looking like your grandmother (sorry grandma, but you folks know what I mean). But when the face becomes retracted in this fashion, the airway can become compromised as well. This leads to difficulty breathing and eventually sleep apnea. Sleep apnea can then lead to diseases like cardiovascular problems, diabetes, and even cancer.

Now let’s look at the TMJ component of excising all those teeth. So, when you pull out those four teeth and retract the lower jaw, now the condyles (the heads of the jaw bones) will more likely bang into the jaw socket and pinch up the discs that cover those condyles. Hmmmm … now that’s  a huge management problem – the patient not only has a sunken face leading to sleep apnea, but also has a TM joint problem from a shoved back condyle. Let’s just give up and call it quits already!

By now you are getting the idea- try to avoid extractions or if you cannot then provide support for the correct positioning of your jaw and airway. It is simple as that! I will admit that many years ago, I used to pull teeth for orthodontic treatment. I very quickly realized that this was wrong, and I started doing palatal expanders. Since those early years, I have graduated to using the ALF appliance to not only help with growth, improve the swallow, and to level the bones of the cranium – it’s a much better technique!

Let’s talk about wisdom teeth. Sometimes it’s just necessary to remove them.  There is just not enough room for those teeth. Wisdom teeth removal isn’t just about the procedure itself — it’s about what comes next. When there’s no room for those teeth, extraction is often necessary. But did you know that this process can leave behind 16 square centimeters of bone gaps in the skull? Without support, these areas may collapse, leading to long-term issues. That’s why I recommend ALF appliances to my patients. These devices keep the skull’s bones stabilized, reducing the risk of further complications and minimizing the need for additional treatments. By addressing the aftereffects of extractions, we can ensure better outcomes for our patients. Let’s manage this wisely.

As you can see, dear readers, sometimes you just have to remove teeth as that may be the only option. If that moment arrives, be aware of how to manage the any potential problems before they become too big to handle. Make the time and the effort to see the right doctor and be aware of what might happen when teeth are removed. Thank you.

The post The Case of the Missing Teeth and the Mismanaged Mouth first appeared on Sleep & TMJ Therapy.

As a practitioner of the TMJ disorders, it is important to be sure that the disc goes back into proper perspective, i.e., on top of the condyle, or the slipped disc is managed and monitored. There are occasions, at the end of appliance therapy, the discs are still displaced and not exactly where they really should be. But that does not mean you need surgery – no way! By orthodontically erupting the teeth to protect the jaw joints, oftentimes those pesky little discs will no longer be a worry. The eruption of the teeth means that the condyle is no longer ‘jammed’ into the disc up in the socket which can greatly reduce pain and discomfort. In other words,  you can ‘manage’ and do just fine for years to come.

The important part of all this is that you have to remember that if the discs are slipped off the condyle, you really should do a new MRI and CBCT X-ray every few years to keep an eye on those condyles and make sure they do not get worse. The patients in our office are well aware that if the displaced discs do one day cause the condyles to worsen/degenerate/break down, then it is time to surgically put the discs back into proper position. This is why we tell people: Once a TMJ patient, always a TMJ patient. It’s no big deal to have a new MRI and CBCT every few years. It’s no more difficult than seeing your PCP or your dentist.

With the big question “why is this condylar erosion thing so important to track?” Well, that’s easy enough to answer. First and foremost is if the disc displacement worsens and the condyle breaks down further, then it is time to do the surgery to put the disc back on top of the condyle where it belongs. Sometimes the discs are already too damaged to put back into place, so the disc needs to be removed. There is no need for a disc to be replaced as long as you wear your protective splint. These types of surgery are simple and take less than an hour to perform by a qualified surgeon. No wiring of the jaw.

Now, here is where we get down to the nitty gritty. If the condyle erodes too much, the next step is TJR (Total Joint Replacement) in which the surgeon has to cut away bone and replace it with titanium joints. This is truly a much more involved surgery than the ones described in the previous paragraph. And now the real kicker with any surgery you need to understand the possible side effects. For this the trouble could be with anesthesia, possible infection, damage to the nerves surrounding the face or ear, and structural failure causing the surgery to be re-done. The procedure itself requires the knuckle of the joint to be cut off with a titanium replacement installed. Sometimes, a little of the bone at the base of the skull is removed, and a high-density type of plastic is replaced. The new titanium knuckle now sits into the plastic acting as the new joint and allowing the full range of movements. Recovery generally is 2 to 6 weeks.

As you can imagine, it’s so much easier and so much less involved if you can just keep up with the program, i.e., monitor your situation with an MRI  and CBCT every couple of years and monitoring. So don’t let  that condylar erosion get the best of you!

The post Why Is Condylar Erosion Important with TMJ Treatment? first appeared on Sleep & TMJ Therapy.

Damage to the temporomandibular joint (TMJ) arises from various causes, including injuries, teeth grinding, arthritis, and misaligned jaws. This joint is essential for proper jaw movement, and its damage can manifest pain, difficulty chewing, ongoing headaches, and ear discomfort. When left untreated, symptoms can escalate, resulting in complications that are more difficult and time-intensive to resolve.

In the world of TMD treatment, I tend to find that our patients end up in my office after much frustration and having seen multiple practitioners. Routinely, I will meet a new patient who has been the gamut of ENT, PCP, Neurologist, Spinal specialist, and everything in between and basically all over the map. My record was meeting a patient who had seen 50+ doctors before I met her, and by then it had been years and years of damage to the slipped discs in her joints. Needless to say, she was both upset and angry. After the exam, it took just a few minutes to figure out the problem and demonstrate how the symptoms correlated with the behavior of the discs.

It is unfortunate that so little is known about TMJ disorders and the problems those little slipped discs can cause. With that, I consult with our existing patients and referring doctors to spread the word. Just ask them to ‘spread the word’ and tell family and friends what should be looked at if there is popping and clicking, headaches, any dizziness, and even neck and back pain. If so, the jaw joint discs might be out of place. It is time to get the proper diagnosis.  After a complete head and neck exam the next step will be to order a CBCT x-ray and an MRI of the TMJs to figure out what is going on.

The other side of this imaging can present another problem. The MRI itself, if not done by a really great technician and read by a really great radiologist, may not turn out right. So, here we go again with delays in treatment because the information is not good enough. I actually have had this happen more times than I can count. Frequently, a potential new patient has read my blogs and gets an MRI done at a different location than the one I have used for many years. It might show nothing at all or only minor displacement, but oftentimes it is not quite right and that patient delays treatment and thinks ‘oh well,  the pain should just go away’.  This is part of the diagnosis in treating TMJ disorders – getting the data correctly to avoid difficulties for the patient and delaying proper treatment. Delaying TMJ treatment comes with significant risks. Over time, untreated jaw joint issues can cause lasting damage to the discs and bones in the joint, leading to persistent pain, difficulty moving your jaw, and even the possibility of surgery. Severe cases may require total joint replacement which is a major procedure. This is why addressing TMJ symptoms early is so important.

What this whole experience has taught me is that I really need to spread the word more, and better, to our community. So many people suffer needlessly from TMJ slipped discs and other associated problems, yet they are not seeking treatment. On my end I will keep working at it- one patient at a time. Hopefully this blog will reach more people and help them to understand that it might be a TMJ problem and they might be wise to deal with it sooner than later.

Ignoring TMJ symptoms can lead to severe damage that may require surgery. But with early treatment, you can avoid long-term complications, ease your pain, and restore your quality of life. At Sleep & TMJ Therapy, we offer personalized solutions to treat TMJ dysfunction effectively. Don’t wait for the pain to worsen — schedule your consultation today.

Living with TMJ pain can feel overwhelming, but you’re not alone. TMJ damage is often caused by stress on the jaw joint due to grinding, misalignment, or injury. Left untreated, this condition can lead to long-term complications, including chronic pain, restricted jaw movement, and more.

If you’re experiencing symptoms such as jaw pain, difficulty chewing, or frequent headaches, it’s important to seek treatment sooner rather than later. Acting now can prevent more severe damage, saving you time, money, and discomfort in the future.

The post The Consequences of Ignoring Jaw Joint Problems first appeared on Sleep & TMJ Therapy.

The procedure is especially beneficial for maintaining the health of the temporomandibular joints (TMJs), the two joints connecting your jawbone to your skull. By properly aligning teeth and correcting their height, orthodontic eruption can alleviate stress on the TMJs, protect the sensitive articular discs, and reduce chronic symptoms like: jaw, head, neck, ear, eye pain, jaw sounds while opening or closing, and simply unable to open . It can also promote better long-term dental health by creating a balanced bite that distributes chewing forces evenly.

Orthodontic eruption may take more time and effort than simpler orthodontic approaches, but the benefits it provides extend far beyond aesthetics. This article will explore the science behind orthodontic eruption, its role in TMJ health, and why achieving optimal tooth height is critical to your overall well-being.

The Role of Orthodontic Eruption in TM Joint Health

Your temporomandibular joints (TMJs) play a vital role in everyday functions like chewing, speaking, and swallowing. These joints allow your lower jaw to move smoothly and connect to your skull via a complex structure of bones, muscles, ligaments, and cartilage. At the heart of the TMJs are the articular discs—soft, flexible structures that cushion the bones and prevent wear and tear on the joint.

Orthodontic eruption helps support TMJ health by ensuring that your teeth are properly aligned and that their height supports a balanced bite. When teeth are too short or misaligned, they can create an uneven bite pattern that places excess stress on the TMJs. Over time, this imbalance can cause the articular discs to wear out, leading to discomfort, jaw dysfunction, and conditions such as temporomandibular joint disorder (TMD).

By carefully guiding teeth into their ideal positions, orthodontic eruption can reduce the pressure on the TMJs and promote a more even distribution of forces when you bite or chew. This process not only protects the articular discs but also alleviates strain on the surrounding muscles and ligaments, which can contribute to tension headaches and neck pain. Patients who undergo orthodontic eruption often report improvements in their overall quality of life, including reduced pain and better jaw function.

In addition to preserving the health of the TMJs, orthodontic eruption can improve other aspects of oral health. For example, better-aligned teeth are easier to clean, reducing the risk of cavities and gum disease. A well-balanced bite also prevents uneven wear on teeth, which can lead to long-term dental complications. Ultimately, the procedure is designed to address the root causes of TMJ issues and other oral health concerns, providing lasting benefits for patients.

The Importance of Taller Teeth

One of the primary goals of orthodontic eruption is to achieve optimal tooth height. While the idea of “taller teeth” might seem unusual at first, it plays a crucial role in maintaining the health and functionality of your jaw and the TMJs. When teeth are the right height, they provide adequate support for the jaw, ensuring that the TMJs function smoothly and without unnecessary stress. Short or worn-down teeth, whether due to genetics, grinding, or other factors, can lead to an imbalanced bite. This imbalance forces the TMJs to compensate for the lack of proper support, which can cause the articular discs to bear more pressure than they are designed to handle. Over time, this excessive pressure can damage the discs and lead to painful conditions such as TMD.

Orthodontic eruption addresses this issue by gradually adjusting the height of teeth to create a balanced and harmonious bite. Taller teeth help distribute chewing forces evenly across the dental arches, reducing the risk of joint strain and minimizing wear and tear on the TMJs. As a result, patients often experience less jaw pain, fewer tension headaches, and improved neck alignment. In addition to their functional benefits, taller teeth also contribute to a more youthful and attractive smile. As teeth wear down over time, the lower third of the face can appear shorter, giving the face an aged or sunken appearance. By restoring tooth height through orthodontic eruption, patients can achieve a more balanced facial profile and a rejuvenated appearance.

Beyond aesthetics, taller teeth also improve the effectiveness of orthodontic and restorative treatments. When teeth are at their ideal height, they provide a stable foundation for crowns, bridges, and other dental appliances. This stability ensures that restorative work lasts longer and functions more effectively, reducing the need for additional treatments in the future.

In short, achieving the proper height of teeth is essential for maintaining the health of your TMJs, preventing chronic pain, and improving overall oral function. Orthodontic eruption offers a precise and effective solution to this complex challenge, benefiting both your smile and your long-term well-being.

Three-Dimensional Orthodontic Eruption vs. Cosmetic Orthodontics

Orthodontics can generally be divided into two categories: cosmetic orthodontics and three-dimensional orthodontic eruption. While both approaches aim to straighten teeth and improve the appearance of your smile, they differ significantly in their scope, objectives, and long-term benefits.

Cosmetic orthodontics, such as traditional braces or clear aligners, primarily focuses on the visual alignment of teeth. The goal is to create a straight and aesthetically pleasing smile, often by correcting issues like crowding, spacing, or rotated teeth. While cosmetic orthodontics can enhance your appearance, it may not address deeper issues related to bite alignment, tooth height, or TMJ health.

In contrast, three-dimensional orthodontic eruption takes a more comprehensive approach. This technique not only aligns teeth but also ensures that they are positioned at the correct height and angle to support a balanced and functional bite. By considering the three-dimensional movement of teeth, orthodontic eruption addresses underlying issues that cosmetic orthodontics may overlook, such as uneven bite forces, jaw tension, and TMJ strain. At our office, Sleep and TMJ Therapy, we have developed a method of using the clear aligners to erupt the teeth in a precise and logical pattern to get the optimal positioning for the condyles and articular discs.

The process of three-dimensional orthodontic eruption requires more time, expertise, and patience than cosmetic orthodontics. Each tooth is carefully guided into its ideal position over the course of treatment, ensuring that it contributes to the overall harmony of the bite. While the results may take longer to achieve, the benefits are well worth the effort. Patients who undergo orthodontic eruption often experience improved jaw function, reduced pain, and better long-term oral health. At our office we have done many hundreds of orthodontic cases in this fashion and the success rate is amazingly high.

Another key difference between the two approaches is their focus on durability. Cosmetic orthodontics may produce quick results, but these results can be short-lived if underlying bite issues are not addressed. For example, teeth that are straightened without correcting their height or alignment in relation to the jaw may relapse or cause new problems over time. Three-dimensional orthodontic eruption, on the other hand, provides a more stable and lasting solution by addressing the root causes of misalignment.

In summary, while cosmetic orthodontics can enhance the appearance of your smile, three-dimensional orthodontic eruption goes a step further by improving functionality, relieving TMJ stress, and promoting long-term dental health. This comprehensive approach ensures that the benefits of treatment extend far beyond aesthetics, making it a worthwhile investment in your overall well-being. At our office we will take the time to analyze the relationship between the teeth, the condyles, the articular discs, the cervical spine, and the cranial bones. As we tell our patients, we are going to look BEYOND the teeth and take the time to diagnose the overall picture and treat the underlying problem well before orthodontic treatment is considered. Orthodontic eruption is a transformative approach to dental health that goes beyond the surface to address the root causes of malalignment and TMJ dysfunction. By carefully guiding teeth into their optimal positions in three dimensions, this procedure ensures a balanced bite, improved jaw function, and better overall oral health. One of the most significant benefits of orthodontic eruption is its ability to protect the temporomandibular joints (TMJs). By reducing stress on the articular discs and surrounding structures, the procedure helps prevent chronic pain, jaw dysfunction, and other complications associated with TMD. Patients often experience relief from tension headaches, neck pain, and other symptoms that stem from bite imbalances. Achieving the proper height of teeth is another critical aspect of orthodontic eruption. Taller teeth provide the necessary support for the jaw, reducing pressure on the TMJs and creating a more even distribution of forces during chewing. This adjustment not only protects the joints but also enhances the appearance of the smile and contributes to a more youthful facial profile.

While orthodontic eruption requires more time and effort than cosmetic orthodontics, its benefits are long-lasting and far-reaching. By addressing both the aesthetic and functional aspects of dental alignment, this approach ensures that patients enjoy a healthier, more comfortable, and more confident smile.

In conclusion, orthodontic eruption is a valuable investment in your oral and overall health. Whether you are seeking relief from TMJ-related pain, looking to improve the function of your bite, or simply striving for a more balanced smile, this comprehensive procedure can help you achieve your goals. With the guidance of a skilled orthodontic professional, you can enjoy the benefits of a healthier and more harmonious bite for years to come.

The post Orthodontic Eruption Explained: What It Is and Why It’s Important first appeared on Sleep & TMJ Therapy.

The CBCT X-ray is widely utilized for assessing the cranial region, offering unparalleled precision in analyzing the intricate alignment and proportionality of the skull’s bone structure. This noninvasive technology captures high-resolution, 3D images, which allow medical practitioners to observe subtle irregularities that might otherwise go unnoticed with traditional imaging methods. For example, deviations in cranial symmetry can result from congenital conditions, trauma, or lifestyle factors. CBCT aids in diagnosing these issues accurately, facilitating targeted treatments like physical therapy, orthodontic adjustments, or surgical interventions. This comprehensive approach supports enhanced diagnostic accuracy and personalized care.

Cone Beam Computed Tomography (CBCT) is essential for detailed assessments of the jaw’s structural and functional integrity. Beyond its role in analyzing the cranium, it provides high-resolution imaging that captures the precise positioning of the temporomandibular joint (TMJ), which functions as a critical hinge for jaw movement. The TMJ consists of the condyle fitting into the mandibular fossa, separated by the articular disc. Misalignment of the condyles can disrupt smooth movement, potentially causing cartilage displacement. This displacement can compress sensitive nerves and blood vessels, resulting in discomfort, inflammation, or restricted motion. By identifying these irregularities, CBCT aids in diagnosing conditions like TMJ disorders and planning effective treatment strategies.

CBCT imaging not only highlights structural relationships in the cervical spine but also plays a crucial role in diagnosing issues that may arise in this region. It evaluates the alignment and spacing between vertebrae, such as C-1 and C-2, as well as the occiput, ensuring these measurements meet healthy standards, generally around 6 millimeters. When these spaces are narrowed, it can signal compression, potentially leading to symptoms like headaches, neck stiffness, or even conditions such as tinnitus. Additionally, CBCT aids in assessing cervical lordosis, the natural curve of the neck, which, if flattened or exaggerated, could cause chronic discomfort. By identifying these factors, CBCT facilitates targeted treatment, such as the use of TMD appliances, to restore balance and reduce symptoms.

The TMJ view within the CBCT provides critical insights into the health and positioning of the temporomandibular joints. When evaluating the condyles, it is essential to carefully assess their structural integrity, ensuring they are free of abnormalities such as thinning, notching, or irregularities in shape. Additionally, the condyles’ relationship within the joint socket should be evaluated for any signs of displacement, wear, or misalignment. Using the CBCT, practitioners can also verify the efficacy of treatment appliances, such as TMD splints, by confirming that they maintain joint stability and safeguard the surrounding structures.

Overall, the CBCT plays an essential role in diagnosing TMD as it delivers detailed three-dimensional imaging that reveals critical aspects of the craniofacial structure, including the temporomandibular joints, dental occlusion, and soft tissues. This advanced imaging technique helps detect subtle abnormalities, such as joint degeneration or misalignment, that may not be visible in conventional X-rays. Utilizing CBCT in conjunction with clinical evaluations enhances diagnostic accuracy, supporting more tailored and effective treatment strategies for patients.

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Temporomandibular joint disorder (TMD) refers to a condition that affects the jaw joints, muscles, and surrounding structures, often leading to pain, discomfort, and functional issues. The temporomandibular joints (TMJs) are located on either side of the jaw, connecting the lower jaw (mandible) to the skull. These joints play a critical role in chewing, speaking, and other jaw movements. When they don’t function properly, it can result in symptoms like jaw pain, clicking or popping sounds, headaches, and difficulty opening or closing the mouth.

The causes of TMD can vary widely, but common factors include stress-related jaw clenching or grinding (bruxism), trauma to the jaw, misaligned teeth, arthritis, and even genetics. One often overlooked but critical factor in TMD is the height of the teeth, which plays a significant role in maintaining proper support for the TMJs. The height and alignment of teeth directly affect the way the upper and lower jaws come together, known as the bite. When teeth are worn down, misaligned, or missing, the balance of the jaw can be disrupted, putting strain on the TMJs. For this reason, restoring optimal bite alignment is a key component of TMD treatment.

The start of proper TMD treatment begins with diagnosis based on good imaging. That imaging requires an MRI and CBCT X-ray. The MRI can be somewhat difficult to acquire because it takes a really good radiologist with lots of experience to provide an effective report on the status of the TM joints. The CBCT also requires proper expertise in order to provide good documentation and a good plan for treatment.

The MRI shows if the articular discs are displaced and how far. This image can even show if they are already perforated or torn prior to treatment. These are crucial factors in developing a good plan of treatment and properly informing the patient. The CBCT x-ray shows the cervical spine and how malaligned it might be. If out of alignment, this causes the neck to tip and this subsequently sends the condyles and sockets out of alignment as well. The CBCT also identifies calcified stylohyoid ligaments, condylar damage, condylar distance to the bony socket, airway volumetrics, deviation of the nasal septum, mastoid bone protrusion and elevation, along with multiple other salient points in planning. It takes a skilled TMD practitioner to understand the nuances of TMD treatment.

Prior to actually beginning treatment, it is the job of the practitioner to explain to the patient that once done wearing the appliance(s) it will be logical to consider finishing the case and being done with appliance therapy. Most patients do not want to wear devices all their lives and would prefer an approach that allows them to finish up so they can eat most foods they want rather than staying with a fork tender diet. In almost all cases, finishing will entail doing orthodontics to erupt the teeth tall enough to support the TM joints and/or placing onlays or crowns to make the teeth taller, again this is to support the jaw joints for the long term.

Non-Surgical Orthodontics for TMD

Non-surgical orthodontic treatments offer a conservative and effective approach to addressing TMD. This type of treatment focuses on correcting bite misalignment and improving the overall function of the jaw through gradual, natural adjustments. One common goal of non-surgical orthodontics is to encourage the eruption of teeth to improve their height and provide better support for the TMJs.

Orthodontic devices, such as braces or clear aligners, are often used to reposition teeth into their ideal alignment. By doing so, the bite can be restored to its proper form, reducing stress on the TMJs. Additionally, in some cases, specialized oral appliances may be employed to stabilize the jaw, alleviate muscle tension, and prevent harmful behaviors like teeth grinding. These appliances are typically custom-made to fit the patient’s mouth and can be worn at night or during the day, depending on the treatment plan.

Another key aspect of non-surgical orthodontics for TMD is the controlled eruption of teeth. When teeth have been worn down over time or are naturally too short, it can lead to a lack of proper jaw support. Orthodontic treatments can help guide teeth into a taller position, restoring the vertical dimension of the bite. This not only supports the TMJs but also improves the overall appearance of the smile.

One of the main advantages of non-surgical orthodontics is that it addresses the root cause of TMD without the need for invasive procedures. It is a gradual process that allows the jaw to adapt naturally, promoting long-term stability. However, it does require patience, as treatment times usually require a few years, depending on the severity of the case. Despite the longer timeline, many patients appreciate the conservative and minimally invasive nature of this approach.

In the past we could only offer metal brackets and wires for this type of treatment. Today, however, we only offer clear aligners made by the Spark company. Their AI has learned how to erupt teeth properly and can achieve an excellent end result. A typical case usually takes about two years to complete so this must be understood at the beginning of treatment.

Crown-Based Solutions for TMD

Another effective method for treating TMD involves the use of crowns or overlays, which are custom-made restorations designed to cover the entire surface of a tooth. This approach focuses on restoring the height of worn-down or damaged teeth, which in turn helps to improve bite alignment and provide proper support for the TMJs.

When teeth become worn, they lose their original height, which can lead to a decrease in the vertical dimension of the bite. This change places added strain on the jaw joints and muscles, contributing to TMD symptoms. Crowns can address this issue by rebuilding the teeth to their optimal height and shape. By restoring the natural contours of the teeth, crowns allow the jaws to come together more comfortably, reducing stress on the TMJs.

The process of using crowns for TMD treatment begins with a thorough evaluation of the patient’s bite and jaw function. Dentists often use advanced imaging and diagnostic tools to assess how the teeth and jaw interact. Based on this analysis, a customized treatment plan is developed. The teeth are prepared to receive the crowns, which are then carefully designed to fit seamlessly with the surrounding teeth and provide the desired level of support.

Crowns can be made from a variety of materials, including porcelain, ceramic, and metal alloys. For TMD treatment, dentists typically prioritize materials that are both durable and aesthetically pleasing, ensuring that the restorations blend naturally with the patient’s smile. Once the crowns are placed, patients often experience a noticeable improvement in their bite and a reduction in TMD symptoms.

One of the key benefits of crown-based solutions is that they can deliver relatively quick results compared to non-surgical orthodontics. In many cases, the treatment can be completed in just a few visits, making it an appealing option for patients seeking a faster resolution. However, it’s important to note that crowns are a more invasive treatment, as they require the removal of some natural tooth structure. Additionally, the cost of crowns can be higher than other treatments, which may be a consideration for some patients.

In our office, once the patient has worn their orthotic for the required amount of time- usually 12-18 months- they are generally ready to finish up. Crowns are always offered as a quick way to finish the case, however, not always a viable option if you are talking multiple crowns. This is why orthodontics is usually the first course of treatment because the cost is significantly lower.

Comparing Long-Term Solutions for TMD

When it comes to long-term solutions for TMD, both non-surgical orthodontics and crown-based treatments offer distinct benefits and drawbacks. Choosing the right option often depends on the patient’s specific needs, preferences, and the severity of their condition.

Non-surgical orthodontics stands out for its conservative nature. By gradually repositioning teeth and encouraging natural eruption, this approach addresses the underlying causes of TMD without the need for invasive procedures. It’s an excellent choice for patients with mild to moderate TMD who are willing to invest the time required for treatment. Orthodontic solutions are particularly well-suited for younger patients or those who have a history of teeth grinding, as they can help prevent further damage to the teeth and jaw. However, the longer treatment timeline may be a drawback for those seeking a quicker solution.

In addition, orthodontics does not work for people with periodontal problems like bone loss, short tooth roots, and gum recession. This is why we have patients keep up with their dental cleanings and have their dentist carefully watch the bone while the teeth are slowly erupted. Sometimes we erupt the teeth and the body will only allow a certain amount of eruption and we have to finish the case with crowns/onlays. This is why you need to understand your options prior to treatment. You don’t want to start all this only to discover that you will be unable to spend the time or the money to finish your case.

On the other hand, crown-based treatments offer the advantage of faster results. By restoring the height of worn teeth, crowns can quickly improve bite alignment and alleviate TMD symptoms. This approach is ideal for patients with significant tooth wear or damage, as it provides both functional and aesthetic benefits. Additionally, crowns can be customized to match the patient’s natural teeth, creating a seamless and visually appealing smile. The main drawbacks of crown-based solutions are their invasiveness and cost. Since they require the removal of some natural tooth structure, they may not be the best option for patients who prefer to preserve their natural teeth as much as possible.

Ultimately, the decision between these two approaches should be made in consultation with a qualified dental professional. Factors such as the patient’s age, overall oral health, budget, and treatment goals will all play a role in determining the best path forward.

Conclusion and Next Steps for TMD Treatment

Temporomandibular joint disorder can significantly impact a person’s quality of life, but effective treatment options are available to address the underlying causes and provide lasting relief. Non-surgical orthodontics and crown-based solutions are two of the most common approaches for managing TMD and restoring proper jaw function.

Non-surgical orthodontics offers a gradual and conservative way to realign the bite and support the TMJs, making it a great option for those who prefer a minimally invasive treatment. Crown-based solutions, on the other hand, provide faster results by restoring the height of teeth and improving bite alignment. Both approaches have their unique benefits and challenges, and the choice between them will depend on the individual patient’s needs and circumstances.

If you’re struggling with TMD, it’s essential to take the time to explore your treatment options and make an informed decision. By addressing the root causes of the condition and restoring proper jaw function, you can achieve long-term relief and enjoy a better quality of life.

If you’re experiencing symptoms of TMD, now is the time to take action. Consult with a dental professional or TMD specialist to evaluate your condition and explore the best treatment options for your needs. With the right care and guidance, you can find relief from TMD and restore comfort, function, and balance to your jaw. Don’t wait — schedule a consultation today to start your journey toward a healthier, pain-free smile.

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Coping with TMJ Disorder and Holiday Stress

Grasping the Basics of TMJ Disorder

Temporomandibular joint disorder (TMJ) affects the joint connecting the jaw to the skull. Symptoms include jaw pain, headaches, earaches, jaw locking, and clicking sounds. Factors like injury, arthritis, genetics, and stress can all contribute to its development.

Diagnosis may involve physical exams and imaging like MRIs, which are now considered the standard. Treatment options range from home remedies to physical therapy, dental appliances, and medication.

The Influence of Holiday Stress on TMJ

Holiday stress can intensify TMJ symptoms. Increased responsibilities, social obligations, and disrupted routines often lead to jaw clenching, teeth grinding, and poor sleep. Stress also contributes to emotional tension, especially in challenging family dynamics.

Lack of sleep, dietary changes, and alcohol consumption during festivities can further aggravate symptoms. Low vitamin D levels may also disrupt sleep. It’s helpful to monitor these areas with the guidance of a TMJ specialist.

Elevated Stress During Festive Seasons

Common holiday stressors include event planning, time constraints, and social pressure. These can lead to anxiety and behaviors that worsen TMJ. Managing this stress is key to minimizing flare-ups.

Time Management

Prioritize essential tasks and delegate when possible. Set realistic expectations and plan ahead to avoid feeling overwhelmed.

Mindfulness Practices

Incorporate meditation, breathing exercises, or yoga to reduce anxiety and physical tension. Being present can help prevent stress-induced habits like teeth grinding.

Setting Boundaries

Limit your participation in high-stress social events and communicate your needs with friends and family to maintain emotional balance.

Dietary Awareness

Eat jaw-friendly foods and minimize sugar and caffeine. A balanced diet supports energy and mood stabilization.

Prioritize Sleep

Maintain a consistent sleep routine. Quality rest reduces muscle tension and stress, alleviating TMJ symptoms.

Effects of Stress on TMJ Symptoms

Stress worsens TMJ symptoms through muscle tension and poor habits like jaw clenching. Addressing lifestyle factors can offer relief:

• Diet: Avoid chewy, hard foods. Limit alcohol and caffeine.
• Exercise: Regular physical activity helps reduce muscle tension and stress.
• Physical Therapy: Exercises improve jaw function and build resilience.
• Relaxation Techniques: Deep breathing, meditation, and yoga reduce tension and improve mental well-being.
• Ergonomics: Proper posture and workspace setup can prevent added stress on the jaw.
• Professional Support: Consult a TMJ specialist for custom appliances, medication, or advanced care.

Alleviating Holiday Stress

Maintaining a self-care routine during the holidays is essential for TMJ management.

Self-Care and Breaks

Take frequent, short breaks during holiday prep. Stretch, breathe, and unwind to prevent muscle buildup and fatigue.

Balanced Scheduling

Don’t overcommit. Learn to say no when necessary to protect your well-being. Stick to a realistic, manageable to-do list.

Mindful Eating

Choose soft, easy-to-chew foods. Avoid foods that can worsen TMJ pain and prioritize nutritional balance.

Effective Communication

Set clear boundaries when dealing with stressful family situations. Protecting your mental space helps maintain emotional and physical health.

Stay Physically Active

Light activities such as walking and stretching reduce stress and boost mood. Incorporate movement daily.

Seek Support

Talk with trusted friends, family, or your healthcare provider. TMJ specialists can guide you through managing symptoms and minimizing joint strain.

Happy Holidays from Sleep and TMJ Therapy!

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When TMJ Surgery Becomes Necessary

Understanding TMJ Surgery: A Last-Resort Option

Introduction to TMJ Surgery

Temporomandibular joint (TMJ) surgery is a specialized procedure used to treat severe dysfunction or pain in the jaw joint. Most TMJ disorders respond well to non-surgical treatments. However, when symptoms persist and quality of life declines, surgery may become necessary. As a last-resort option, it is considered only after thorough evaluation and the failure of conservative approaches.

Non-Surgical Treatments for TMJ

Before recommending surgery, healthcare providers typically exhaust several non-invasive options:

Physical Therapy

Therapies such as jaw exercises, ultrasound, and TENS can relax tight muscles, reduce pain, and restore mobility.

Oral Orthotics

Custom oral appliances help realign the jaw and reduce strain. Devices like the Gelb orthotic can offer long-term relief and may eliminate the need for surgery when followed by orthodontic stabilization.

Pain Medications

OTC pain relievers or prescribed muscle relaxants and antidepressants are used to manage symptoms and associated sleep disruptions.

Stress Management

Managing stress through yoga, therapy, or meditation can reduce teeth clenching and jaw tension.

Lifestyle Modifications

Simple changes—avoiding hard foods, maintaining good posture, and using heat/cold therapy—often provide symptom relief.

When TMJ Surgery Becomes Necessary

Surgery is considered when all other methods fail and the condition significantly impacts daily life. Common indications include:

• Chronic, Severe Pain: Persistent, disabling pain unresponsive to conservative care.
• Restricted Jaw Movement: Inability to open or close the mouth properly, also known as “jaw locking.”
• Structural Joint Damage: Conditions such as torn discs, dislocated joints, or bone deterioration, often visible on MRI or CBCT scans.
• Failed Non-Surgical Treatments: Continued dysfunction despite commitment to conservative protocols.
• Specific Diagnoses: Conditions like ankylosis, tumors, or severe deformities may require immediate surgical intervention.

Types of TMJ Surgery

• Arthrocentesis: Minimally invasive flushing of the joint to remove scar tissue.
• Plication or Menisectomy: Repositioning or removing damaged discs depending on their condition.
• Total Joint Replacement (TJR): Replacement of the joint with titanium or synthetic components in severe cases.

Risks and Benefits of TMJ Surgery

Risks

• Nerve Damage: Potential for temporary or permanent numbness or tingling in the jaw, face, or tongue.
• Infection: Like all surgeries, there is a risk of infection, minimized with antibiotics and proper care.
• Altered Bite Alignment: Some patients may require follow-up dental or orthodontic care post-surgery.
• Limited Improvement: There’s no guarantee of full symptom resolution, and some patients may need further treatment.

Benefits

• Pain Relief: The primary benefit is significant or complete pain reduction.
• Improved Function: Restores normal jaw movement and reduces jaw locking.
• Prevents Further Damage: Stops progression in degenerative conditions like arthritis.
• Enhanced Quality of Life: Restores comfort and daily function, reducing emotional and physical stress.

Conclusion and Decision-Making

TMJ surgery is a major decision that should be made with full awareness of the risks, benefits, and alternatives. Patients should discuss all options with a TMJ specialist or oral surgeon and seek second opinions if necessary.

At Sleep and TMJ Therapy, Dr. Brown provides comprehensive consultations and partners with trusted oral surgeons to ensure patients receive expert care tailored to their condition. With proper evaluation and planning, TMJ surgery can offer life-changing relief and restore function for those in need.

The post When TMJ Surgery Becomes Necessary: Understanding Last-Resort Options first appeared on Sleep & TMJ Therapy.

Laser Treatment for TMJ: Inflammation and Mitochondria Explained

Introduction to TMJ and Pain Management

Temporomandibular joint disorder (TMJ) can cause significant discomfort, including jaw stiffness, headaches, and difficulty chewing. Traditional treatment includes therapy, medications, and lifestyle adjustments. However, laser therapy is gaining popularity as a non-invasive, effective solution for TMJ pain and inflammation.

Understanding Laser Therapy

Low-level laser therapy (LLLT) uses low-intensity light to penetrate tissues and stimulate healing. With wavelengths ranging from 600–1000 nm, LLLT reaches deep tissues without harming skin or surrounding areas. Power levels and dosages—ranging from 1.5 J/cm² to 112.5 J/cm² and 1.76 mW to 500 mW—can be adjusted to patient needs, offering personalized care.

LLLT targets mitochondria, boosting metabolism, improving blood flow, and accelerating tissue repair. This supports inflammation reduction and pain relief, addressing both symptoms and root causes of TMJ.

Its non-invasive, incision-free nature makes LLLT ideal for those seeking safe, customizable treatment without the risks of surgery or medication side effects.

Benefits of Laser Therapy for TMJ Pain

• Reduces inflammation: Alleviates swelling and tenderness around the jaw joint.
• Improves function: Enhances jaw mobility, decreases stiffness, and increases comfort.
• Cellular healing: Stimulates mitochondrial activity, promoting recovery and tissue health.
• Non-invasive and low-risk: No surgery or drugs needed, with minimal side effects.
• Customizable treatment: Adjustable settings ensure therapy is tailored to each patient’s needs.

Research and Evidence Supporting Laser Therapy

A systematic review of 37 studies found that 33 had low bias and high quality. Of those, 18 confirmed LLLT’s effectiveness in relieving TMJ pain. Research also shows LLLT improves mouth opening, pressure thresholds, and overall jaw function.

Compared to invasive treatments, laser therapy is safer and easier to tolerate. Its ability to stimulate cellular healing without medication makes it an appealing alternative for many patients.

Ongoing research aims to optimize laser wavelengths, energy outputs, and application techniques, potentially leading to more personalized and effective TMJ treatment protocols.

Patient Experiences with Laser Therapy

Patients often report noticeable pain relief, better jaw mobility, and improved function. Many also describe psychological benefits, such as less stress and better sleep.

Side effects are rare and mild—typically a temporary warm sensation at the treatment site. Individual results vary, and the number of sessions required depends on the severity of symptoms and treatment goals.

Finding a Qualified Practitioner

To ensure optimal care:

• Choose a practitioner experienced in TMJ and laser therapy.
• Confirm they use FDA-approved therapeutic lasers.
• Ask about their training, success rates, and familiarity with current research.
• Discuss costs, insurance options, and treatment frequency upfront.
• Look for reviews and testimonials from past patients.

Building a collaborative relationship with a knowledgeable provider enhances treatment outcomes and ensures safety.

Conclusion and Future Directions

Laser therapy offers a non-invasive, customizable solution for TMJ pain by targeting inflammation and supporting cellular healing. With growing scientific support and minimal side effects, it presents a promising alternative to medication or surgery.

As technology and research advance, laser therapy is expected to become even more accessible and effective, allowing patients to achieve lasting relief and improved quality of life.

Note: At Sleep and TMJ Therapy, Dr. Brown and the team use both Biolase and Fotona lasers. With years of experience and thousands of patients treated, they are a trusted provider of laser-based TMJ relief. Call today to find out if laser therapy is right for you.

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