In so many people, the disc that covers the condyle (top of the jaw bone) has slipped or been displaced off the condyle and this can lead to pain such as headaches, neck pain, tremors, dizziness, and even poor sleep. The displaced discs create a rubbing effect in the joints and this can lead to inflammation and swelling that can wreak havoc with the whole body.

For women, this inflammation is not good if you are pregnant or nursing because it can hurt the unborn baby and make nursing more difficult. As you can well imagine, if a woman is pregnant, she would not want to have inflammation in her body while the fetus is developing. The inflammation can also have an adverse effect on hormones as well. You can get cortisol spikes occurring when inflammation is present. The cortisol can worsen inflammation when in excess. Imbalances in thyroid hormones will occur and this will affect other bodily functions. Prostaglandins are hormone like substances that are also key players in inflammation and contribute to pain, swelling , and blood vessel dilation.

There is special mention here to cytokines. These are signaling proteins whose actions regulate inflammation, immune responses, and cellular growth. They influence cell growth, differentiation, and survival of various cell types including blood cells. Foods like sweets, cakes, cookies and soda are rich in cytokines which is why a pregnant woman should watch her diet carefully. So now, you can well imagine that a pregnant woman needs to pay careful attention to her diet while being aware that her TMJ disorder can and will likely affect her entire body which in turn can affect the development of the baby in the uterus.

The post Why is the TMJ So Important to Women’s Health? first appeared on Sleep & TMJ Therapy.

I am currently a TMJ Massage Therapist for Sleep and TMJ Therapy. I have been with the practice for over 7 years helping patients manage their pain alongside Dr. Brown. During a morning huddle, I shared my experience of a recent conference I attended. Everyone thought it would be a great idea for me to share this with our patients and publish it on YouTube for reference.

Whole Health

The pursuit of whole health is a powerful journey that transcends the mere alleviation of symptoms, aiming instead for a harmonious balance of body, mind, and spirit. This holistic approach is crucial in today’s fast-paced world, where daily stressors can significantly impact overall well-being. Integrative therapies like massage therapy are essential in this journey, showing profound potential to enhance both physical and mental health.

At the International Massage Therapy Research Conference, Dr. Tracy Goudet illuminated the transformative power of massage therapy on whole health. Her research highlighted how massage therapy fosters balance and harmony, promoting physical relaxation, mental clarity, and emotional resilience. Dr. Brown and our team deeply value this interconnected view of health—encompassing TMJ care, mental wellness, and emotional stability.

Massage therapy plays a pivotal role in reducing stress and tension, which are foundational in our treatment of TMJ Disorder. Stress can manifest as headaches, muscle tension, digestive issues, and emotional disturbances like anxiety. Therapeutic touch helps mitigate these effects, paving the way for appliance therapy to succeed by aiding the repositioning of the disc onto the condyle.

Benefits of Massage in a Whole Health Regimen

Incorporating massage into a whole health approach brings multiple benefits: improved circulation, enhanced immune function, boosted energy levels, and the release of endorphins—natural mood enhancers and painkillers. Within our practice, Dr. Brown consistently recommends massage therapy as a complementary treatment to reduce the recovery time for TMD patients and minimize long-term appliance dependence.

Massage Therapy in Public Health, Rehabilitation, and Palliative Care

Massage therapy is increasingly recognized in public health, rehabilitation, and palliative care. Its effects go beyond relaxation, offering meaningful improvements in physical and emotional well-being. A key study showed massage can significantly reduce anxiety and pain, making it a valuable complement to our appliance therapy.

Massage in Rehabilitation

Rehabilitation patients recovering from injuries or surgeries, including TMJ disorders or condylar damage, benefit immensely from therapeutic touch. It improves circulation and flexibility, which accelerates healing. A powerful case presented at the conference showed a man with third-degree burns regain significant range of motion through massage—underscoring its effectiveness. Similarly, our TMD patients experience faster improvements in mobility when massage is combined with appliance therapy.

Massage in Palliative Care

In palliative settings, massage therapy eases pain and discomfort, enhancing quality of life for patients and families. Its ability to soothe and relax makes it invaluable in managing the symptoms of serious illness. This role aligns perfectly with our mission to treat TMJ pain through gentle, effective methods.

Public Health Integration

Beyond treating symptoms, therapeutic touch plays a vital role in preventive health. Regular massage therapy can address stress, anxiety, and chronic pain—common in modern society. By integrating massage into public health strategies, we support long-term wellness and a more resilient population.

Massage Therapy for TMJ Pain and Tension

TMJ pain can hinder daily functions like eating or speaking. Massage therapy addresses the core issues—muscle tension and stress—offering a comprehensive, non-invasive solution. Targeted techniques reduce pain, restore function, and support appliance therapy or surgical recovery.

A systematic review emphasized the effectiveness of manual therapy, exercise, posture training, and relaxation in decreasing TMJ pain and improving mouth opening. This multifaceted approach aligns with our individualized treatment plans that integrate massage and appliance therapy.

Long-Term Benefits

The true power of massage lies in both its immediate relief and long-term results. At Sleep & TMJ Therapy, we’ve seen how focusing on TMJ-related muscles reduces inflammation, improves circulation, and promotes deep relaxation—enhancing appliance therapy outcomes.

Patient Satisfaction

A study found 60.9% of patients rated massage as the most satisfying complementary therapy for TMD. High satisfaction rates reflect the real improvements patients experience, from pain relief to better functionality.

Preventing TMJ Recurrence

Regular massage sessions help prevent TMJ symptoms from returning. By maintaining muscle flexibility and disrupting clenching and grinding patterns, massage reduces inflammation, normalizes muscle tone, and supports better neck and shoulder posture.

Conclusion

Overcoming TMJ pain requires a commitment to innovative therapies like massage. When combined with a well-planned appliance therapy regimen, patients can experience meaningful improvements. If you’re dealing with TMJ discomfort, now is the time to explore the benefits of therapeutic touch. Take the first step toward a pain-free, balanced life today.

The post TMJ Relief: The Power of Therapeutic Touch first appeared on Sleep & TMJ Therapy.

The first issue in identifying TMD (temporomandibular disorder) is to see someone who understands and can diagnose it.  Often, this requires an MRI of the jaw joints to determine how displaced the discs are. If they are already torn or perforated, then surgery just might be needed, but even if they are that bad, surgery can usually be avoided by learning how to manage the damaged discs and allow for healing. In our office, the surgery rate is only one percent, so most issues can likely be managed non-surgically.

For almost all people, wearing appliances like an orthotic and an ALF (Advanced Light Force therapy) can greatly reduce the pain caused by the slipped discs. The orthotic is a device that fits on the lower teeth, and you would wear it 24/7. This is to ensure the condyles do not bang into the damaged discs. The ALF helps to reduce asymmetry of the cranial bones, allowing the jaw joint sockets to line up better. Together, these devices can greatly improve the pain management in the TM joints. You would wear these appliances for 12 to 18 months until the damaged discs can heal and move back into the sockets where they belong.

If a person is new to our practice and is suffering badly, we will often have them see our massage/laser provider, who is a certified massage therapist in the state of Virginia. She will use the laser to help stimulate blood flow, healing and reduce inflammation of the tissue around the TM joints. This has worked out very well for those cases in which a person needs immediate relief from the pain. This step allows time to complete the MRI, CBCT X-ray and discuss long-term treatment.

Another device that has proven very helpful for immediate relief is the Neubie machine. This device has sticky pads that go on the side of the neck, the traps (trapezius muscle responsible for shoulder and neck movements) and other areas to create a zone for the unit to pulse the muscles. The Neubie is a TENS machine on steroids! (TENS is a device that helps to vibrate the tissue to relieve pain; kind of like a fancy massage gun.) The stimulation goes to where the pain is being experienced to increase the limited range of motion, reduce spasms, increase blood flow and relieve pain.

Another adjunctive treatment we offer is BOTOX® therapy. This injection is used to relax the tension within the muscles and help alleviate the pain. The tightness or tension within the muscle creates these trigger points because the muscle has failed to relax. Prolonged irritation creates referred pain to other parts of the body as well. Keep in mind, the relief is not immediate in most cases, but within two to three days. This treatment can last up to three months or longer.

Another area to be looked at is the muscles around the head and neck. The palpation in this area is performed to see how tight the muscles are, and if very tight, this can cause tension to the airway. Most people with displaced discs have very tight neck muscles. This tightens the throat, hence the airway as well. If sleep is an issue, it just might be connected to a TMJ disorder. In other words, it is all connected!

The post TMJ and How to Help With the Pain When It Happens first appeared on Sleep & TMJ Therapy.

In many cases, the ALF wire is a really great device to help in so many ways. It will help position the tongue to the roof of the mouth, which helps with better nasal breathing. It also promotes better swallowing. With good tongue positioning and better swallowing, you will breathe better as time goes by. This is one reason the ALF is very helpful.

Another appliance called the Gelb is an orthotic device that makes sure the condyle (hard bone) does not bang into the soft tissue disc. This appliance is helpful for so many people, as it helps avoid the need for TMJ surgery in many cases. The idea is that you wear the Gelb for a year, maybe more, to give the discs a chance to get back into the proper position. In almost all cases, pain is reduced, and the person also sleeps better.

One of the most interesting bits of technology we have is the Fotona laser. This is a nonsurgical laser that penetrates deep into the tissue to reduce pain and inflammation. It stimulates the regeneration of damaged tissue. This device has been amazingly successful with our patients who need some degree of relief right away. In addition, the laser has a specific protocol that helps to reduce fat in the tongue, along with lifting the palate area to improve symptoms from sleep apnea. This, too, is a nonsurgical procedure and fairly easy to do in almost all cases.

Of course, it should always be mentioned that you can use things like BOTOX^® and other injectables to mitigate pain, however, our office prefers to fix the actual problem, not just mask it over. Other techniques, like arthrocentesis, are available. This involves flushing the joints to remove toxins. It does not fix anything, but it likely buys a little more time for those who are not ready to treat the problems.

Technology has greatly improved over the past decades. There are more and more modalities of treatment offered. The ALF and Gelb are the time-honored, traditional approaches. This appliance therapy has been around since before the ’70s. The fix takes time to implement, whereas the injectables are a quick source of pain relief. Ultimately, the patient will decide the technology for their health!

The post Finding Relief From TMJ: What You Need To Know About Today’s Technology first appeared on Sleep & TMJ Therapy.

It is not very often that a long-term study can conclusively state that lack of sleep can harm you, but this study does reflect that and more. It has also concluded that treating OSA slashes your daytime sleepiness by 45%. This is remarkable. Now, because of studies like this, individuals or employers who count on themselves or their team to be awake and alert will now pay more attention to how serious OSA can be. Most insurance carriers cover the diagnosis of OSA (getting a sleep study), but some restrictions may apply.

The way to determine if OSA is present, and to what extent, is by doing a PSG (Polysomnograph) analysis. This is a fairly simple test and is often done at home initially. If the home test shows serious issues, then the MD does a more advanced test at their in-office facility. The PSG generates a value called the AHI (Apnea Hypopnea Index) that describes how many times the patient stops breathing for more than 10 seconds, along with the times that breathing is slowed. This is not an exact science, and some doctors argue that AHI is an antiquated technique to measure the problem, but for now, this is what they have. Here is a quick review of the meaning of the numbers and the severity:

• None/Minimal AHI = <5 recorded events per hour
• Mild AHI = ≥ 5, but < 15 recorded events per hour
• Moderate AHI = ≥ 15, but < 30 recorded events per hour
• Severe AHI = ≥ 30 recorded events per hour

Back to the infamous, or soon-to-be-infamous, study. The Wisconsin Cohort Study also looked at death rates and concluded that cardiovascular mortality accounted for 26% of deaths for people who did not have SDB (Sleep Disordered Breathing), and the death rate for severe SDB was 42%. This is substantial. For those who had OSA and did not wear a CPAP, the death rate was significantly higher than for those who wore their CPAP. In other words, if your sleep MD dictates that you need a CPAP, then you need a CPAP! If you are CPAP intolerant, then you should discuss this with your MD. The conversation may lead to an alternative suggested use of a dental appliance to help keep the airway as open as possible. Generally, this is a great alternative for patients.

The study concluded that premature death occurred in severe OSA patients. Additionally, the estimate of a 3-fold greater odds of cardiovascular mortality may be underestimated when compared to community controls and patients without SDB. The death rate amongst those who did not use CPAP was significantly higher than that of patients who were dedicated to wearing the CPAP. The bottom line is that although many patients typically do not like the CPAP, it is keeping them alive, and that is what counts.

If you have OSA or symptoms, get it checked! You will likely be saving your own life or the life of a loved one. To learn more about OSA treatments in Falls Church, Virginia? Dr. Jeffrey Brown and our team at Sleep & TMJ Therapy are here to help. Please call 703-821-1103 today to book a reservation.

The post Untreated OSA (Obstructive Sleep Apnea) Is More Serious Than We Thought first appeared on Sleep & TMJ Therapy.

Temporomandibular Disorder–TMD–is a disorder that affects the jaw joints and the muscles controlling jaw movement. Some common symptoms (but not all) often include jaw pain, difficulty chewing, neck pain, and ear pain and can also include a clicking or locking of the jaw. These symptoms can vary in intensity and may sometimes lead to chronic discomfort.

Sleep Apnea is a condition characterized by sleep breathing being disrupted. Some symptoms mostly reported are loud snoring, fatigue, unable to concentrate, morning headaches and of course irritability. Typically, this is because the soft tissue (collagen) is not tight and most cases the tongue has extra fat cells. Both of these causes blocked the airway when lying down.

Both Sleep Apnea and TMD are often overlooked or misdiagnosed, making awareness crucial for effective management. Effective diagnosis usually involves a combination of medical history, physical examination, sleep test (at home or in-lab) and advanced diagnostic tools like MRI and a CBCT X-ray of the joints. Recognizing the signs and seeking professional help are key steps in managing these disorders. If you are looking for studies, there are clear links between OSA and TMD.

Both Sleep Apnea and TMD share several risk factors that can exacerbate symptoms. If the discs in the jaw joints are displaced, this will greatly contribute to TMD as well as OSA. Oftentimes, genetics are involved, and a family history of OSA and/or TMD is common. People experiencing symptoms of either condition should seek medical evaluation to prevent long-term complications. Understanding the underlying mechanisms of these conditions can help in recognizing the need for timely and appropriate treatment.

Another important factor is age; the likelihood of developing Sleep Apnea and TMD increases as one gets older. Being overweight is another significant risk factor for Sleep Apnea, as excess fat can obstruct the airway. This excess weight can also put additional stress on the jaw muscles, contributing to TMD symptoms.

Technological advancements are making significant strides in the diagnosis and treatment of both OSA and TMD. For Obstructive Sleep Apnea, the use of devices like Continuous Positive Airway Pressure (CPAP) machines has been revolutionary. These machines ensure that airways remain open during sleep by providing a constant flow of air through a mask. For those who cannot tolerate the mask, a custom-fitted dental appliance can be made to allow the airway to stay open by repositioning the jaw and tongue. Another noninvasive treatment is laser therapy. This can reduce the fat cells found in the tongue and tighten up the tissue in the back of the throat.

On the TMD front, appliance therapy is a great treatment. The focus is to drop the jaw joint down to allow for the disc to migrate back into the correct anatomical position on top of the jaw. This type of treatment also focuses on realignment of the cranium which in most cases helps greatly.  Appliance therapy like the Gelb orthotic and the amazing ALF have come to the forefront in TMD treatment, and coincidentally, helps with OSA.

Another option in conjunction or stand-alone treatment is laser therapy. This is being increasingly utilized to treat jaw pain and inflammation. Laser treatments can reduce pain and promote healing by stimulating blood flow and tissue repair. Another treatment in conjunction with appliance therapy is Botox injections. This typically is used to help calm the pain associated with TMD. These injections are given primarily to the masseter muscles.  This calms the muscles by temporarily paralyzing and then reduces the tension. Another type of treatment that helps is TMJ massage therapy. This adjunctive service focuses on the muscles of the head and neck. The massage results in less muscle tension, improves blood circulation and enhances the jaw’s working function of opening, chewing, speaking and yawning.

Additionally, advancements in imaging techniques, such as digital X-rays (bone views) and MRIs (soft tissue views) provide detailed views of the jaw joint and surrounding structures and tissues. This allows healthcare providers to make more accurate diagnoses and tailor treatments to individual needs.

Most of all, be sure to talk to a well-educated healthcare professional who understands your needs and can analyze the situation correctly. Are you struggling with TMJ issues and want to learn more about TMJ treatments in Falls Church, Virginia? Dr. Jeffrey Brown and our team at Sleep & TMJ Therapy can help you find the relief you need! Call 703-821-1103 today to schedule your consultation.

The post The Connection Between Sleep Apnea and TMJ Disorder first appeared on Sleep & TMJ Therapy.

Snoring might seem like an ordinary part of sleep, but in children, it can sometimes signal underlying health concerns that warrant closer inspection. While occasional snoring is not uncommon and often harmless, frequent snoring in kids could indicate various issues that need to be addressed.

Understanding what to look for can help parents determine if their child’s snoring requires further investigation or professional advice. It is crucial to pay attention to the nature and frequency of the snoring, as well as any other accompanying symptoms. Some children may snore due to temporary conditions like a cold or allergies, but others might have more persistent issues that need medical evaluation.

Parents should be mindful of not just the snoring sounds but also any signs of disrupted sleep patterns. If your child appears restless, wakes up frequently or shows signs of breathing difficulties during sleep, these could be important indicators. Snoring accompanied by pauses in breathing, gasping or choking sounds can be particularly concerning and may suggest a more serious underlying problem.

Addressing snoring in children early on can prevent potential complications and contribute to better overall health and well-being. By staying observant and proactive, parents can help ensure their children get the restful, uninterrupted sleep they need for healthy growth and development.

At Sleep and TMJ Therapy, we consult with parents regarding the sleep issues with their children. It is important to note that we will often work with an ENT or specialist in sleep medicine to be sure their child is receiving the best treatment possible. Part of the determination in treatment involves examining the temporomandibular joints, the Mallampati score, addressing any asymmetries and looking at posture as well. These are just a few of the things we look at. It is important that you take a team approach to your child’s treatment — the dentist, the MD, the sleep doctor and possibly the myofunctional therapist.

Signs of Snoring in Children

Identifying snoring in children requires observing specific behaviors during their sleep. One of the most noticeable signs is noisy breathing, where you may hear consistent loud snoring sounds emanating from your child’s room. Pay close attention to whether these sounds are regular or if they vary in intensity.

Another key sign is pauses in breathing. These interruptions might be brief, but they are significant and could suggest a more serious sleep-related issue. If your child frequently stops breathing for a few seconds and then resumes with a gasp or choking sound, it is essential to take note.

Restlessness during sleep is another indicator. If your child is constantly moving, tossing or turning, it could be a sign that they are not getting restful sleep. This restlessness may be accompanied by frequent awakenings throughout the night.

Observe your child’s sleeping position. Some children who snore may sleep in unusual positions to try to alleviate the discomfort caused by airway obstruction. They might sleep with their neck extended or in a sitting position to improve airflow.

Morning headaches can also be a sign. If your child frequently complains of headaches upon waking, it might be linked to poor oxygen levels during sleep due to snoring. Additionally, excessive daytime sleepiness can be an indicator. If your child seems unusually tired during the day or has trouble staying awake in school, it could be related to disrupted sleep caused by snoring.

Another aspect to consider is your child’s behavior and mood. Persistent snoring and poor sleep can lead to irritability, mood swings and difficulty concentrating. If you notice these changes in behavior, it could be linked to their sleep quality.

Monitor for any signs of mouth breathing during the day. Children who breathe through their mouth rather than their nose are more likely to snore at night. This habit can also lead to other issues like dry mouth or sore throat upon waking.

Facial asymmetry is another sign that can be associated with snoring in children. If you notice any irregularities in your child’s facial structure, it might be related to chronic mouth breathing and airway obstruction, both of which can contribute to snoring.

Lastly, consider if your child has frequent colds or allergies. These can cause nasal congestion and make it harder for them to breathe through their nose, leading to increased snoring. Keeping an eye on these signs can help you identify if your child’s snoring needs further medical evaluation.

In so many of the child cases, the ALF appliance can help with opening the airway. The ALF will increase the vertical inside the oral cavity and also can begin to widen the arches to some extent to allow for more room for the tongue.

Potential Causes of Snoring

Snoring in children can stem from a variety of causes. One common cause is enlarged tonsils or adenoids, which can obstruct the airway and lead to noisy breathing during sleep. Additionally, allergies or colds can contribute to nasal congestion, making it more difficult for air to pass smoothly and increasing the likelihood of snoring. Other factors include weight issues and environmental influences. Studies indicate that children who are overweight are at a higher risk of snoring. Allergies can exacerbate the problem; when flare-ups occur, they can lead to inflammation in the nose and throat, increasing snoring risks. Exposure to environmental tobacco smoke is another contributing factor that has been linked with a higher risk of snoring in children.

In the past, parents would often say, “My child snores…it’s so cute!” but it really is not. Snoring causes damage to the throat and can lead to other health problems. The dentist is often the one who can help with this with a referral to a practice like us or talk with your child’s pediatrician.

Health Concerns Related to Snoring

Persistent snoring in children can impact their overall health significantly. One primary concern is the potential effect on sleep quality, which can lead to various cognitive and behavioral issues. Recent research indicates that habitual snoring is associated with cognitive impairment and behavior issues.

In some instances, snoring might be a sign of Obstructive Sleep Apnea (OSA), a disorder where the airway becomes blocked during sleep, leading to breathing interruptions. This condition can result in more serious health consequences. OSA in children has been connected to impaired brain development, reduced academic performance, cardiovascular issues such as high blood pressure, altered metabolism and behavioral problems.

Cognitive development is particularly vulnerable to poor sleep quality caused by persistent snoring. Children who do not get adequate, restful sleep may struggle with attention, memory and learning. These cognitive deficits can lead to difficulties in school, affecting their academic performance and long-term educational outcomes. Furthermore, the lack of proper sleep can exacerbate behavioral problems, including hyperactivity, irritability and difficulty concentrating.

Another health concern related to snoring in children is the risk of cardiovascular issues. Chronic snoring and sleep apnea can strain the heart and blood vessels, potentially leading to high blood pressure and other cardiovascular problems. Early intervention is crucial to mitigate these risks and ensure a healthy cardiovascular system as the child grows.

Metabolic issues are also linked to sleep disturbances caused by snoring. Disrupted sleep can affect hormones that regulate appetite and metabolism, potentially leading to weight gain and other metabolic disorders. This is particularly concerning given that obesity can further exacerbate snoring, creating a vicious cycle that can be challenging to break.

Behavioral and mood disorders are another significant concern. Children with disrupted sleep may experience mood swings, anxiety and depression. These emotional challenges can affect their relationships with family and peers, as well as their overall quality of life. Addressing snoring and improving sleep quality can help alleviate these behavioral and mood issues, promoting better emotional health.

In addition to cognitive and behavioral issues, children who snore frequently may also face developmental delays. Sleep is essential for growth and development and interrupted sleep can hinder these processes. Ensuring that children get sufficient, high-quality sleep is vital for their physical and cognitive development.

Finally, persistent snoring can also impact a child’s immune system. Poor sleep quality can weaken the immune response, making children more susceptible to infections and illnesses. A strong immune system is crucial for overall health and well-being, particularly in growing children. Addressing snoring can help improve sleep quality and, consequently, enhance the immune function.

When to Seek Medical Advice

Parents should be attentive to certain red flags when it comes to their child’s snoring. If the snoring is accompanied by frequent interruptions in breathing, such as pauses, gasps or choking sounds, it is essential to seek medical advice. These symptoms could indicate Obstructive Sleep Apnea (OSA) or other sleep-related disorders that require professional evaluation and treatment.

Daytime symptoms are also important to consider. If your child exhibits excessive daytime sleepiness, irritability or difficulty concentrating, these could be signs of inadequate sleep quality due to snoring. Persistent morning headaches or complaints of a sore throat and dry mouth upon waking are additional indicators that medical advice should be sought. These symptoms often suggest that the snoring is affecting the child’s overall sleep and health.

Another sign to watch for is unusual sleep positions. Children who sleep in positions that seem intended to open their airway, such as with their neck extended or in a sitting position, might be experiencing discomfort due to snoring. This compensatory behavior is a significant indicator of possible airway obstruction.

Behavioral changes are equally important. If you notice your child has become more irritable, experiences mood swings or shows signs of hyperactivity, it could be linked to poor sleep quality caused by snoring. These behavioral changes can impact their social interactions and performance in school.

Monitoring for facial asymmetry is also crucial. If you observe any irregularities in your child’s facial structure, it might be due to chronic mouth breathing and airway obstruction. These physical changes can develop over time and might be related to persistent snoring and its underlying causes.

It is also essential to consider any underlying health conditions that might contribute to snoring. For instance, if your child has frequent colds or allergies that lead to nasal congestion and you notice an increase in snoring during these periods, discussing these patterns with a healthcare provider is important. They might suggest treatments to alleviate congestion and improve airflow, thereby reducing snoring.

Weight is another factor that can contribute to snoring. If your child is overweight, this can increase the risk of snoring due to excess tissue around the throat that can obstruct the airway. A healthcare professional can offer guidance on weight management strategies to help mitigate this risk.

Finally, environmental factors should not be overlooked. Exposure to tobacco smoke, even secondhand, can contribute to snoring by irritating the airways. If your child is regularly exposed to smoke and has persistent snoring, it is important to discuss this with your doctor as well. They can provide advice on minimizing exposure and managing any related respiratory issues.

By being vigilant and proactive about these signs, parents can ensure their children receive the appropriate medical evaluation and care to address snoring and any associated health concerns.

Tips for Parents

Parents can play a vital role in managing and potentially reducing their child’s snoring by making a few adjustments at home. One effective approach is to maintain a regular sleep schedule. Ensuring that your child goes to bed and wakes up at the same time every day can promote better sleep hygiene and overall sleep quality.

Creating a comfortable sleep environment is also important. Make sure your child’s bedroom is cool, quiet and dark. Using a humidifier can help keep the air moist, which might alleviate some breathing issues that contribute to snoring.

Elevating your child’s head during sleep can improve airflow and reduce snoring. You can achieve this by slightly raising the head of their bed or using an extra pillow. However, make sure the elevation is not too high as it might cause neck strain.

Encouraging your child to sleep on their side instead of their back can also make a difference. Back sleeping can cause the tongue and soft tissues to fall back, blocking the airway and leading to snoring. Side sleeping can help keep the airway open. For some of our patients, there is a pillow called Medcline (found on Amazon, of course) that actually forces the person to sleep on their side and slightly elevated — this is a good sleeping position.

Addressing nasal congestion is another crucial step. Using saline nasal sprays or a nasal rinse can help clear nasal passages, making it easier for your child to breathe through their nose. Over-the-counter nasal strips can also be useful in keeping nasal passages open during sleep. In our office, we promote the ‘Mute’ nasal dilator that greatly opens the nasal passages to promote much better nasal breathing. This is very important to the formation of nitric oxide in the sinuses.

If allergies are a trigger, managing them effectively can reduce snoring. This might include using air purifiers, washing bedding frequently and keeping pets out of the bedroom. Allergy medications, as recommended by a healthcare provider, can also help.

A healthy diet and regular physical activity can contribute to better sleep and reduced snoring. Encourage your child to eat a balanced diet rich in fruits, vegetables and whole grains and to engage in regular exercise. This can help maintain a healthy weight, which is important as excess weight can contribute to airway obstruction and snoring.

For children who suffer from frequent colds or allergies, it is important to manage these conditions proactively. Ensure they are taking any prescribed medications as directed and consult with a healthcare provider for additional strategies to minimize symptoms.

Lastly, if your child is exposed to tobacco smoke, take steps to minimize this exposure. Not only does tobacco smoke irritate the airways, but it can also contribute to snoring and other respiratory issues.

By implementing these strategies, you can help your child achieve better sleep and reduce the occurrence of snoring, contributing to their overall health and well-being. Be sure to see a highly trained medical/dental professional who understands sleep-disordered breathing and how to treat this condition.

If your child is dealing with TMJ issues and you want to learn more about TMJ treatments in Falls Church, Virginia,  Dr. Jeffrey Brown and our team at Sleep & TMJ Therapy are prepared to help. Please call 703-821-1103 with your questions or to schedule a consultation with Dr. Brown. Your child deserves a good night’s sleep!

The post Key Indicators of Snoring in Kids first appeared on Sleep & TMJ Therapy.

TMJ articular disc perforation occurs when the disc within the temporomandibular joint sustains a tear or hole. This disc is essential for cushioning the bones of the joint and ensuring smooth, pain-free movement of the jaw. A perforation disrupts this function, leading to discomfort and mechanical problems with jaw movement. People with this condition may notice an array of symptoms that affect their daily lives, making it challenging to chew, speak or even yawn comfortably.

The temporomandibular joint itself is a unique and intricate system. It connects the lower jaw (mandible) to the skull, allowing for complex movements required for chewing, talking and other activities. The articular disc within this joint is made of fibrocartilage and is designed to withstand significant stress and pressure. However, factors like trauma, bruxism and arthritis can cause this disc to weaken and eventually perforate.

Understanding what leads to TMJ disc perforation is crucial for effective management and prevention. Traumatic events such as sports injuries, car accidents or any direct impact to the jaw can cause immediate damage to the disc. On the other hand, chronic conditions like bruxism involve repetitive grinding or clenching of the teeth, which exerts constant pressure on the disc, leading to gradual wear and tear. Additionally, arthritis can degrade the joint structures over time, making the disc more prone to perforation.

Recognizing the importance of this disc and its function within the TMJ helps to appreciate the impact of perforation. It is not merely a structural issue but one that can significantly impair the quality of life. For instance, individuals with this condition may experience severe discomfort, mechanical restrictions in jaw movement and associated symptoms like headaches or earaches.

The anatomy and functionality of the TMJ and its components, particularly the articular disc, underline the necessity of addressing any damage promptly. Proper diagnosis and tailored treatment plans can help mitigate the effects of a perforated disc, allowing individuals to regain normal jaw function and alleviate pain.

Causes Behind TMJ Disc Perforation

Various factors can contribute to the development of TMJ disc perforation. Trauma to the jaw is one primary cause. This can result from incidents such as sports injuries, falls or car accidents where direct impact is sustained by the jaw. Such traumatic events can lead to immediate damage to the disc, disrupting its function and causing a perforation.

Chronic conditions also play a significant role. Bruxism, or the habitual grinding and clenching of teeth, exerts continuous pressure on the TMJ disc. Over time, this repeated stress can wear down the disc, eventually leading to perforation. People who experience high levels of stress or anxiety are more likely to develop bruxism, increasing their risk for TMJ disc damage.

Arthritis is another notable contributor. Both osteoarthritis and rheumatoid arthritis can degrade the cartilage and other structures within the TMJ. This degradation weakens the joint and makes the disc more prone to perforation. Age-related wear and tear associated with osteoarthritis can cause the disc to deteriorate gradually, while the inflammatory processes in rheumatoid arthritis can accelerate joint damage.

Genetic predisposition may also influence the likelihood of developing TMJ disc perforation. Individuals with a family history of TMJ disorders or connective tissue diseases might be more susceptible to disc damage. Additionally, certain anatomical abnormalities in the jaw or TMJ can predispose individuals to this condition.

Habits and lifestyle choices can further exacerbate the risk. Repetitive behaviors such as chewing gum excessively, biting nails or using the teeth to open packages can strain the TMJ. Occupational hazards, like jobs requiring prolonged speaking or jaw movements, can also contribute to disc wear.

Understanding these causes is crucial for preventing TMJ disc perforation. By identifying and mitigating risk factors, individuals can take steps to protect their TMJ health and reduce the likelihood of experiencing this painful and debilitating condition.

Symptoms and Diagnosis

Jaw pain is one of the most common signs of TMJ disc perforation. People with this condition often report discomfort that can range from mild to severe. This pain can be persistent or intermittent, and it may worsen with jaw movement. In addition to pain, individuals might notice clicking or popping sounds when they open or close their mouths. These sounds occur due to the irregular movement of the damaged disc within the joint.

Difficulty in opening or closing the mouth is another key symptom. Some individuals might experience a limited range of motion, making it hard to perform everyday activities like eating or speaking. This restriction can vary from person to person and can be quite frustrating. Headaches are also frequently associated with TMJ disc perforation. These headaches can range from tension-type headaches to more severe migraines and can significantly impact daily life.

To diagnose TMJ disc perforation, healthcare professionals often turn to imaging techniques. MRI (Magnetic Resonance Imaging) is a common tool used to get a detailed look at the soft tissues in the joint, including the articular disc. CT (Computed Tomography) scans can also provide valuable information by offering a clear picture of the joint’s bony structures. These imaging methods help in confirming the presence of a perforation and assessing the extent of the damage.

Clinical examination is another crucial component of the diagnostic process. A healthcare provider may palpate the jaw area to check for tenderness, listen for abnormal sounds during jaw movement, and assess the range of motion. These steps, combined with patient history and reported symptoms, aid in forming a comprehensive diagnosis.

In a study by Johansson et al., it was found that pain from TMJ affected 6.7% of males and 12.4% of females, highlighting the importance of addressing these symptoms promptly (Johansson et al., 2002).

Early and accurate diagnosis is vital for the effective management of TMJ disc perforation. The combination of patient-reported symptoms, clinical evaluation and advanced imaging techniques provides a robust framework for identifying and addressing this condition. Perhaps the best imaging to confirm a perforation of the disc is an MRI of the TM joints. For some reason, MRI imaging of the TM joints is somewhat controversial. I believe this is because so few doctors actually order the imaging, or so few radiologists are familiar with reading this MRI. It takes a lot of experience to understand how to read this imaging.

Treatment Options

To treat TMJ articular disc perforation, both conservative and surgical methods are available. Conservative management often involves physical therapy to improve jaw function and reduce pain. Physical therapists may guide patients through exercises designed to strengthen the jaw muscles and improve mobility. Medications can also play a role in alleviating symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to manage pain and inflammation associated with TMJ disorders.

Another conservative approach is the use of an orthotic, especially for those who suffer from bruxism. These devices help to minimize teeth grinding and clenching, which can further damage the TMJ disc. Orthotics are custom-made to fit an individual’s teeth and provide optimal protection. They are made to fit to the lower teeth and MUST be worn 24/7 so that the condyle does not further damage an already compromised disc. Within our practice, for those who want to finish with this lower appliance, and we have determined the correct height of the back teeth, then we can finish with orthodontics (Spark Aligners). Many patients prefer this to traditional braces.

In more severe cases, surgical interventions may be necessary. Arthrocentesis is one less invasive surgical option where the joint is flushed with fluid to remove debris and reduce inflammation. For more significant damage, open joint surgery might be required. This procedure allows surgeons to repair or remove the damaged disc. It must be understood that arthrocentesis, although more conservative, does nothing to correct the damaged disc, it only might help reduce the symptoms and make them more manageable.

Joint realignment procedures are another surgical option, aimed at correcting any misalignment that contributes to the wear and tear of the disc. Minimally invasive techniques such as arthroscopy can be employed to perform these corrections with smaller incisions, leading to quicker recovery times. Again, only an open joint surgery can remove the actual disc.

The choice between conservative and surgical treatment depends on the severity of the condition and individual circumstances. Consulting with healthcare professionals specializing in TMJ disorders is crucial for an accurate diagnosis and personalized treatment plan. By tailoring the approach to the specific needs and conditions of the patient, effective management of TMJ articular disc perforation can be achieved.

Recovery and Management

Recovery from TMJ disc perforation treatment requires dedication to a structured care plan to achieve optimal healing and prevent future issues. After either conservative or surgical treatment, patients should closely follow their healthcare provider’s recommendations, which might include attending scheduled follow-up appointments to monitor progress and make necessary adjustments to the treatment plan.

Massage therapy and sometimes physical therapy play a significant role in the recovery process. It can help restore normal jaw function and reduce discomfort. Patients are often provided with exercises tailored to their specific needs to strengthen the jaw muscles and enhance mobility. These exercises should be performed consistently and correctly to maximize their benefits.

Medications may continue to be part of the recovery process, especially if there is ongoing pain or inflammation. It is essential to use these medications as directed and report any side effects or concerns to the healthcare provider promptly.

Lifestyle modifications are equally important in managing recovery. Incorporating stress management techniques can help reduce habits like teeth clenching and grinding, which can exacerbate TMJ issues. Practices such as meditation, deep-breathing exercises and yoga can be beneficial in managing stress levels. Additionally, a soft diet can help minimize strain on the jaw during the healing process. Foods like mashed potatoes, yogurt and smoothies are good options that do not require extensive chewing.

Good posture, particularly during activities that involve prolonged speaking or jaw movements, can also aid in reducing stress on the TMJ. Avoiding habits such as chewing gum or biting nails will further protect the joint from unnecessary wear.

By diligently following these recovery and management strategies, individuals can significantly improve their chances of a successful outcome and reduce the risk of future complications associated with TMJ articular disc perforation.

If you currently struggle with TMJ issues and want to learn more about TMJ treatments in Falls Church, Virginia, we are here to help. Dr. Jeffrey Brown and our team at Sleep & TMJ Therapy can help you find the relief you need. Please call 703-821-1103 to learn more or schedule a consultation with Dr. Brown.

The post TMJ Articular Disc Perforation: What You Need to Know first appeared on Sleep & TMJ Therapy.

As 2024 wraps up, we take a moment to reflect on the significant progress made in understanding and treating Temporomandibular Joint (TMJ) disorders. Throughout the year, our efforts have focused on enhancing patient care and exploring innovative treatments. This journey would not have been possible without the dedication of our team and the tremendous support of our patients. THANK YOU!

We have witnessed firsthand the remarkable resilience and determination of individuals facing TMJ challenges. Their stories have not only inspired us but have also driven us to push the boundaries of what is possible in TMJ therapy. The advancements made this year have provided new hope for those dealing with chronic pain and dysfunction associated with TMJ disorders.

One of the highlights of 2024 has been the introduction of new treatment methods that show great promise in managing TMJ symptoms. From manual therapy techniques (Neubie, Laser or Massage) to minimally invasive procedures like arthrocentesis and arthroscopy. The field has seen a range of developments aimed at improving patient outcomes. These treatments have offered many patients significant relief and have contributed to a better understanding of the complexities involved in TMJ disorders.

We have seen a rise in collaborative efforts among healthcare providers, researchers and patients, which has led to more personalized treatment plans and improved patient education. These partnerships have been instrumental in advancing our understanding of TMJ disorders and tailoring therapies to meet individual needs.

Community involvement has played a crucial role in our mission this year. Through workshops, informational sessions and support groups, we have fostered a sense of community among patients, enabling them to share their experiences and support one another. These initiatives have been invaluable in raising awareness about TMJ disorders and in offering practical strategies for coping with the conditions. Looking back, it is clear that 2024 has been a year of significant progress and growth in the field of TMJ disorders. The dedication of our patients and the tireless efforts of our team have paved the way for a brighter future in TMJ care.

Breakthroughs in TMJ Therapy

This past year has brought about some new ideas in appliance therapy for TMJ disorders. I have been noticing an increase in allergies these past few years–and mostly to metals like nickel–so my lab and I have developed some new appliances that work better than anything we have had in the past.

Our office recently acquired the fantastic Fotona laser. This deep-tissue laser treatment reduces inflammation and stimulates the cells in your body to heal. It feels wonderful–soothing, calming and just plain ‘delicious’ as some of our patients have told us. For patients with obstructive sleep apnea, I can use the Fotona laser to reduce the size of a thick tongue and tighten the palate for better breathing. This is in lieu of PPP (Palatal Pharyngeal Plasty) surgery that has to be repeated every few years. I think it is infinitely easier, less expensive, far less painful (little to no pain with our laser) and therefore makes more sense than having surgery.

We also have the Biolase which is used in conjunction with massage therapy. My assistant Ruth is now here more days than ever due to the increased demand for laser and massage at the same time. If you need a break from day-to-day stress, see Ruth and experience what laser massage can do.  This treatment calms the tension in the muscles around the jaw, face, neck and shoulder. This procedure of identifying trigger points helps relieve the symptoms associated with TMD. As Ruth massages the masseter (jaw), sternocleidomastoid (front of the neck) or temporal muscles, relief comes to the patient experiencing symptoms like headaches, earaches, neck or facial pain or simply relieving pressure on the TM joints.

This year brought other developments in TMJ therapy. One of the more noteworthy breakthroughs is manual therapy. This approach involves physical therapists using their hands to stretch the soft tissues and muscles around the joint, effectively improving function and relieving pain.

Another promising technique is arthrocentesis, a procedure where fluid is injected into the TMJ to remove scar-like tissue and inflammatory substances. This method has shown positive effects in pain relief and improving mouth opening, although these benefits might be short-lived.

Arthroscopy continues to be a valuable tool for TMJ treatment It involves inserting an instrument with a tiny video camera into the jaw joint to visualize the area and remove adhesions or reposition the joint’s disc. This procedure has been moderately successful in improving pain and function.

Another innovative option explored this year is prolotherapy. This involves injecting a solution into the TMJ area to stimulate the body’s natural repair mechanisms. Prolotherapy shows promise, particularly in cases where the joint is dislocated or exhibits hypermobility. However, more research is needed due to the limited number of studies available.

Although we can offer both arthroscopy and arthrocentesis, neither of these techniques will actually fix the underlying problem; a displaced disc. The oral surgeon who performs this procedure is always very clear that these techniques are used to help alleviate discomfort and attempt to improve the situation. These techniques basically help a patient buy time and see if they can put off a full TMJ surgical procedure.

Emerging therapies like platelet-rich plasma (PRP) injections are also gaining attention. PRP involves using a patient’s own blood components to promote healing in the TMJ area. This treatment aims to reduce inflammation and encourage tissue regeneration, offering a potential new avenue for those who have not found relief through other methods. Again, the surgeon would explain that this will not likely fix the displaced articular disc, but if it helps to heal some of the joints, it might be worthwhile and easier than surgery.

Of course, the someday-to-be-famous ALF appliance is helping both adults and children. For each patient, this lightweight wire helps with realigning the cranium avoiding unnecessary strains. For the patient in need of arch development, this is a great alternative to a palatal expander and for pre-orthodontic needs, reducing their time in braces. By re-aligning the jaws in a very natural and careful fashion, many children need far less time in orthodontics. The additional benefit goes along myofunctional habits like a tongue thrust or resting with lips apart.

And speaking of orthodontics, we have come a long long way since the time of ugly metal braces. In almost every case, I can use clear aligners to erupt the teeth gently, slowly and carefully to the proper height to support the jaw joints after we determine the correct height needed. It took quite a while for the Spark company to understand what I needed to have done, but they finally understand and can produce aligners that do what is needed!

Another area of interest is the application of botulinum toxin (BOTOX®) injections. Botox is traditionally known for cosmetic uses, but it has been found to alleviate TMJ symptoms by relaxing overactive muscles around the joint. I am a certified provider of Botox injections. I have found that using this treatment provides good relief to tense muscles. Again, it is only temporary for most lasting up to six to eight months.

Stories and Experiences from Our Patients

Throughout 2024, we have had the privilege of witnessing the incredible journeys of many of our patients. Their stories reflect not only the progress in TMJ treatment but also the unwavering spirit and determination they exhibit in their recovery process.

One such story is of Cynthia, who had been grappling with chronic TMJ pain for several years. She finally found relief through a combination of manual therapy and lifestyle modifications. Sarah’s commitment to adhering to her treatment plan and maintaining a positive outlook was key to her progress. Her journey serves as an inspiring example of how patient involvement can significantly influence outcomes.

Another remarkable case is John, who underwent a plication surgery procedure to address his TMJ dysfunction. Despite initial challenges and setbacks, John’s perseverance and dedication to his recovery routine led to significant improvements in his functionality and overall quality of life. His story underscores the importance of patient resilience in the face of adversity.

We also had the honor of supporting Maria, who explored prolotherapy as a treatment option. Initially skeptical, Maria decided to give it a try after discussing the potential benefits and limited research with her healthcare team. Her willingness to explore new avenues of treatment resulted in noticeable pain relief and improved joint stability, showcasing the potential of emerging therapies in TMJ management. The prolotherapy provided some degree of relief without needing TMJ surgery

I like to explain to each of our patients that THEY need to be their own advocate for their course of treatment. Sure, this treatment addresses the damaged disc/joint system but in so many cases there is already nerve and muscular damage. You need to try things like acupuncture, massage, physical therapy, osteopathy and many other treatments to provide a long-term approach to managing your health.

Each patient’s journey is unique, and their experiences highlight the varied approaches to managing TMJ disorders. For example, Emily, a young professional, found that a combination of platelet-rich plasma (PRP) injections and stress management techniques significantly reduced her symptoms. Her proactive approach to integrating different treatments demonstrated the value of personalized care plans.

The resilience and determination of our patients continue to inspire us. Their willingness to engage in their treatment plans and try new methods has been crucial in their journey towards better health. We are grateful for their trust and partnership, which drive us to continually improve and innovate in the field of TMJ disorders.

Innovations and Research

Research conducted in 2024 has illuminated the intricate nature of TMJ disorders. Studies indicate that a combination of genetic factors, psychological stressors and pain perception can influence the onset and persistence of TMJ disorders. This comprehensive approach has helped in better understanding the multifactorial aspects of the condition, paving the way for more effective treatment plans.

Additionally, research has dispelled several myths surrounding TMJ disorders. The small amount of research, and the teaching in dental schools, tell us that a bad bite or orthodontics does not cause TMJ disorders. Here is the reference to such thinking.

For those of us who actually treat TMJ disorders, we are well aware that if the bite is not correct and does not support the TM joints, this will indeed cause the articular discs to be displaced, and then pain will happen. As part of the treatment protocol, the patient will wear an orthotic to ‘open’ the bite taller, and then later on do three-dimensional orthodontics to erupt the teeth to better support the condyle/disc system within the jaw bone socket. Therefore, a bad bite and/or regular orthodontics can indeed lead to TMJ disorder.

Innovative technologies have also emerged, providing new avenues for treatment and management. Virtual reality tools are being developed to assist in pain management and rehabilitation exercises. These tools offer patients immersive environments where they can perform guided exercises designed to improve TMJ function. The use of virtual reality in TMJ care promises to make therapy more engaging and effective for patients.

AI-driven diagnostic methods are another area of significant progress. These advanced systems can analyze a multitude of patient data, including imaging and clinical history, to provide more precise diagnoses. The integration of AI into diagnostic processes helps in identifying subtle patterns that might be missed by traditional methods, ensuring a more accurate assessment of TMJ disorders.

In addition to technological advancements, there has been an increased focus on integrative approaches to treatment. This involves combining traditional medical treatments with alternative therapies such as acupuncture, yoga and mindfulness. Such integrative care approaches aim to address the physical, psychological and emotional aspects of TMJ disorders, offering a more holistic treatment plan tailored to individual patient needs.

The strides made in 2024 have been possible due to collaborative efforts between researchers, clinicians and patients. Continuous research and innovation are essential for discovering new insights and developing more effective treatments for TMJ disorders.

Looking Forward to 2025

In 2025, we foresee promising advancements in the field of TMJ disorders that will enhance both diagnostic and therapeutic approaches. The integration of artificial intelligence (AI) in diagnostic processes is expected to refine the accuracy and speed of TMJ disorder diagnoses. AI can analyze patient data more comprehensively, offering personalized insights that aid in creating tailored treatment plans.

Additionally, virtual reality (VR) tools are likely to become more prevalent in TMJ therapy. These tools provide immersive environments for patients to engage in rehabilitation exercises, making the treatment process more interactive and effective. By incorporating VR, we can offer patients a unique way to manage their symptoms and improve joint function.

The focus on integrative care will likely intensify, with a blend of traditional and alternative therapies becoming a standard approach. This holistic method addresses not only the physical symptoms but also the psychological and emotional aspects of TMJ disorders. Techniques such as acupuncture, yoga and mindfulness will be integrated with conventional treatments, providing a well-rounded care plan that caters to individual needs.

Research into emerging therapies, such as platelet-rich plasma (PRP) injections and prolotherapy, is expected to yield more definitive results. These treatments show potential to promote healing and reduce inflammation in the TMJ area. As more studies are conducted, we anticipate clearer guidelines on their efficacy and broader adoption in clinical practice.

Community engagement will become part of our efforts in the near future. We plan to create outreach programs, workshops, support groups, informational sessions and other events to increase awareness of TMJ disorder–will continue to be a cornerstone of our efforts. We plan to expand our outreach programs, offering more workshops, informational sessions and support groups. These initiatives will aim to educate, support and empower patients and their families

Our collaborations with local organizations will be strengthened to raise public awareness about TMJ disorders. By hosting more public events and awareness campaigns, we aim to reach a larger audience and reduce the stigma associated with these conditions.

In essence, 2025 holds the promise of significant progress in TMJ care, driven by technological innovations, integrative therapies and community involvement. Our commitment to advancing the quality of care and supporting our patients remains steadfast, and we look forward to another great year of helping people navigate and overcome TMJ disorders.

At Sleep & TMJ Therapy,  Dr. Jeffrey Brown and our team are here to help you get the relief you need from TMJ issues in Falls Church, Virginia. Please call our office at 703-821-1103 to learn more or schedule a visit.

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