Another aspect of having a tooth pulled out is that upon removal of the tooth, the bite on that side will experience an almost immediate collapse in which the jawbone (condyle) will now go more deeply into the socket. This is where a TMJ problem begins. When that condyle jams further up into the jaw socket, it will impinge on the articular disc that covers the condyle. This can cause a gradual displacement of the disc and subsequent TMJ disorder. If multiple teeth are removed this can readily lead to the discs being pushed way out of proper placement and this can be quite painful for so many people.

With periodontal disease, the bone and gum support around the tooth becomes weaker over time. This can lead to the tooth getting loose in the socket and it can no longer be a good vertical support for the jaw joints. Just like the foundation of a house, if it starts to rot away, the whole house can tip sideways. The jaw is similar. If the teeth become looser due to periodontal disease, this can destabilize the jaw joints and the discs in those joints can become damaged more readily. By maintaining good periodontal support for your teeth, this will help the jaw joints stay healthier and stronger.

Unfortunately, oral cancer should be mentioned in this blog. Cancer in the mouth can lead to loss of teeth and bone which of course can lead to loss of TMJ support. This is why it is so important to keep up with your dentist and at least yearly have them do an oral cancer screening. This screening only takes a few minutes, yet it could save your life and your health. So many people are very afraid of cancer but if detected early enough it is fairly easy to treat.

As Dental Health awareness month is April, be smart and reach out to your dentist about your dental health. Ask questions. Ask if they are checking for periodontal disease. Ask about cavities. And most importantly, ask if they are checking for any signs of oral cancer or other diseases.

The post How Oral Health Affects the TM Joints first appeared on Sleep & TMJ Therapy.

Did you know that a gorgeous smile with great teeth and well-supported Temporomandibular joints also means less neck pain?  It’s so true! Time and time again it has been shown that losing a tooth means that the structural integrity of the cervical spine is compromised. This is why it is not advisable to remove any teeth unless completely necessary. In so many cases, it is necessary to remove the patient’s wisdom teeth.  For this reason, many people would benefit from wearing the ALF appliances to maintain support of the bones of the skull during the healing process. When wisdom teeth are removed, the research indicates there will be about 16 square centimeters of holes in the skull and the bone has a tendency to collapse from this. The ALF appliance will help to support the bones of the skull and more readily allow the bone to fill into the holes created by the extractions, without causing a collapsing effect.

In the past, it was much more commonplace to have all your teeth pulled out and have dentures made. The problem with the denture route is that most of the time the dentist’s lab uses a type of plastic material and the dentures have a tendency to wear down quite quickly. What happens next is the top of the jaw – the condyle – will more readily jam into the socket and we have more TMD problems. This is why it is good to avoid dentures and go the implant route.

When a person has implants done, it would be wise to get the implant crowns to the proper height. This would require working with someone like a TMJ specialist who understands that the condyles must be in the right place to protect the joints from degeneration. By paying attention to the vertical height of the implant crowns, this will allow the patient to feel better with their brand-new smile!

Another facet of dealing with a gorgeous smile is that a great smile looks better if the bones in your skull are more balanced and symmetrical. When you think about it, it kind of makes sense. If your cranial bones are level, the body is happier and looks better. Again, this is what the ALF wire is all about – symmetry and balance – and this creates a more beautiful appearance too.

So, make sure that beautiful smile translates into a beautiful and healthy YOU!

The post The Case of Why We Need a Gorgeous Smile (From a TMJ Perspective) first appeared on Sleep & TMJ Therapy.

With the work that we do at Sleep and TMJ Therapy, it is important that we all work together as a team to provide you with the very best treatment possible. When it comes to your regular dentist, this means seeing him or her regularly for the dental cleanings and checkups. Sometimes we have you see them more often – like every three months instead of the normal six months. This helps keep the teeth cleaner and healthier when heavy buildup is present or there are periodontal issues. Since our appliances rest on the teeth, it is imperative that you keep those teeth as healthy as possible!

Another reason for maintaining good teeth and healthy gums is that if you are wearing ALF wires, there will be some degree of expansion of the arches and gaps could open between the back teeth. When gaps open up, it is more important than ever to use floss every day and see your dentist regularly enough. On the back end of treatment, we advise our patients that they may need some of these small gaps closed with a filling or onlay, depending on the situation. However, in most cases, once the ALF treatment is completed, the gaps usually close all by themselves as we notice the teeth moving forward over time. This occurs naturally when the teeth and gums are healthy.

As part of the finishing up of treatment, in some cases, it is necessary for your general dentist to do some crowns or overlays of certain teeth to make them taller. This is sometimes needed with root canaled teeth because they usually will not lift up doing ALF therapy. It is quite simple for this to be done, but much easier if your dentist is kept apprised of your situation during treatment and maintains the bone and gums during the transition process.

So, keep up with those dental cleanings while we work on the TMJ disorder. Your treatment is much easier when a “team approach” keeps things in order!

The post Why You Need Your Dentist While Undergoing TMD Treatment first appeared on Sleep & TMJ Therapy.

In the world of dealing with craniofacial and TMJ disorders, it is critical to look at any asymmetries or irregularities that might exist within a person’s skull. This can be as simple as just visually sitting down in front of that patient and looking at them from a critical viewpoint, or as detailed as taking X-rays from all angles and making photographs part of the assessment as well.

When a patient is examined initially by the doctor, they need to look at their face, their posture, their neck, and shoulders as well. Here is the first part of proper treatment planning for any orthodontic or craniofacial pain case. Are the eyes even? Are the ears level? Is the sclera more evident on one side or the other? How does the jaw open – does it open straight or does it swerve to one side upon opening and closing?

Although this extremely basic analysis seems mundane, it is quite useful in determining the outcome of a case. For example, if the eyes are not even or level, then the sphenoid bone is not level, which leads to imbalances in the jaw bones (condyles) and so moving teeth might make this imbalance worse and cause pain. If the ears are not even, then it is highly likely that the glenoid fossas (jawbone sockets) are not level and performing orthodontics on this patient could end up pushing the condyles deeper into the disc on one side or the other. creating head and neck pain. The analogy is this: If the front-end alignment is off with your car, there really is no point in putting two new tires on the front of the car. So, if the teeth are moved around by orthodontic treatment and the skull is not in good alignment, then further distortion can occur which will lead to pain in the head and neck. From the diagram, distortions from the cranium can affect the shoulders, hips and through to the feet.

To do the best orthodontics possible, it is important to have the dentist understand craniofacial asymmetry and what to do about it. Most regular dentists are trained to use the RPE (Rapid Palatal Expander), however, this device will not level bones that are not in good alignment to begin with. The RPE will just widen what is already there and widen the asymmetry which is detrimental to the patient’s overall health.

There is a particularly useful device called the ALF (Advanced Lightwire Functional) that will nicely align the cranial bones given enough time and patience. Unfortunately, there are only a few dental practitioners out there who have the training and understanding of how the device works. It is NOT a palatal expander, not at all. It is a quite simple device that levels the bones within the skull, achieving balance and stability. Another analogy: it opens the vise grip on a person’s skull so the bones can settle in more balanced. It’s as simple as that! If you have any questions for our team or to schedule an appointment, we welcome you to give us a call at 703-821-1103 today!

The post Why Should We Look at Facial Asymmetry? first appeared on Sleep & TMJ Therapy.

TMJ and sleep disorders are very common but not really understood.  This can explain why myths or misconceptions are out there.  The other side of this coin is this is also commonly misdiagnosed because symptoms vary from person to person and are similar to other problems.  One example of similarities is with Lyme Disease.  This is caused by a tick bite and the symptoms could be chronic headaches or migraines, jaw pain and tingling in the hand or fingers, notable symptoms of TMJ disorder. The big difference is Lyme disease does not have the clicking and popping or vertigo symptoms of TMJ disorder.  There are other examples as well; migraines, Trigeminal Neuralgia (short, sharp pain from touching of the jaw joint), or even a Ganglion Cyst (on the TM joint causing swelling and jaw pain).

Just remember all of us get sore muscles from time to time. The big difference is when the muscles in your jaw joints get sore and the soreness does not go away.  This is when you should ask your dentist for a referral. Otherwise, you could be prolonging the unnecessary pain or soreness and allowing the disc to possibly become further damaged.  TMJ disorder does affect other parts of your body. The myth of no popping or clicking means no TMJ disorder is not true.  These displaced discs can cause other symptoms of neck pain, backache, loss of balance, or hearing loss without the clicking or popping.

Another common myth is that TMJ disorder is harmless and that living with it will not cause problems.  It is true this condition is non-life-threatening but at the same time, it should be addressed.  Some possible development would be bruxism.  This process causes grinding of your teeth and clenching, wearing down your tooth’s enamel, and can cause sleep issues.  If the tooth enamel is worn down, then the potential of decay or tooth loss becomes greater.

For the sleep side of things, sleep can be interrupted by the clenching and grinding of your teeth.  Interrupted sleep or waking up unrefreshed is a symptom of both TMJ disorder and sleep apnea. It is not considered just a sleep issue.  The myth of sleep issues coming with age is not exactly true.  The aging process does decrease the tone in muscles and the airway muscles are not immune to this. The muscles in the airway no longer hold the jaw in the correct place and in turn, the airway becomes restricted. Your body is now fighting harder to breathe.  The use of a CPAP as the only treatment for sleep apnea is another myth.  The American Academy of Sleep Medicine has determined that an oral sleep appliance is very effective for mild to moderate apnea index.  This index tells us how many times your sleep is interrupted within a night.  The Epworth scale (tiredness level) in conjunction with the apnea index can determine if the oral appliance will be effective.

An interesting myth, sleeping on your side cures sleep apnea, actually helps with sleep apnea but does not cure it. By sleeping on your side, the tongue is not relaxed enough to obstruct the airway by falling back into the throat creating a blockage.  The tongue is off to the side allowing air to pass through the airway.  This is noted with mild cases of sleep apnea.  The side sleeping is most definitely not a cure but is recommended a lot for “positional apnea”.

There are so many more myths out there for both TMJ and sleep disorders.  Always consult with your dentist or physician when it comes to these issues.  You do want to address these symptoms because both these conditions will affect your brain and in turn affect cognitive functions, generating higher stress, and possible memory loss.

The post Myths about TMJ and Sleep first appeared on Sleep & TMJ Therapy.