Category: TMJ

TMJ

The Best Treatments For TMJ – So You Can Feel Better

If you’re suffering from painful jaw problems and are looking for the best treatments for TMJ, this article is for you. I’ve been a TMJ and orofacial specialist for many years, and I want to share some useful tips with you that help my patients feel better.

Start Here

For even the best treatments for TMJ to be successful, it’s crucial to try and understand the reasons why you have jaw problems in the first place.

Over the years, we have come to recognize that a significant number of TMJ problems occur as a result of the jaw muscles and temporomandibular joints being overworked. Since TMJ problems are essentially orthopedic problems in the jaw, daytime jaw over-use behaviors such as chewing gum, biting your nails or cuticles, clenching your teeth, bracing your jaw muscles, cheek and lip biting, or gnawing on non-edible items can all fatigue the jaw muscles and sprain the TM joints.

The origin of these daytime jaw overuse behaviors, however, can be rather complex and, as a result, often difficult for patients to change.

The Key Is To Stop Injuring Your Jaw Muscles and Joints

It seems like a no-brainer, right? Just stop your jaw over-use behaviors, and your TMJ problems will disappear. I wish it were that simple.

It requires a tremendous amount of focus and effort to stop behaviors that have likely been in your life for years and may even be comforting in times of stress. Just stopping these behaviors may not be sufficient to ease symptoms of pain and jaw clicking if the jaw muscles or joints have already been persistently injured.

In addition, the way you hold your head can increase the risk of developing a jaw problem. If you work at a computer all day or use your cell phone for hours a day, the position of your head could fatigue your neck muscles leading to jaw pain and even limited jaw motion. Remember, your head is heavy – and when it is forward, the neck muscles are put under strain leading at times to jaw problems.

Reducing or eliminating these behaviors and postures is, therefore, an important part of the getting better process, but achieving these changes takes time. While you’re working on that, I’d like to share with you the treatments we rely upon in our practice to help our patients heal and get better.

What Are The Best Treatments For TMJ?

The best treatments for TMJ always start with an accurate diagnosis. Not every pain in the face and jaw is due to a TMJ disorder. In fact, the broad term Orofacial Pain is now used to describe any discomfort or pain in the mouth, face, and neck region, including the jaw joint (temporomandibular joint or TMJ), muscles, teeth, and nerves.

In 2021, Orofacial Pain was designated as a recognized specialty within dentistry, and as a result, research relating to TMJ disorders will receive additional attention and funding.

Today we design treatment plans based on current research and what we learn from our patients – their medical and dental history and, most importantly, what is going on in their lives.

On a daily basis, there are several TMJ treatments that we rely upon that help the majority of our patients feel better and get better. They are:

Exercises – We frequently prescribe jaw and neck exercises to ease jaw/neck tension, stretch overworked muscles, and help them heal.
Physical Therapy/Chiropractic Care – If your TMJ symptoms have lingered for months or even years, a short physical therapy or chiropractic care regimen can help break the cycle of jaw muscle tension.
Oral Appliances – There’s a misconception that oral appliances (nightguards, mouthguards, bite plates, etc.) stop nighttime tooth clenching and grinding. They don’t. But what they can do, when designed correctly, is reduce the impact of clenching and grinding forces and limit potential injury to the jaw muscles and TM joints.
Medications that address pain, spasms, muscle tension, and inflammation.
Trigger Point, Prolo Therapy & Steroid Injections – Some of the best treatments for TMJ disorders involve injections that address pain, spasms, muscle guarding, soreness, and inflammation.

Trigger Point Injections and Dry Needling can be highly effective in breaking up stubborn knots in the jaw/neck muscles. In both cases, a few injection sessions are necessary for full benefit.Prolo Injections, which are a combination of local anesthetic and dextrose, are often used to reduce inflammation in tendons, ligaments, and joint capsules but have been shown to assist in tissue regeneration as well.Steroids still play an important role in reducing inflammation in the TM joints and supporting tendons and ligaments.
BOTOX® & Xeomin – BOTOX® and Xeomin are injectable neuromodulators that can ease muscle pain, tension, and nerve pain. These neuromodulators are commonly used in our practice, surrounded with ongoing education as to what these injectables can achieve, their limitations, and potential side effects.

Conclusion & Recommendations

If you’ve been suffering from persistent TMJ symptoms and live near one of our four offices in the NYC metropolitan area (Manhattan, White Plains, Long Island and New Jersey), give us a call at 212-265-0110 to set up a consultation.

If you live outside our area, try to find a board-certified Orofacial Pain specialist in your area. Ask your dentist for a referral or check the American Academy of Orofacial Pain’s directory and search for a specialist with Diplomate status.

You don’t have to live with pain forever. Help is here!

Dr. Donald R. Tanenbaum

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Orofacial Pain TMJ

The #1 Reason You Have TMJ Pain

Post author By Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain
Post date May 4, 2023
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Suffering from TMJ pain? You’re not alone. Nearly 18% of the population suffers from a TMJ disorder, too. As a TMJ and Orofacial Pain specialist with over four decades of experience, I’ve helped thousands of people get relief from their pain and acquire control over their TMJ problems.

The symptoms of TMJ pain can be very different from person to person. For some, the pain is sporadic. For others, it lingers. Some people can’t open their mouths without intense pain; some suffer from severe headaches. TMJ pain is usually described as dull, aching, and sore. And many patients say their TMJ problem has taken over their life.

The #1 Reason For TMJ Pain Is Overworked Jaw Muscles

I’m happy to say most people do get better. The most important element of your TMJ treatment, and where we always start, is for you to unravel the mystery behind your TMJ pain.

The clue to your TMJ pain is found in your masseter and temporalis muscles, which are your jaw muscles. Your jaw muscles react to being overworked the same way as any other muscle – when they are overworked they can get sore, stiff, and achy.

For example, when you work in your garden for many hours on a Saturday, your back muscles are probably going to be sore and achy on Sunday. When you work out intensely at the gym, your muscles can ache. If you lift and carry your baby or toddler, you know how painful your arm, shoulder, and back muscles can be.

Your masseter and temporalis muscles are just as susceptible to overuse and fatigue as your back, legs, shoulders, and arms. So, what causes jaw muscles to become overworked? The most common reasons for jaw tension are continuous daytime jaw over-use behaviors, such as:

Teeth grinding and clenching
Gnawing on pens
Chewing gum
Biting your nails or cuticles
Biting your lips or the inside of your mouth

But there’s something behind the persistent muscle tension that just may be the cause of your TMJ pain…

Your TMJ Pain May Well Be Tied To Your Emotions

It may seem strange to tie your jaw muscle problems to your emotions. But over the years, TMJ specialists began to notice some stark similarities among their patients. They discovered that the majority were living lives filled with negative emotions such as constant stress and worry. Many were dealing with a serious illness, unrelenting pressure at work, caring for an aging parent, or having marital problems, to name a few.

Negative emotions that come from constant stress and worry can lead to what I like to call “an upset brain.” An upset brain can lead to persistent muscle tension, which can then trigger daytime jaw over-use behaviors such as the ones I listed above.

Constant stress and worry can harm the quality of sleep, as well. An upset brain can trigger nighttime teeth clenching or grinding, which overworks your muscles and often results in morning TMJ pain and stiffness.

The Link Between Overworked Jaw Muscles & Prescription Medications

There’s another possible reason you have TMJ pain. Many people rely on medications such as Adderall, Ritalin, Concerta®, and Vyvanse® to enhance their brain focus. While they’re effective, they can also stimulate your internal fight-or-flight system, which in turn can lead to jaw over-use behaviors, which in turn can cause jaw problems.

What To Do Next

TMJ and Orofacial Pain Specialists have a toolbox full of treatments to help people get in control of their TMJ so they can feel better, heal, and get their lives back. Treatments include behavior modification, relaxation and breathing strategies, exercises, medications, and oral appliances. Trigger point injections, prolo injections, and BOTOX® can be very effective as part of an overall treatment plan, as well.

Now that you are aware that the #1 reason you have TMJ pain is your overworked jaw muscles, it’s time to get help. Click here to learn more about the best treatments for TMJ.

Are you located in the NYC metro area? We can help you. Our practice has four convenient locations: Manhattan, White Plains, Long Island (2 locations), and Springfield, NJ. To make your appointment, call 212-265-0110.

Nightguards & Oral Appliances TMJ

Can Mouth Guards Cure TMJ?

Post author By Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain
Post date January 23, 2023
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Patients will often come to me suffering from symptoms of TMJ and looking for solutions that don’t involve medication or surgery. Symptoms such as facial pain, headaches in the temples, inability to open to the mouth widely, sensitive teeth, or aching and throbbing jaw muscles can be unbearable. There are numerous remedies, for jaw related symptoms that include massages, home exercises, physical therapy, modified diets, and changes in daytime behaviors/postures. At times an oral appliance is an important part of care. These devices are commonly used for the treatment of TMJ problems and can be used in a number of different ways.

What is an oral appliance?

An oral appliance is a device that fits over your teeth with the intent of reducing tooth wear, tooth mobility, tooth sensitivity, muscle pain and soreness and joint pain and instability. At times but not frequently these devices are designed to “align the jaw.” They can also be used to discourage some of the daytime behaviors many patients don’t realize they’re doing, such as resting their teeth together, clenching their teeth, or biting their nails or cuticles. These appliances can be worn at night and/or during the day

In general the intent of these appliances is based on the problems experienced by patients.

Night guards: Most commonly these appliances are chosen by dentists to address tooth wear, soreness, and mobility that occur as a result of night clenching or grinding of the teeth. Many patients that develop tooth wear do not even realize that they have a problem and often deny grinding their teeth at night. These devices when used in patients without active symptoms (just wear of the teeth) don’t require much adjustment and should be brought by the patient when they return to the dentist for tooth cleaning visits. Typically these devices are custom fit so that they are retentive, not too thick, and modifiable over time. Over the counter devices sold in pharmacies and online are for the most part inadequate, as they are often too thick, poorly retentive, and inadequately cover all of the teeth. As a result these devices can often prompt more clenching, and/or allow tooth shift.

Night appliances to address TMJ problems: Based on the specific jaw problem that is diagnosed (muscle soreness, morning temporal headaches, limited jaw opening in the morning…etc) oral appliances at night are designed to reduce overuse and loading forces to the TM Joints and jaw muscles. The biting surface of the appliance is therefore designed and modified to most efficiently address the problems at hand. Most commonly the biting surfaces are flat but, at times, inclines and ramps are used to confront unstable joint ligaments and displaced discs. When used in patients with active symptoms, these appliances require frequent modifications requiring patient follow-up visits.

Day appliances to address TMJ Problems: At times there is necessity to have a patient wear an appliance during the day. For the most part these appliances are needed when there is extreme instability in a TM joint that has led to clicking, locking, and pain problems. These appliances are not worn all day and virtually never during chewing. At other times, oral appliances worn during the day hours can be used to get in the way of day behaviors and/or remind patients that during the day the jaw should be hanging in a rest position with the teeth apart.

How about oral appliances to re-align the jaw? This concept of jaw re-alignment to address a TMJ problem remains controversial. To date there is no science to support the concept that a poor bite or mal-aligned jaw is responsible for the emergence of TMJ symptoms. At most a bad bite or mal-aligned jaw may be a risk factor but with no more weight than other risk factors such as; female gender, gum chewing, clenching, night grinding, or stress. As long as there remain millions of people with bad bites and asymmetric jaws without symptoms this concept has to be viewed with skepticism. In addition, if an appliance were to be made to re-align the jaw, it would require the patient to bite or rest on it when in the mouth to hold the jaw in the ‘better’ position. This action of course would violate the principle that the jaws should hang at rest during the day. Clearly this option must be chosen with great care.

From an overall perspective the concept of curing a TMJ problem with an oral appliance is probably a bit of a stretch. Their use however is a critical part of TMJ treatment!

These appliances are extremely helpful in reducing the damage from night clenching or grinding. They work by diminishing the forces exerted on the TM joints and by diminishing the amount of contracture that can be generated in the jaw muscles. Night guards are most effective when custom fit, and adjusted over the course of time. Or you can purchase a generic set at a drug store. Obviously, custom-made night guards that have been conformed to your individual bite-print are more effective in treating TMJ symptoms, but the trade-off is that they’re more expensive.

Bite Splints: This form of therapy uses a mouth guard to physically correct the bite, rather than just relieve pain or reduce damage to the teeth. Bite splints are best for you if you have more extreme TMJ symptoms that need correcting in order to have a hope for any long-term relief. The primary difference between a bite splint and a night guard is that bite splints are worn around the clock, 24-7. It’s a full commitment to correcting the misalignment issues that are causing your TMJ.

So, can mouth guards cure your TMJ? The short answer is: Yes. In some cases, particularly with corrective bite splints, you can realign your bite over the course of time and eliminate those painful TMJ symptoms. In other cases, mouth guards can relieve your symptoms to the point where you feel very little pain or discomfort at all.

If you or someone you know is experiencing persistent or acute pain in the face or jaw, we invite you to set up a consultation with one of our Orofacial Pain specialists in the NYC metropolitan area. Our office locations and contact information are below.

Tags Can Mouth Guards Cure TMJ, Donald Tanebaum, Dr. Tanenbaum, TMJ, TMJ and Mouth Guards, TMJ and oral appliances, What is an oral appliance

TMJ

What Is TMD?

You might have heard about the temporomandibular joint disorder (TMD), and this disorder is also called TMJ. If you have felt pain in your jaw, you might have this common condition. Or your dentist might have told you that you have it. If you have questions about it, keep reading to find out more.

About TMD

This is not just a single disorder. Instead, it is a group of several painful conditions. These affect the temporomandibular joint as well as the surrounding muscles. It is not known how many people have the condition. However, women are often affected more than men.

There are three main kinds of this condition. The most common type of TMD is myofascial pain. It is pain or discomfort in the muscles that work with the function of the jaw. It can also cause pain in the shoulder or neck muscles.

With internal damage to the joint, there might be a displaced disk. The condyle might be injured, or the jaw might be dislocated. With degenerative joint disease, the patient might have rheumatoid arthritis or osteoarthrosis. Someone might be able to have one or more of these conditions at once. Research is still being done on how physical, behavioral, and psychological factors might contribute.

Causes of the disorder

A severe injury to the joint might cause TMD. With a heavy blow, the bones can be fractured, or the disk can be damaged. That can disrupt the motion of the jaw and cause locking or pain. Arthritis can also develop after an injury.

In some cases, a bad bite might also trigger the condition. With orthodontic treatment, such as braces, TMD might be triggered. Some people believe that chewing gum can cause clicking sounds since the joint can be overused in that case. However, if there is only clicking, then the condition might not need to be treated.

Diagnosis of TMD

The symptoms and causes of TMD are still not known. That means that diagnosing them can be hard at times. Currently, there is no standard test that can identify the condition. However, the patient can usually describe the symptoms for a diagnosis. The physical examination will include:

Feeling the chewing muscles and joints for tenderness or pain
Listening for popping, grating, or clicking as the joint moves
Looking for jaw locking or limited motion while the mouth closes or opens

It is also important to look at the dental and medical history of the patient. Many times, this will give the provider enough information to find the source of the pain. Then the jaw problem or pain can be identified. The patient can then get treatment.

Visit a dentist for TMD treatment

If you have pain in your jaw, you might want to consider having a dentist look at your symptoms. If you do have a TMD disorder, then getting treatment can provide you with relief. That will also prevent long-term damage to your joint. Making an appointment today is your first step.

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Pain & Sleep

Post author By Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain
Post date December 2, 2022
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The Connection Between Pain And Sleep

Over the last 10 to 15 years, there has been a great deal of research looking at the relationship between sleep and pain. As a result of these studies, it is now very clear that pain thresholds are significantly impacted by both the quality and quantity of your sleep.

If the quality and quantity of your sleep are compromised, your pain thresholds drop, which can lead to situations where pain is experienced in your muscles and joints on a daily basis. This is in spite of the fact that no clear evidence of joint or muscle injury exists. Rather, your pain is experienced as a result of normal activity and accentuated when muscles or joints are overworked.

Many people who are seen in our office describe pain in their muscles and joints as a result of normal eating and even talking. This points to the possibility that the nerve endings in their jaw muscles and joints are operating at a low threshold and, therefore, they experience pain almost all the time. This is called allodynia: when normal stimulation generates pain. In addition, excessive jaw use from teeth clenching and grinding produces even higher levels of pain beyond what is normally expected. Poor sleep can lead to all of these TMJ symptoms.

If you have insomnia (the inability to get to sleep or stay asleep), your pain thresholds can drop significantly. You may experience morning headaches and/or an assortment of body pain symptoms during the course of almost every day.

Sleep quality is also impacted if you have airway difficulties. If you’ve been diagnosed with upper airway resistance or respiratory effort-related arousal, your pain symptoms are commonly in your head and neck region. Headaches and temporomandibular problems are very common in people with airway challenges. Many patients who grind and clench their teeth (bruxism) have been shown to have airway problems, and some are diagnosed with obstructive sleep apnea.

There is an association (not an absolute relationship) between fragmented sleep and the occurrence of grinding and clenching activity. If you wake up with sore or tight jaw muscles, it is likely a result of bruxism activity.

We will ask you many questions about your sleep history during the evaluation process. Most sleep problems can be helped in my office. If your problem is more complex, we will consult with a sleep professional to help you get on the road to feeling better.

TMJ

How a Dentist Can Treat Your TMJ Pain

Post author By Dr. Steven Syrop
Post date October 15, 2022
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The temporomandibular joints (commonly abbreviated as TMJ) are the two joints connecting the jawbone to the skull. While healthy TMJ will work painlessly, the U.S. Department of Health and Human Services estimates that over 10 million Americans suffer from some kind of TMJ disorder. A dentist can often successfully treat TMJ pain with treatments either provided in the office or as part of an at-home regimen.

First-line therapies

Most dentists will first want to treat TMJ pain using noninvasive methods. Often, one or more of these therapies can help to reduce or eliminate TMJ pain.

Jaw exercises

Depending on a patient’s specific type of TMJ pain, a dentist may recommend exercises to stretch the jaw muscles, strengthen them or both. Regular, controlled working of the jaw can help increase mobility and promote healing. There is no single set of exercises that is beneficial for TMJ pain; a dentist will evaluate the causes of a specific patient’s pain and prescribe exercises based on that.

Mouthguards

A 2009 study published in the Journal of Manual & Manipulative Therapy found that occlusal orthotics (commonly called “mouthguards”) are one of the most effective ways to manage TMJ pain. These guards are custom-fitted to each patient and are designed to keep the jaw in a healthy, pain-free position. Patients who wake up with pain usually wear these at night. For those whose pain worsens throughout the day, a dentist will likely recommend wearing a guard for part of the day in order to break the habit of clenching the jaw.

Prescriptions

Often, a dentist will recommend over-the-counter pain medications to manage TMJ pain. For patients whose pain is severe, a dentist may briefly prescribe stronger pain medication. This type of prescription is almost always a temporary measure to relieve pain as treatment begins to take effect. For some patients, a dentist may also prescribe muscle relaxants, which can help reduce pain when the symptoms are caused by muscle spasms.

Advanced therapies

If conservative treatments do not improve a patient’s TMJ pain, a dentist may move to more advanced methods of addressing symptoms. These therapies carry more risk, but in some cases, they are the only way to eliminate pain.

Injections

In some people, corticosteroid injections into the affected joint can reduce TMJ pain. This is not a permanent treatment, but it can bring severe pain to a manageable level. Occasionally, botulinum toxin type A (commonly sold under the brand name BOTOX®) injections into the jaw muscle can also reduce pain.

Surgeries

There are a variety of surgical options available to treat persistent TMJ pain. These range from minimally invasive arthroscopic surgery to riskier, more involved open-joint surgery.

Conclusion

TMJ pain can get in the way of living a happy, productive life. For most patients, a dentist will be able to develop a treatment plan that works. If you are experiencing TMJ pain and looking for relief, do not hesitate to contact your dentist.

BOTOX® Jaw Problems Orofacial Pain TMJ

BOTOX® For TMJ Treatment – Your Questions Answered

As a board-certified orofacial pain specialist in NYC and Long Island, I’ve used BOTOX® for TMJ treatment for over fifteen years. If jaw problems greet you upon waking up in the morning, limit your food choices, prompt you to take pain medications like Advil®, Aleve®, or Tylenol® on a routine basis, and have had a negative impact on your life, BOTOX® injections may be something for you to consider.

7 Common Questions About BOTOX® For TMJ Treatment

BOTOX® for TMJ treatment is a subject around which there is a considerable amount of confusion. To make the best decision for yourself, you should know what BOTOX® is, how it is administered for TMJ treatment, and how to choose the right health provider. Here are 7 of the most common questions I get from new patients and the answers:

1. What Is BOTOX®?

BOTOX®, or botulinum toxin, is what’s known as a neuromodulator. Neuromodulators reduce the ability of a muscle to contract to its maximum capacity. In BOTOX® for TMJ treatment, it is injected into your temporalis and masseter muscles, which are the muscles that enable you to bring your upper and lower teeth together.

When we inject BOTOX® into masseter and temporalis muscles, it partially inhibits their ability to tighten to their fullest extent. The result is a reduction in the force of jaw clenching and grinding – one of the common causes of TMJ pain. When the force is lessened, the pain being experienced is also often reduced.

BOTOX® can also reduce the bulk and size of your jaw muscles. Some patients come to my office simply seeking to change the shape of their jaw or reduce the size of their masseter muscles.

2. What’s The Difference Between BOTOX® For Wrinkles & BOTOX® For TMJ Treatment?

In your face, you have “muscles of facial expression.” These muscles enable you to frown, scowl, flare your nostrils, move your eyelids, and smile. To do so, they pull on your skin. As you age and your skin loses some elasticity, it causes wrinkles to appear.

BOTOX® injections have been found to effectively reduce or even eliminate wrinkles by reducing the ability of the muscles to pull on your skin. But, the forces of facial expression are always present, so the use of BOTOX® injections to reduce wrinkles is a lifetime commitment.

BOTOX® for TMJ treatment works differently – instead of injecting into your muscles of facial expression, the injections are into your “muscles of mastication” (your jaw muscles). During an office visit, BOTOX® is commonly injected into four to six areas in the masseter muscle and three to four areas in the temporalis muscles.

While skin wrinkling is a normal part of aging, overworked and symptomatic jaw muscles are not. They get that way for a reason, regardless of whether you’re 18 or 80.

BOTOX® can be a valuable tool to allow your jaw muscles to heal if your pain and stiffness persist after the risk factors that caused your TMJ problems have been identified, reduced, or eliminated.

3. How Long Does It Take For BOTOX® To Kick-In?

BOTOX® and other neuromodulators, such as Xeomin®, can be life-changing. But the benefits do not kick-in right away, and most people have to wait four days to a week before they experience the first indication of relief. Here’s why:

Your muscles contain and rely on a neurotransmitter called acetylcholine which enables them to contract. After BOTOX® injections, it will take a few days for your muscles to use up their supply of acetylcholine. When the level of acetylcholine drops and is not replenished to its normal level, the positive effects of the injections are usually felt.

4. How Long Will The Benefits Last?

The vast majority of TMJ patients that chose BOTOX® find that their symptoms are reduced even after the first injection visit, though not eliminated. The getting better process is slow, as it takes months for long-term muscle injuries to heal.

The best results are achieved when patients continue to complement the BOTOX® with a nightguard, jaw stretching exercises, a cautious diet, and ongoing efforts to pay attention to daytime jaw overuse behaviors. For most patients, there is a need for one or two additional injection sessions, spaced three months apart, so that the jaw muscles continue to get the rest they need to recover adequately. Within nine to twelve months, there is often a significant reduction in jaw muscle pain, tightness, and daily soreness.

5. How Many Injections Will I Need?

The full benefits of BOTOX® for TMJ treatment are typically not achieved from just one round of injections. Instead, you will likely require a series of injections spaced three months apart.

BOTOX® is, in most cases, not the first treatment you’ll be offered to reduce your jaw pain, soreness, stiff muscles, and motion limitations. The truth is that other treatments usually get the job done. Most of my patients get better by a combination of treatments such as modifying their diet, jaw exercises, massage, physical therapy, chiropractic care, medications, nightguards, and by non-BOTOX® muscle injections. And most importantly, trying to reduce or eliminate daytime jaw overuse behaviors such as nail-biting and teeth clenching.

6. What Are The Side Effects Of BOTOX® For TMJ Treatment?

Repeated injections of BOTOX® in masseter and temporalis muscles over a long period of time can cause some problems. If it is not administered properly, the result can be muscle weakness, and an acceleration of joint noises, making it difficult to eat certain foods. It could hollow out your temporalis muscles and flatten the contour of your face.

Therefore, it is of critical importance that when you seek a healthcare professional to administer BOTOX® for TMJ treatment, you choose one who fully understands the anatomy and function of the muscles of mastication and the risk factors that prompted your muscles to become overused.

7. Will I Need Long-Term, BOTOX® Injection Sessions?

There is always a small percentage of patients whose chronic jaw muscle pain (often years in the making) require ongoing BOTOX® injections, in a way similar to Migraine sufferers. Here’s why:Muscle pain occurs when muscle fibers are injured or overworked. Injured and overworked jaw muscles, often due to daytime clenching and nighttime grinding, a high level of lactic acid is produced. When the lactic acid builds up to a high level, a muscle’s nerve endings become excessively excited, which leads to persistent pain.

The pain is now not only in the muscles but in the nerves themselves. This condition is called sensitization (think of it as a sunburn). Sensitization is much more challenging to turn off than simple muscle.

Fortunately, BOTOX® can help nerve sensitization, but the results are harder to achieve and maintain. As a result, ongoing BOTOX® injections may be needed for some patients, with a frequency of three to four times a year without an absolute stop date. Careful attention is required for these patients to ensure their jaw muscles do not become excessively weakened.

BOTOX® For TMJ Treatment – The Bottom Line

If your problems have persisted for a long period of time and despite treatment by your dentist, you’re still suffering, the next step is to find a board-certified orofacial pain specialist that has experience using BOTOX® for TMJ treatment.

You do not have to suffer every day from the pain and discomfort of TMJ. Relief is available.

More helpful information about BOTOX® from Dr. Tanenbaum:

7 Things To Know If You’re Considering BOTOX® Injections For Your TMJ

BOTOX® for TMJ Pain

Tags Botox, Jaw Problems, Orofacial Pain, TMJ

TMJ

Are TMJ and TMD the Same Thing?

Post author By Dr. Steven Syrop
Post date July 14, 2022
No Comments on Are TMJ and TMD the Same Thing?

The terms TMJ and TMD are similar but not the same. TMJ stands for temporomandibular joint, which connects the jaw to the skull bones located right in front of the ears. There are certain issues that cause this joint to work incorrectly, and when this happens, it is referred to as TMD, which is short for TMJ disorder. Many people, however, incorrectly refer to disorders of the joint as TMJ.

Symptoms of TMD

Factors involved with disorders of TMJ include injury to the jaw or joint, chronic tension in the face and jaw, teeth grinding and arthritis. These can cause a variety of symptoms, and these range from mild to severe:

Soreness and tightness around the jaw
Clicking and popping with jaw movement
Trouble chewing due to crooked bite
Extreme pain around joint and facial muscles
Aching in and around the ear
Locking of the jaw in the open position

If TMD is caused by increased stress and tension, this may put extra strain on the surrounding muscles of the neck and upper back. This may lead to secondary symptoms such as neck pain, headaches or sore shoulder muscles.

Treatment for TMD

The treatment for TMJ disorders varies based on the cause and the severity of the symptoms. For mild symptoms, no medical treatment may be necessary. At-home remedies can include ice packs, relaxation techniques and avoiding foods that stress the jaw.

Mouthguards, bridges and crowns

For moderate and severe symptoms, the dentist or doctor typically begins with conservative treatment before more invasive procedures. With teeth-grinding or clenching, a splint or mouth guard is recommended. In some cases, the symptoms are due to an issue with the teeth, so treatment may include dental work such as bridges or crowns.

Pain medications, muscle relaxants and antidepressants

Medication may be recommended for pain relief and muscle relaxation. Over-the-counter anti-inflammatories are often used first, but prescription pain meds may be recommended if the discomfort persists. Muscle relaxants may also be prescribed for the short term to relieve muscle tension. In rarer cases, anti-anxiety medication or antidepressants may be prescribed in low doses. These have been shown to improve relaxation, relieve pain, help improve sleep and decrease the occurrence of teeth grinding.

Physical therapy, acupuncture and surgery

Alternative therapies, such as physical therapy, massage, chiropractic, low laser therapy, ultrasound, acupuncture and biofeedback may help some who suffer from symptoms. If other methods do not relieve TMD symptoms, surgery or other procedures may be recommended. Surgical procedures include open-mouth surgery, arthroscopy and arthrocentesis. Injections, such as botulinum toxin type A or corticosteroid, may also alleviate pain.

Conclusion

People who suffer from TMJ disorders experience a wide variety of symptoms, and a number of them can reduce the quality of life. If someone suspects they have issues with the joint, they should seek help from a doctor or dentist because some of the symptoms mimic other conditions. Fortunately, there are effective treatment options for TMD to help reduce pain and increase the function of the jaw.

BOTOX® TMJ

BOTOX® For TMJ Pain

Post author By Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain
Post date July 12, 2022
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Does It Work?

Despite the press advocating BOTOX® for TMJ pain problems, my clinical experience using it over the past 15 years suggests that it represents another supportive treatment at best and may not live up to the hype over the long term.

To start the discussion let’s focus on who is even a candidate for BOTOX®, a chemical agent that can be used to partially reduce muscle contracture. Since most of the commonly seen TMJ problems are orthopedic in nature, patients typically experience muscle and joint pain, limited jaw motion, difficulty chewing, and at times joint clicking, popping and locking.

Those patients whose problem is mainly mechanical – whose jaws click, pop, and lock – are typically not good candidates for BOTOX® injections. BOTOX® for TMJ pain and for people whose jaws have become more prominent due to excessive teeth grinding are more likely to get relief.

If you look at the common muscle problems we encounter with TMJ, the vast majority of patients will get better by:

Education, behavior, and diet modification
Postural awareness
Home exercise
Massage
Short-term medication

More stubborn problems will get better by adding:

Oral appliances
A prescription for physical therapy
Trigger point injections and/or acupuncture

That leaves only a small percentage of patients who would benefit from using BOTOX® for TMJ pain. It can be very effective in alleviating persistent jaw muscle pain resulting from the accumulation of lactic acid and other irritating substances. What makes people grind their teeth? Teeth grinding for most people is the result of negative emotions (stress), daytime overuse behaviors that fatigue the jaw and/or restless sleep associated with frequent arousals, and at times tooth clenching and grinding. Even when BOTOX® for TMJ pain is used in this select population of patients, success can only be achieved if what caused the problem in the first place is controlled or eliminated. It’s not an easy task!

People who opt for BOTOX® for TMJ pain typically need injections over a period of 9-12 months. If you are among the select few who are candidates, you have reasons to be optimistic. Patients for whom first-line therapies have failed report reduced suffering. Although still clench or grind their teeth they feel less pain as a result.

BOTOX® For TMJ Pain – The Take-Away

BOTOX®does have a place in the management of jaw muscle pain, but it is important to understand that it’s far from the remedy it is made out to be by those trying to sell it as a cure for TMJ problems.

Pain issues and sleep challenges do not have to be lifetime afflictions. You need someone who listens and possesses the knowledge and compassion to get your pain and sleep problems under control. I am that someone – and you’re in the right place.
Dr. Donald Tanenbaum, DDS MPH

Tags botox for TMJ, does Botox cure TMJ, Dr. Tanenbaum, TMD, TMJ treatment options

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TMJ

Can A Dentist Treat a TMJ Headache with BOTOX®?

Post author By Dr. Steven Syrop
Post date July 5, 2022
No Comments on Can A Dentist Treat a TMJ Headache with BOTOX®?

BOTOX® is probably best known as a cosmetic treatment for wrinkles; however, it can also be used to treat the symptoms of TMJ disorders. Patients who experience tension headaches due to nighttime teeth clenching and grinding are most likely to experience relief from this treatment.

BOTOX® injections for TMJ relief

Temporomandibular joint disorders cause some people to clench and grind teeth during sleep. This activity puts a large amount of stress on the TMJ. This often causes tension headaches, sore facial muscles and stiff joints. An injection of BOTOX® into the facial muscles can reduce the jaw tension that often triggers grinding and clenching. This treatment works by preventing jaw muscles from being able to perform the unconscious movement of the jaw.

The injections only affect the muscles at the site of injection. Patients do not experience the effects in any other part of the body. The most common injection sites are the temporalis, frontalis and masseter, but other sites may receive injections if required to relieve symptoms.

Benefits

Muscle tenderness, headaches, lockjaw, jaw discomfort, and shoulder and neck pain may begin to diminish shortly after the injection. Though the primary purpose of this treatment is not cosmetic and some patients may not experience any change in appearance, wrinkles at the injection sites may begin to fade 24-48 hours after the procedure and may continue to fade for as much as a week after.

The procedure

BOTOX® injections can be administered in a dentist’s office. The length of the procedure varies, depending on the number of injections that are given, but usually lasts from 10-30 minutes. Some patients experience brief, mild, pain that can be reduced by the use of numbing agents. Results usually last three to six months. Regular treatment is required to maintain results.

Recovery

Most patients can return to normal activities immediately; however, care should be taken to avoid spreading the toxin to other parts of the body. Patients should avoid rubbing or massaging the area around the injection site or lying down for several hours after the procedure. It is also recommended to limit strenuous physical activity for 24 hours.

Side effects

The side effects of botulinum toxin treatment are infrequent and usually mild and short-lived. Patients sometimes experience pain, redness at the injection site, bruising and muscle weakness. The most common symptoms usually resolve within seven days:

Respiratory infection
Flu-like symptoms
Temporary eyelid droop
Nausea

Limitations

Overuse of BOTOX® injections around the mouth can make chewing and speaking more difficult or result in drooling for some people. Additionally, long-term use may result in the development of antibodies that can reduce the effectiveness of the treatment. These treatments are not recommended for people who are pregnant or lactating.

Conclusion

BOTOX® injections can help relieve headaches and other symptoms for some patients with TMJ disorders caused by clenching and grinding teeth. Additionally, the injections may reduce the appearance of wrinkles at the injection sites.

TMJ

Is BOTOX® for TMJ Safe?

Thinking about undergoing BOTOX® treatment to address your TMJ problems? Making an appointment with a TMJ specialist is the first step. According to Healthline, BOTOX®may help treat the following TMJ disorder symptoms: jaw tension, headaches due to teeth grinding and lockjaw in cases of severe stress.

About TMJ

Wondering if you should try BOTOX® to address your TMJ symptoms? Many people who have been diagnosed with a TMJ disorder will use over-the-counter or prescribed medications to help them deal with the discomfort and pain associated with TMJ. Some will have their dentist make a custom-made mouthguard for them, as this helps prevents the grinding and clenching that can make TMJ symptoms worse. For those who do not get relief by using one or both of these options, BOTOX® is considered to be the next level of treatment.

About BOTOX®

BOTOX® is a drug that offers many benefits. One of these benefits includes temporarily paralyzing the muscles in and around the jaw joint area. When this drug is used in small doses, it allows TMJ sufferers to experience relief from the discomfort or pain they experience on a daily basis due to their disorder symptoms. BOTOX® is a temporary solution for those diagnosed with TMJ. Patients will need to make an appointment to make sure they are a good candidate to undergo this procedure.

How safe is using BOTOX® to treat TMJ?

Since BOTOX® is a drug, many people wonder how safe it is for them to undergo BOTOX® treatment. Since BOTOX® is approved by the Food and Drug Administration, it is a safe treatment option. While the FDA has deemed BOTOX® to be safe when used to address certain situations, anyone who is interested in this option must understand that BOTOX® injections need to be performed by a trained professional. This makes finding a TMJ specialist a good idea, as they are highly qualified to administer BOTOX® to TMJ patients.

Choosing a trained professional means that patients can expect to be informed of everything they need to know about this treatment for TMJ. This includes understanding where the injections will take place, how many injections they will receive and how long they can undergo BOTOX® injections, as well as understanding what the potential side effects are, e.g., soreness, nausea, etc. It is also important for patients to carefully follow any aftercare instructions when it comes to successfully treating TMJ using BOTOX®.

In need of TMJ treatment?

Thinking that BOTOX® may be the right solution for addressing your TMJ-related problems? Making an appointment with a TMJ specialist is the next step. For those who still have questions, please do not hesitate to contact us at your earliest convenience.

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TMJ

Why You Should Seek Out Help for Your TMJ Disorder

Post author By Dr. Steven Syrop
Post date May 11, 2022
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If you are experiencing symptoms like jaw pain and stiffness, TMJ disorder might be the problem. This disorder can have a significant impact on your physical and mental health. The condition generally worsens without treatment. A TMJ specialist is a trained and experienced professional who offers treatment for TMJ disorders. Continue reading to find out why going in for treatment is crucial.

TMJ disorder and the treatment options

The temporomandibular joint (TMJ) is a complex joint that enables the jaw’s range of motion. The joint is one of the most used joints and is therefore prone to issues. Sometimes, the joint’s soft tissues may get inflamed. Aside from repeated usage, stress is another major cause of TMJ disorder. People tend to clench their jaw when feeling nervous or anxious, which only induces more stress on the joints.

The TMJ specialist has different treatment options for the disorder. First, they will have a consultation session and examine the patient’s jaw, then they will recommend the best solution to the issue. The first choice is generally conservative, and patients will continue to visit for progress assessment so the doctor can determine if further care is required. Treatment options include oral splints, medications, stress management, and lifestyle adjustments. Corrective jaw surgery or minimally invasive surgery is only recommended in severe cases.

Reasons to seek TMJ treatment

Treating TMJ disorder is important due to its impact on health and quality of life. Reasons to seek help for the disorder include the following.

Relieve discomfort: Jaw pain is not the only TMJ disorder symptom. It can also result in neck pain, jaw stiffness, chronic headaches, and upper back pain. Jaw pain inhibits normal jaw functions, so activities like eating can become uncomfortable. Getting treatment relieves pain and restores normal functionality.

Minimize risk of dental damage: Bruxism and TMJ disorder are usually related. Teeth grinding can cause the disorder and vice versa. Chronic bruxism can cause enamel deterioration and teeth damage. Treating TMJ disorder may resolve the grinding habit and prevent further damage to the teeth.

Protect ear health: Serious cases of TMJ disorder can cause tinnitus or constant ear ringing. The ringing can disturb hearing and sleeping. While scientists are continuing to research the connection between the two conditions, treating TMJ almost always resolves tinnitus as well.

Improve overall health: TMJ disorder has been associated with many systemic health disorders, including chronic fatigue, sleep apnea, rheumatoid arthritis, dizziness, fibromyalgia, and Meniere’s disease. Also, it is uncertain what the link between these conditions is. However, treating the disorder can be necessary for resolving those health conditions and restoring general wellbeing.

Seek help from the TMJ specialist

TMJ disorder symptoms can have devastating effects on your health. The TMJ specialist will develop a personalized treatment plan to treat the condition and alleviate the accompanying discomfort. If you are suffering from the condition, you need to seek help as soon as you can. This prevents complications and ensures that you can benefit from minimally invasive treatment options.

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TMJ

How TMJ Disorder Can Trigger Migraines

Post author By Dr. Steven Syrop
Post date May 2, 2022
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TMJ disorder is common in the United States and affects more than three million people annually. One of the more frequent and severe symptoms of TMJ disorder is migraines. Often, treating TMJ disorder is essential for stopping chronic migraines.

TMJ disorder and migraines: is there a connection between the two?

TMJ disorder can put a lot of stress on a person and lead to the onset of migraines. Migraines can hinder a person’s ability to function properly each day, so treating the underlying concern is often essential. The following is a review of how patients are able to find relief through TMJ treatment.

What is TMJ disorder?

TMJ disorder affects the joint that is responsible for the mouth opening and closing, known as the temporomandibular joint (TMJ). This joint serves as a sliding hinge and may become stiff, sore, or even locked, which can create discomfort in the face and lead to symptoms such as locked jaw and migraines.

How are TMJ disorder and migraines related?

TMJ disorder is not considered a cause of migraines. However, it is often considered a trigger. This is largely due to the physical stress that TMJ disorder places upon the facial muscles. It can lead to a tension headache that can eventually progress into a full-blown migraine. Studies have suggested that many who treat their TMJ disorder see the frequency of their migraines significantly reduce or go away entirely.

How is TMJ disorder treated?

TMJ disorder treatments vary based on the severity and reason for the problem. Self-care and the use of a mouthguard to wear while sleeping may be all that is necessary in some minor instances. Therapies such as biofeedback and some medications may be appropriate as well. In the most severe cases, surgery may be an option.

What are the symptoms of TMJ disorder?

TMJ disorder may look different for everyone who has it. However, some symptoms are more frequently reported. These symptoms include:

Chronic jaw pain
Headaches
Migraines
Difficulty chewing
A clicking sound from the jaw
Locked jaw
Face and ear pain
Toothache

Many of these symptoms could be related to alternative oral health concerns, so it is important to visit a TMJ specialist for an accurate diagnosis and an appropriate treatment plan.

Additional tips for migraine prevention

For many patients, particularly those whose underlying cause of migraines is TMJ disorder, treating TMJ disorder is all that is necessary to relieve the migraines. However, some patients may still experience migraines if there are other causes. To further reduce the risk of migraines, consider keeping a journal of foods and activities to determine potential triggers that may increase the risk of migraines.

Speak with a member of our team about TMJ disorder treatment

Our TMJ specialist can help you put together a treatment plan that not only addresses your migraines but also relieves TMJ disorder, which is often the primary reason for migraines. To learn more about TMJ disorder treatment, contact our team today to schedule a visit.

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How To Get Relief From TMJ Pain When Nothing Is Working

When exercises, medication, nightguards, relaxation techniques, and a soft diet don’t provide relief from TMJ pain, injections for TMJ may be the next step.

What Causes TMJ/TMD Problems?

Note: TMJ stands for Temporomandibular Joint, which is your jaw joint, and TMD stands for Temporomandibular Joint Dysfunction, which refers to jaw problems. Because most people use the catchall term “TMJ” to describe all TMDs, I use the term TMJ in this article.

Anything that causes your jaws to be overworked and fatigued, such as continually clenching your teeth, biting your nails during the day, or clenching and grinding at night, puts you at high risk for TMJ. However, your TMJ problem could stem from a history of trauma or a medical or dental procedure that sprained your jaw joints or strained the muscles and tendons. In some cases, systemic disease or a disorder can predispose you to experience inflammation, pain and instability in your jaw joints, ligaments, and/or tendons.

Regardless of the cause of your TMJ, if your jaw’s in trouble, you want treatment that will provide relief.

First-Line Therapies For Relief From TMJ Pain

I’ve been a TMJ doctor and orofacial pain specialist for nearly four decades. During that time, I’ve treated thousands of patients and have at my disposal many first-line therapies to help my patients feel better and get better (once an accurate diagnosis has been made). They include:

Nightguards or specifically designed oral appliances that address teeth clenching, grinding, and joint instability during sleep
At-home exercises
Anti-inflammatory and/or muscle relaxant medications
Stress-reducing activities such as meditation or yoga
Adherence to a soft diet
Reducing or eliminating the daytime behaviors that overwork the jaws
Physical therapy

While most of my patients respond well to the first-line therapies above, you may be someone for whom the above strategies simply don’t work. What’s next for you?

Injections For TMJ

I’m sure you’ve read about people having BOTOX® injections for TMJ problems, but BOTOX® is not the only injectable that can help. In fact, it is not the right choice for many patients. The good news is there are injections for TMJ that are less risky and can be very helpful to provide relief from TMJ pain. They include jaw muscle injections, injections into the tendons or ligaments, and injections into the temporomandibular joint itself.

Jaw Muscle Injections For TMJ

Trigger point injections, sometimes called dry needling, can help reduce the muscle spasms, tension, associated pain and limited jaw motion experienced by many TMJ sufferers. They’re also designed to reduce the likelihood of “referred” pain when irritated jaw muscles refer pain to other locations such as your teeth, ears and sinuses. With trigger point injections, the mechanical prodding of the muscle with a needle creates the benefit. Some providers inject a bit of Lidocaine, a local anesthetic, to make the procedure more comfortable. Trigger point injections are typically repeated several times before the spasms and muscle tension release. When combined with exercises and other home care techniques, trigger point injections for TMJ can be very effective for people whose problems have not responded to first-line treatments.

Tendon and Ligament Injections For TMJ

Sometimes first-line therapies fail because pain is due to stubborn and persistent inflammation in a jaw tendon or ligament. In this case, prolotherapy and steroid injections are often effective:

Prolotherapy, also known as proliferative therapy, involves a combination of dextrose and an anesthetic. Dextrose is a natural irritant that can kick-start your body’s natural healing response and the anesthetic helps deaden pain. When injected directly into damaged tendons and/or ligaments prolotherapy can strengthen and repair them. When combined with exercises and home care strategies, prolotherapy injections for TMJ can provide a great deal of relief from TMJ pain and also promote healing. The injections typically need to be repeated several times over a few months for full effectiveness.
Steroid injections into irritated tendons and ligaments can also provide life-changing relief from TMJ pain and usually are administered in a series. If overused, however, steroids carry some serious risks, so your steroid injections should be administered only under the guidance of an experienced clinician.

Injections Into The Jaw Joint

Some TMJ problems stem from inflammation or structural compromises in the jaw joint itself. They can’t move their jaw without severe pain and experience mechanical symptoms as well, such as clicking, popping, or locking and gravelly sounds emanating from the joint. Injections directly into the temporomandibular joint can often help. There are two types of joint injections for TMJ: steroids and hyaluronic acid.

Steroid injections are frequently used to ease pain in the knees, hips, shoulders, etc. So, it’s no surprise that steroids can also provide relief from pain in the TM joint. Depending upon the severity of your underlying joint problem, one shot may be all you need for life-changing pain relief. If your pain doesn’t diminish with just one injection, you may need a series. Proceed with caution because, as I mentioned above, steroid injections carry risks when overused.
Hyaluronic acid injections into the jaw joint are another strategy. Your jaw joint contains a substance called synovial fluid, which provides nourishment and shock absorption to keep them healthy. When there’s a change in the volume or quality of synovial fluid due to jaw overuse or trauma, the result can be pain and joint noises. When hyaluronic acid, a lubricating substance, is injected into the joint, the relief from TMJ pain and noises can be profound. Research suggests that hyaluronic acid also provides an anti-inflammatory effect. The only drawback to hyaluronic acid injections for TMJ is that the positive effects can be short-lived.

New Injections For TMJ Are On The Horizon!

Many research efforts show that over 30 million Americans have TMJ/TMD problems. Some problems are minor, but others can lead to life-compromising pain and jaw function limitations. There is a great need for earlier diagnoses and pain and discomfort management for people who suffer. There’s also a need for therapies that are specifically designed for treating stubborn and persistent TMJ problems.

Fortunately, emerging therapies such as stem cell and blood component injections may be able to regenerate new tissue in TM joints, ligaments and tendons. The research is very promising, and I suspect in the near future, these new and innovative types of injections will become commonplace for treating TMJ/TMD problems and provide the kind of healing that has not been achievable with other established injection therapies.

The Last Word

If you’re suffering from jaw problems, we know what you’re going through. Orofacial pain specialists like us have the knowledge to accurately diagnose your problem and the skills to help you find relief from TMJ pain, whether by first-line therapies or injections for TMJ. We invite you to set up a consultation with one of our Orofacial Pain specialists in the NYC metropolitan area. Our office locations and contact information are below. If you’re not in the NYC metropolitan area, go to the American Board Of Orofacial Pain and search for a physician with diplomate credentials in your area.

Feel Better!

Options for TMJ Disorder Treatment

Post author By Dr. Steven Syrop
Post date March 10, 2022
No Comments on Options for TMJ Disorder Treatment

You may not think much about TMJ disorder unless a dentist diagnoses you with it. This is a serious condition that can cause much pain and discomfort. Untreated, this disorder can make it difficult to chew and even speak. Instead of suffering and being in agony, you can speak to your dentist. Fortunately, relief is available with a few different treatments. Your dentist can look at various options.

A look at TMJ

On both sides of the jaws is a joint called the temporomandibular joint. This sliding hinge-like joint connects the jawbone to the skull. It is critical for any activities that require opening and closing the mouth. Most of the time, people do not even think about using this joint. However, injury, wear and tear, or bad habits can put a strain on the joint, irritating it.

Disorder of this joint can bring excruciating pain to the individual. The feelings can radiate up to the ears and throughout the face. The jaw may even be tender to the touch. This disorder can limit a person’s range of motion in the jaw. It may even cause headaches and interfere with a person’s quality of life.

Diagnosing the disorder

A person can look for the signs and symptoms of TMJ, but a dentist will diagnose it. The dentist will examine the patient and confirm that there are concerns with the joint. First, there will be a series of X-rays to see if there are visible signs of injuries. The dentist will look at the jaw and check the range of motion. It may even help to listen as the patient opens and closes the mouth, as the jaw could make popping or clicking sounds. The dentist will also press on both sides of the jaw and ask the patient how uncomfortable it is.

Medication

Controlling the effects of TMJ is a good first step that the dentist will take. The dentist can prescribe a variety of medications, including pain relievers and anti-inflammatories. Taking muscle relaxants can also help the person feel more comfortable and have an improved range of motion in the jaw. Some dentists may even give the patient an antidepressant, which is sometimes shown to relieve pain and help stop teeth grinding.

Physical therapy

Another approach is to walk the patient through mobility exercises to strengthen the jaw. The dentist can help the patient stretch the jaw muscles and improve flexibility with the joint. The patient should always follow the dentist’s instructions when it comes to these exercises. The dentist may also advise the patient to apply heat and cold packs to the jaw to reduce pain and any swelling.

Surgical options

In more advanced TMJ cases, surgery may be necessary and effective. One approach is a process called arthrocentesis. The dentist will drain the joint of fluid and other materials using small needles. Arthroscopy is another option and is less invasive than open-jaw surgery. However, open-jaw surgery may be the right treatment when other measures have not been successful.

You can find relief

Living with TMJ can be difficult. You should not have to suffer the effects of this disorder. Your dentist can properly diagnose you and provide the right treatment. If you have jaw pain, make a dental appointment today and get the help you need.

Headaches Jaw Problems Nightguards & Oral Appliances Orofacial Pain TMJ

Which Type Of Dental Night Guard Is Right For You?

As an orofacial pain specialist, patients come to me when they’re suffering from the painful symptoms of a temporomandibular disorder, which you may know as TMJ. TMJ refers to the temporomandibular joint, the joint that enables you to open and close your mouth. Many new patients who come to my office have been wearing a standard dental night guard (sometimes called an oral appliance, occlusal splint, or mouth guard) while they sleep, but their symptoms are not improving or even getting worse. Before I explain which type of dental night guard is right for you, I want to make sure you understand TMJ and its causes.

First, What Causes TMJ?

Symptoms of jaw (TMJ) problems often arise due to sleep bruxism, a condition characterized by constantly grinding or clenching your teeth during sleep. Sleep bruxism affects about 10% of adults and up to 15% of children.

The American Dental Association has been surveying dentists about TMJ since the beginning of the pandemic. More than 70% report a significant increase of patients who are grinding and clenching their teeth both during sleep and while awake (called awake bruxism) – many of whom never had the issue before. Some patients even have cracked or broken teeth as a result of bruxing. Bruxism is thought to be related to several risk factors, including high-stress levels – so it comes as no surprise that this increase coincides with the pandemic.

How To Determine Which Type of Dental Night Guard Is Right For You

If you’re like many people, your dentist may have informed you that your teeth are becoming flat and worn-down because of grinding and clenching while you’re asleep. Your dentist may have recommended you start wearing a dental night guard while you sleep, or you may have already purchased one over-the-counter at your pharmacy.

If this sounds familiar, the standard type of night guard made by your dentist is probably adequate. However, over-the-counter night guards must be used with caution and for a limited amount of time because they can cause your teeth to shift.

However, if you’re one of those people who have a sense that something’s wrong because your teeth are sore, or your jaw muscles feel tight when you wake up in the morning, or if you have any of the symptoms listed below, a standard guard made by your dentist or an over-the-counter night guard you buy at a pharmacy is probably not the dental night guard that’s right for you.

All Dental Night Guards Are Not The Same

TMJ problems often involve the structures of your temporomandibular joints and usually require more evaluation and different types of dental night guards for your specific problem. If you suffer from any of the TMJ symptoms below, a standard dental night guard will likely not address your specific problem and could even make your problems worse.

Symptoms of TMJ:

Difficulty opening your mouth
Pain (beyond soreness or discomfort) when opening/closing your mouth
Jaw pain when you eat
Clicking or popping in your jaw during movement
A sense that your jaw is locked
A feeling that your bite is “off”
Daily pain and tension in your face
Headaches when you wake up
Tension or pain in your neck

Like other joint systems in your body, TM joint problems are orthopedic problems. There are ligaments that support your jaw joints and shock-absorbing discs that cushion them. And, there’s also a lubrication system that keeps your TMJs moist and nourished. These all can become compromised due to teeth grinding and clenching, whether it happens while you’re asleep, during the day, or both.

The result is often injury to your TMJs resulting in sprains, instability and painful inflammation. Sometimes, the pressure of grinding and clenching can even cause one of your shock-absorbing discs to change and cause joint noises, lockjaw and pain.

What To Do Next

Your next step is to make an appointment with an orofacial pain specialist. An orofacial pain specialist will likely provide you with a clear understanding of your problem (a specific diagnosis beyond “you have TMJ.”). And explain why your jaw muscles and joints are in trouble and what treatments are available in addition to a dental night guard. Many factors can give rise to a TMJ problem, so you will likely be asked questions about your medical health, mental health, sleep, dental history, and about you as a person.

Based on the information gathered and an examination, there’s a good chance your orofacial pain specialist will fabricate a dental night guard that’s right for you – designed to address your specific orthopedic problem – not just to protect your teeth. Factors like the thickness of the night guard, its surface (flat or designed to prevent shifting of the lower jaw), its use on the upper or lower teeth, and where the support is provided are just some of the factors that will be considered.

To find an orofacial pain specialist in your area, ask your dentist for a referral or check the directory at the American Board of Orofacial Pain website.

Your Dental Night Guard Needs To Be Monitored

A diagnosis beyond “You have TMJ” is essential in designing a night guard that will reduce strain and injury to your jaw muscles and tendons, joint ligaments, shock-absorbing discs and lubrication systems. Here’s the most important thing to understand: regardless of whether your dental night guard was designed by your dentist or an orofacial pain specialist, it will not stop your bruxism. When properly designed, your night guard will instead reduce the impact on your teeth, muscles and TMJs caused by your grinding and clenching. In essence, it lets you clench or grind in a “better neighborhood” with the goal of keeping more injury from occurring while you work on reducing the risk factors that caused your jaw to be in trouble in the first place.

And, because a well-constructed dental night guard redistributes force, it must be monitored and adjusted while healing occurs and your symptoms change. It’s essential to go in for regularly scheduled reassessments and modifications to maximize the potential for treatment to be successful.

So, Which Type Of Dental Night Guard Is Right For You?

If you wake up with any of the TMJ symptoms above – even if you’ve been wearing a dental night guard, do not give up hope! A more specific diagnosis, a better understanding of why you have the problem, and a night guard designed to address your individual symptoms may well be the answer. Based upon the nature of your problem, more comprehensive care is usually part of the plan, which may include exercises, stress-reducing activities such as mediation or yoga, medication, dry needling and trigger point injections, BOTOX® injections or joint injections. These decisions are best made by an orofacial pain specialist.

Feel better!

Learn more about TMJ and bruxism here

Tags Bruxism, Headaches, Jaw Problems, Oral Appliances, Orofacial Pain, TMJ

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Can A Dentist Cure Your Headaches?

Most people who suffer from severe headaches don’t think about going to their dentist to get help. But a dentist may be the right professional to turn to if your physician has not been able to determine the root cause of your pain. But first, it’s important to determine whether the headaches you are experiencing fit into a primary or secondary category.

Primary headaches are migraines, tension headaches, and cluster headaches. Many dentists do see patients with primary headache problems, but it’s for the secondary type of headache that they can be particularly effective.

Secondary headaches can be caused by many things, but in particular, trauma to the temporomandibular joint. The temporomandibular joint is your jaw joint and problems in this area are commonly referred to as TMJ. A traumatized jaw joint can be the result of injury, a structural deficiency, a malocclusion (bad bite), newly placed or worn dental work, oral disease, or sleep bruxism (teeth grinding and clenching at night).

Today, many dentists are trained in assessing and treating these kinds of orofacial pain problems. In fact, in 2020, the American Dental Association approved orofacial pain as a dental specialty. Orofacial pain specialists are now board-certified dental specialists who limit their care to patients with orofacial pain disorders. Dentists trained in this special field are increasingly important as health team members in the diagnosis and treatment of severe and persistent headaches that are TMJ-related.

The Negative Effects Of Sleep Bruxism

If you clench or grind your teeth at night, you are not alone. Millions of Americans do it. Why does bruxism often cause severe headaches? The constant pressure is being exerted by the act of clenching and grinding your teeth can cause trauma to your TMJs. Next, the nerves become agitated, and here comes pain. But what’s tricky is that pain from TMJ can show up in other places on your body, such as your neck, your face, or even your head. This is called referred pain. Your TM joints are positioned very close to your cranial nerves, and severe headaches are often the result.

So, Can A Dentist Cure Your Headaches?

If you feel your headaches could be caused by teeth grinding and clenching (at night or during the day, or both), now’s the time to seek the help of an orofacial pain specialist. They will not only be able to determine the source of your pain, but will put a treatment plan in place that may include massage, relaxation techniques, a nightguard to protect your teeth, or even BOTOX®. I’ve been treating patients with these problems for over 3 years, and in most cases, a change in lifestyle to reduce bruxism combined with treatment, the outcomes are very positive.

Start by asking your physician or dentist for a referral to an orofacial pain specialist or check out the American Board of Orofacial Pain’s physician directory here, and search for a member with “Diplomate” status.

Good luck!

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Tags Bruxism, Jaw Problems, Referred Pain, TMJ

TMJ

A TMJ Dentist Discusses TMJ and TMD

Post author By Dr. Steven Syrop
Post date December 6, 2021
No Comments on A TMJ Dentist Discusses TMJ and TMD

Your TMJ dentist helps with issues in the temporomandibular joint (TMJ). If you are experiencing symptoms of temporomandibular disorders (TMD), you should see a TMJ dentist right away. Disorders in the TMJ can be painful and debilitating. If you want to know more about TMD and TMJ, here are the explanations of a TMJ dentist.

TMJ and TMJ pain

TMJ is the joint that connects the mandible to the skull. It is at the base of the skull, on both sides of the head. TMJ makes the jaw move up and down and also from left to right. TMJ enables talking, chewing, and yawning. The TMJ has a round, bulging structure that fits into the skull’s indentation. It also has a round cartilage or soft bone between two articular discs.

TMJ pain can radiate to the face, head, and neck. TMJ dentists find this pain challenging to treat. Anti-inflammatory medications do not work on their own. The drug therapy must work with heat and cold therapy to become more effective. TMJ pain results from injury, jaw clenching, and teeth grinding.

Symptoms of TMD

TMD is the collective term for the problems that arise from the TMJ. The most obvious symptom of TMD is pain. These disorders may be a result of an uneven bite or bruxism. The TMJ develops this pain because of stress and natural wear and tear.

Patients may dismiss TMD, but some situations could identify it. Injuries to the jaw or a joint disease can announce its presence. This is when the TMJ dentist comes in. The TMJ dentist also looks out for other symptoms like a popping sound in the jaw, muscle pain in the jaw, or earache. The patient may also experience migraines, headaches, locked jaw, and pain in front of the ear. To confirm if the patient is suffering from TMD, the TMJ dentist must perform a proper diagnosis.

Diagnosing TMD

The TMJ dentist will discuss the symptoms with the patient. Then, a jaw examination will follow. The TMJ dentist will feel and listen to the patient’s jaw movements. Then, the TMJ dentist will press the sections of the jaw to determine the pain sites. MRI, dental X-rays, and CT scans will provide additional information that will confirm the patient’s TMD.

Care for the TMJ

A person should avoid any activity that will induce stress to the TMJ. Opening the mouth with force when yelling or yawning and prolonged chewing can put pressure on the TMJ. This also happens when the person takes large bites or chews on hard foods. Habits like teeth grinding or nail-biting also contribute to TMJ pain and disorders.

Learning more about TMJ and TMD from your TMJ dentist can help you care for your TMJ better

The TMJ is prone to pain and TMD because it is that section of your face that you use daily. You need your TMJ for communicating, eating, and drinking. That is why a TMJ dentist is always ready to help at the onset of pain and discomfort. Setting up an appointment with your TMJ dentist can help maintain the health of your TMJ.