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How can my tooth hurt, but my dentist doesn’t find anything wrong?

Though the vast majority of toothaches are due to specific compromises in one or many teeth, the experience of tooth pain can be the result of referred pain. When referred pain is experienced, the site of the pain complaint is different than the origin of the pain. For this reason treating the site of the pain (in this case, the teeth) will not produce relief.

In the offices of New York TMJ and Orofacial Pain, we commonly hear toothache complaints that are not associated with the teeth but are rather due to tight and irritable muscles, migraine mechanisms, or nerves that are firing excessively. This knowledge allows us to make the correct diagnosis first and then treat the cause instead of the location of the pain symptom.

I was told that I have a TMJ problem and that I need my bite corrected to get better. Is that my only option?

In the majority of cases that we see, bite correction is not the primary treatment selected, and oftentimes, patients feel better if we don’t touch their teeth at all. Since the way your teeth come together (called occlusion) is most often not the cause of your TMJ problems, other treatments such as exercises, oral appliances, medication, physiotherapy, and education are all that is necessary to get your problem under control.

Why do I clench and grind my teeth at night?

The medical community does not fully understand why people grind and clench their teeth at night, but it appears that anything that arouses your brain while you sleep could trigger these activities. A crying baby, a painful back, a chronic asthmatic condition, or poor sleep conditions for instance, can be a source of arousal. Though stress can be a source of arousal, it is not the only problem that we consider.

We will help you identify the source of your brain arousals and put together a plan of action that helps you feel better in the mornings.

My jaw really aches, but chewing can make it feel better. How can that be?

It is not uncommon for jaw muscles to become tight and painful as a result of problems in your neck and shoulder region. There is an intimate relationship between the nerves that serve your jaw and those that serve your upper neck. That’s why a problem in your neck can often tighten your jaw muscles leading to soreness and pain. Chewing can ease your jaw pain and tension because it brings fresh blood and oxygen to the jaw.

A long-term treatment plan that focuses on your neck region and combines exercises, muscle injections, and physical therapy goes a long way to getting these problems under control.

My jaw doesn’t hurt, but can anything be done about the clicking and locking in the morning I have been experiencing?

Jaw clicking and locking symptoms are the results of loose ligaments, friction, dryness, bone irregularity, muscle incoordination, and slipping cartilage in the TMJs. Specific types of oral appliances can be extremely effective in preventing jaw locking and diminishing joint sounds.

We will determine which appliance is best for your problem and prescribe certain medications for a short period of time designed to help you sleep more restfully and experience fewer jaw symptoms in the morning.

I was diagnosed with a TMJ problem and was told I have to live with it for the rest of my life. Is that true?

Like most other orthopedic problems, the vast majority of jaw-related problems can be solved or managed to the point where symptoms are no longer a concern. Once your problem is properly diagnosed, education, exercises, short-term medications, physiotherapy, and oral appliances provide excellent results. TMJ problems are not lifetime problems for the majority of our patients.

My partner tells me that I snore. Does that mean I have sleep apnea?

The answer to this question is no. Snoring can occur without the presence of a sleep apnea condition.

Snoring occurs because of turbulence in your airway. A full evaluation is necessary to determine if you have a problem called upper airway resistance syndrome. Upper airway resistance syndrome can lead to cardiovascular stress and is often associated with heart attacks and strokes.

So, regardless of whether your snoring is a social problem or a source of stress to your heart, we will provide you with an accurate diagnosis and help you make the best decisions on how to treat your problem. Many patients opt for a custom-fitted oral appliance, and others ask for a referral to an ear, nose, and throat doctor.

I am currently 45 years old and have to use a mask over my face (CPAP) when I sleep to help my apnea. Can I use an oral appliance on some nights during the week to break up the monotony and also make traveling easier? 

Though CPAP therapy is the gold standard of care for obstructive sleep apnea, oral appliances have proven to be very effective as well. In fact, oral appliances cannot only improve breathing efficiency but they have also been shown to reverse the blood vessel damage that occurs when an apnea condition goes untreated.

An interchange of CPAP and oral appliance therapy influence your airway in different but effective ways. In our opinion, the combination is the perfect marriage between the two treatments.

I have been to my family doctor, a sinus specialist, and a neurologist, but nobody knows why I have a facial headache and ear pain. Is the pain all in my head? 

We know it’s frustrating that, despite multiple medical evaluations, your pain has not been diagnosed. This, however, does not mean that your pain is not real – far from it.

If your situation is similar to the vast majority of patients we see, it is likely that your pain is of muscle origin, and we can help. Evaluation in our office will likely get you started on the right path.

My 10-year-old daughter snores terribly and grinds her teeth, too, to the point that they hurt in the morning. Is there anything that can be done to help her?

10-years old may seem young for these problems, but they are not uncommon. In fact, her snoring may well be related to her tooth grinding. At our office, we will evaluate her situation and determine whether she has an airway problem. Once this is determined, proper treatment can be planned.

To make an appointment at one of our three offices in the NYC metro area, call 888-560-6674 or complete this quick form , and we will reach out to you as soon as possible. We are dedicated to compassionate care.