Frequently Asked Questions

1. What is TMJ?

Answer: TMJ stands for Temporo Mandibular Joint – the joints in front of our ears that connect the lower jaw to the skull. But “TMJ” is often used to refer to symptoms related to jaw joints such as clicking, popping, locking, grinding of these joints. Sometimes patients are told that they “don’t have TMJ” if the joints themselves are OK. TMD symptoms include those symptoms, as well as those related to poorly aligned jaws such as: headaches, ear pain, jaw pain, difficulty chewing, limited mouth opening etc. TMD (Temporo Mandibular Disorder) and CCMD (Cranio Cervical Mandibular Dysfunction) are terms that better describe this condition. You would find much more information about HOW these symptoms are related to TMD at blog.MidwestHeadaches.com or www.facebook.com/prwork.

2. How do I know if I have TMJ?

Answer: Of course, all of us have two TM joints. If there is a problem with TMJ, you would become aware of it if any of the above symptoms appear. It is possible to have a click that does not hurt or just “goes away”. Just because it does not hurt does not mean it is healthy or optimal. At what point does one becomes concerned about “heart problems”? When the cholesterol is high but nothing hurts…or when there is chest pain? Many wait till there is chest pain. It may not be the most effective strategy.

3. Can pain killers help in treating TMJ syndrome?

Answer: Taking Pain killers can be one of the options if the patient desires temporary relief of TMD symptoms. However, informed patients are aware of the many side effects of using medications long term and would rather get the underlying cause precisely diagnosed and treat it. The longer the symptoms go on, it is harder to treat and get the best results.

4. Who should treat TMD?

Answer: For non-surgical treatment of TMD, you need a dentist that has committed to treating TMD on a daily basis and as such has invested the time, training and technological resources to be prepared to offer various treatment options. Having invested in advanced training at Las Vegas Institute for Advanced Dental Studies (LVI) in the area of TMD is a good indicator. Memberships in International College of Cranio Mandibular Orthopedics (ICCMO) and American Academy of Craniofacial Pain (AACP) are good indicators also.

If it has reached the point of complete deterioration of the joints, then an Oral Maxillofacial surgeon’s skills are needed for surgery. This is a dentist that has additional training through a surgery residency.

5. What should you expect from a TMD doctor?

Answer: Expertise, experience and a history of actual results. Ultimately, you need to feel well educated by the doctor on the nature of your particular case, the various options available including “no treatment” and the consequences of each of those options. These consequences include risks, time, discomfort and fees.

Prior to any permanent change, there needs to be reversible temporary treatment, that shows enough improvement of symptoms evaluated subjectively (symptom improvement) and objectively (emg measurements, CT scans) to give you confidence that you are on the right path to recovery.

6. How about surgery?

Answer: These are some of the considerations in contemplating TMJ surgery. It is an irreversible procedure. There is no “undoing” a surgery. Any time general anesthesia is employed, there are risks associated with that, including death. That is spelled out in the anesthesia consent form. Besides, most surgeons readily agree that TM Joint surgery – arthroplasty – is fraught with problems. Typical TMJ surgery consent forms cite success rate of “80% chance of as much as 50% improvement of symptoms”. That means, there is a 20% chance of symptoms getting “worse”. The most improvement one hopes for is a 50% improvement. Is this good enough for you?

7. Is TMJ/TMD covered by insurance?

Answer: Most symptoms such as headaches, ear pain, neck pain, jaw pain are ‘medical symptoms’. As such if it is covered it should be under the medical benefits. There are so many different benefit packages, we ask our patients do check with their plan book to see if it is covered or not. Many policies do have “exclusion” for non-invasive TMJ/TMD treatment. Because it is not treatment of tooth problems – such as decay or gum disease, it is not covered by dental insurance.

8. What is Physiologic Neuromuscular Dentistry?

Answer: When your jaw alignment is such that the bite (how the teeth fit together) is not in harmony with the muscles of your jaw, symptoms such as headaches, jaw pain, limited jaw openings, neck pain, jaw clicking, Jaw popping, grinding teeth, breakdown of the teeth and many, many other symptoms can occur.

Physiologic Neuromuscular dentistry considers the entire system that controls the positioning and function of your jaw and neck. Physiologic Neuromuscular dentists use state-of-the-art jaw computer system such as Myotronics K7 and other electronic instrumentation to precisely diagnose and treat and/or to eliminate the pain and other TMD symptoms. The emphasis is placed more on the physiology of the patient that is measurable in real-time and less on the anatomical relationships such as joint position or teeth relationships.

9. What is the difference between traditional orthodontics and neuromuscular functional orthodontics?

Answer: Traditional orthodontics focuses almost entirely on the nice, cosmetic appearance of teeth (straight front teeth). The neuromuscular functional orthodontics / orthopedics takes into account all the information on teeth, condition of TM joints, adequate tongue room, upper airway, muscles that control the posture and function of the jaw and neck. So the end result of NFOO is optimal, healthy function as well as appearance of a healthy smile. The devices used – braces for example – may be similar, but the main difference is how they are used and to achieve what end results.