Category Archives: TMJ

General Dentist or TMJ Specialist?

I have really good teeth. Never had a cavity or any other problems, though I do grind my teeth. I had a checkup a month ago with an all clear. Yet, this week I keep getting an intermittent pain in my teeth. I can’t tell exactly where it’s from. I don’t know if it’s a cavity or not. My cubicle neighbor said she had a similar problem and it turned out to be TMJ. Should I see a general dentist or a TMJ Specialist?

Norma

Dear Norma,

Woman holding her jaw in pain from TMJ

I want to clear up a common misunderstanding. There isn’t a recognized specialty in TMJ Disorder. Any dentist who treats TMJ is just a general dentist who (hopefully) has done additional study and training in TMJ treatment.

We’ll get into how to find a qualified TMJ dentist in a moment. First, let’s address your pain. You don’t have localized pain, but generalized. That makes me think it’s not a cavity. However, if it’s referred pain, that could still make a cavity a possibility.

Your checkup wasn’t too long ago, so unless your dentist missed something a cavity wouldn’t generally pop up and suddenly hurt in that short period of time. Here’s what I’m going to recommend. Go back to see your dentist and get some x-rays done. If by chance it is decay, it’s much easier to get a simple filling than to put it off until it blows up into a dental emergency. So don’t be afraid to go to the dentist and get diagnosed. It’s better than waiting until things are dangerous.

Finding a Qualified Dentist to Treat TMJ

If it turns out there’s not decay or any other typical dental issue, then it will be time to see a TMJ Specialist. So how do you know who is qualified without that true specialty degree? You ask about their TMJ training.

It should be post-graduate and be at some place like one of the following:

  • The Spear Institute
  • The Dawson Academy
  • The Las Vegas Institute for Advanced Dental Studies
  • The Kois Center

These are just a few of the advanced training centers, but they’re among the most reputable. If they haven’t done significant post-graduate training, look elsewhere. Additionally, you should know that a good TMJ Dentist will start with the least invasive treatment. They wouldn’t start with a full-mouth reconstruction unless it was a serious and obvious problem where that was the only solution.

Best of luck to you! Hopefully, it’s a simple solution.

This blog is brought to you by Dr. Randall Burba.

Can a Dental Crown Cause TMJ

I’ve had a problem over the last month of my jaw aching, especially in the morning. I’ve been under some stress and have caught myself tensing my jaw some throughout the day. Then, I got a dental crown. It’s made the pain so much worse. I went back to the dentist…several times. He’s adjusted it several times, but the pain never seems to go away now, plus, it’s always hitting my other teeth before the others. Could this be causing TMJ?

Beatrice

Dear Beatrice,

Woman holding her jaw in pain

Yes, a poorly placed crown can certainly cause or exacerbate existing TMJ problems. There is a lot that goes into understanding how the bite should go together. Some dentists invest more time and training in that area than others. You may have a dentist who doesn’t invest much in it.

The fact that your teeth are not meeting uniformly is a cause of concern and he should know that. Some dentists who have trouble getting it right will just adjust and adjust until the patient is too embarrassed to keep complaining and drop it. This needs to be fixed.

The fact that your jaw had already had some minor pain and you’d noticed some clenching during the day worries me too. If you notice clenching during the day, you almost certainly are doing it at night as well. You should be wearing a nightguard. They’re custom fit to your bite and comfortable. Their function is to protect your teeth and jaw from the pressures of clenching and grinding.

Finding a TMJ Dentist

It doesn’t sound like your dentist is going to deal with this properly, so you need to see one who understands TMJ. While there isn’t a recognized TMJ Specialty, there are ways to know if a dentist has a good knowledge of the condition.

You’ll want to especially look at their post-graduate training. Don’t feel weird asking them about it. It’s important knowledge for you in choosing the right dentist. For instance, Dr. Stanley Burba invested significant training on TMJ Disorder. He’s studied at both the Spear Institute and the Dawson Academy.

Some other great centers are the Kois Center and the Las Vegas Institute for Advanced Dental Studies (LVI). If a dentist has trained at any of these institutes, they’re sure to be able to help you.

Additionally, if it turns out that your dental crown isn’t properly placed the new dentist can help you get a refund from your current dentist.

This blog is brought to you by Dr. Randall Burba.

New Crown hurts

I got a new crown a few weeks ago. It hits my other teeth funny, which makes it hurt every time I bite. I went to my dentist. He looked at it and said it’s fine and to give it time. I have given it time and it’s still hurting. What do I do?

Cammi

Dear Cammi,

Woman holding her jaw in pain
Damage to a bite can lead to TMJ

“Give it time.” That’s dentist speak for, “I don’t know how to fix this.” Here’s what needs to happen. This crown needs to be adjusted. It’s likely the crown is just too high. When you bite down, the other teeth are hitting the crown before it meshes. The pain you’re experiencing is just part of the deal. If this isn’t adjusted, it can do damage to your bite. Fortunately, there are things your dentist can be doing to deal with this.

First, he needs to determine if the crown problem is simply it is sitting too high. If so, a simple adjustment can fix everything. If that doesn’t work, there is a next step. He can have you bite down on a bite registration paper. Where it registers the bite too high he can make some adjustments.

Of course, dentists with advanced training wouldn’t have this problem to begin with. If they did, they’d fix it with a properly made crown. The key this time is to get you out of pain and make sure your bite doesn’t get damaged. The last thing you want is TMJ Disorder.

What Type of Dentist Can Treat TMJ?

Neuromuscular dentistry requires advanced training. Traning you can’t get simply by going to dental school. It needs post-graduate training. Don’t hesitate to ask where they received their TMJ training. Some schools that are very reputable are:

  • Dawson Academy
  • Spear Institute
  • Pankey Institute
  • Las Vegas Institute of Advanced Dental Studies

This blog is brought to you by Dr. Randall Burba.

How Do I Know if I Have TMJ or TMD?

I’m at a loss. I’ve been doing some research and have narrowed it down to two conditions, but I can’t tell the difference between them so don’t know who to see.
Here are my symptoms:

  • Jawpain
  • Headaches
  • Clicking in jaw
  • Teeth have shifted

Do I have TMJ or TMD? Who do I see for it?

Marilyn

Dear Marilyn,

A Chart showing how joints muscles and teeth all work together in TMJ

I understand why you’re confused. These two acronyms are used interchangeably. TMD stands for Temporomandibular Disorder. TMJ stands for Temporomandibular Joint. When the joint is out of alignment, which can happen for several reasons as seen in the chart above, it causes TMD.

Your symptoms are pointing to this disorder, whether you call it TMJ or TMD. You’ll want to see a dentist, but not just any dentist. First, not all dentists treat it because it is so complex. Secondly, some do treat it who shouldn’t. You really want a dentist who’s invested significant training in diagnosing and treating this disorder. As an example, look at Dr. Burba’s TMJ Dentist credentials. This is the type of dentist you want to find in your area.

What to Look for in TMJ Treatment

Because TMJ is so complex, it is imperative your dentist finds the underlying cause of your TMJ in order to begin proper treatment. You also want to start with the least invasive treatment possible. For instance, if it turns out your problem has stemmed from nighttime grinding, the first thing to do is protect your teeth from any further damage.

From there, you can take up repairing the damage. Maybe your teeth are ground down to nubs and you need dental crowns. Or possibly, your teeth have been pushed out of place and you need Invisalign to realign your bite. Maybe you need a combination. The key is a dentist who knows what to look for.

This blog is brought to you by Dr. Randall Burba.

Store Bought TMJ Treatment

I’m drowning in medical bills right now and don’t think I can afford a dentist. But, my jaw has locked up. My sister says TMJ does that and that I need an oral device to help. All I know is I can’t even eat. I’ve heard you can use an oral mouthguard to treat TMJ. I saw one at the pharmacy the other day and it was only about $20. I can afford that much. Is there anything I need to know about using it?

Drew A.

Dear Drew,

TMJ Treatment Dentist

Your sister is right on both points. Lock-jaw is often caused by TMJ Disorder. While, the orthotic anterior repositioning splint can be used to treat TMJ, that’s not what you saw at the store. A mouthguard is completely different. They’re used to protect people’s teeth from habitual tooth grinding. If that’s an issue you struggle with, you’ll want a mouthguard after you finish your TMJ treatment. However, the store bought ones aren’t custom fit. They just come in small, medium, or large. You can also find a one size fits all. They’re okay on a temporary basis, but you’ll grind through them rather quickly.

One made by your dentist will be more effective. I know your TMJ is the focus right now, but if you don’t protect your teeth from the grinding there are serious consequences. Not only does the grinding aggravate your TMJ, but it can lead to cracked teeth or even teeth coming loose and needing to be replaced. Best case scenario, they end up ground down to nubs and all need to be crowned. Talk about expensive!

But, back to your current issue. Here’s what I’d like you to do in the immediate so we can try to get the swelling down and get you eating again. I’d like you to take 800 mg. of ibuprofen about three times a day. In addition, you need to alternate heat and ice packs. Wear them for about ten minutes at a time, a few times a day as you’re able.

You will need to see a dentist to get the appropriate treatment. I know you’re buried in medical bills right now. Many dentists are compassionate and would be willing to work with you on payments so you can get the treatment you need right away and pay it out later.

Even if you can’t find one willing to work you, Care Credit is a fantastic option. It’s a medical “credit card”, but they let you choose your terms.

This blog is brought to you by Dr. Randall Burba.

Do I Really Need to Destroy Healthy Teeth to Fix TMJ?

I’ve been having horrible jaw pain and merciless migraines. Sometimes it’s so bad I can’t even eat and have to drink my dinner of broth through a straw. I went to several doctors and two different dentists before I was diagnosed with TMU. But, he says the only way to fix it is to crown all my teeth to fix my bite. That would mean not only a fortune in dental bills, but destroying healthy tooth structure as well. Is that really the way to go?

Sydney C.

Dear Sydney,

Sometimes a full-mouth reconstruction is the only option, but it’s usually used as a last resort. There are several other treatments which should be tried before that. Additionally, it takes a significant amount of reconstructive and TMJ training to do a full mouth reconstruction. Done incorrectly, it can cause even more pain then what you’re currently in now.

Also, if you do need it, you may find a dentist who uses the composite resin, like you get for white fillings to adjust the bite instead of porcelain crowns. However, don’t push a dentist to use one type of treatment or another. It’s best they use the materials they’re most comfortable with.

In your place, I’d like to see you get at least two more opinions from dentists with lots of TMJ expertise. For instance, Dr. Burba studied at both the Dawson Academy and Spear Institute. Both of these give advanced training in TMJ. There’s never any harm in asking a dentist what type of training and success they’ve had in specific procedures, especially when you’re talking about such a huge, invasive procedure.

This blog is brought to you by Dr. Randall Burba.

Diet or Dentist For TMJ?

I feel a little foolish asking this question but I’m wondering if TMJ can be a diet related problem? I have horrible jaw and head pain, especially in the mornings. My closest friend truly believes that if I switch to a whole foods diet it will be taken care of. Even as I type it, it seems like a stupid idea. However, I’ll have to admit my friend is a lot healthier than I am. So maybe there is something to what she has to say.  Do I need a dentist or a diet change?

Lucia M.

Dear Lucia,

There is one aspect of TMJ which can be diet related, but one only. Chewing. TMJ is a disorder of the temporomandibular joint.  Changing your diet won’t repair the joint. However, if you’re eating things such as raw carrots and apples it could be adding stress to the joint. It might be a good idea to lay off the hard and chewy foods while your dentist gets to the cause of your problem.

Your symptoms sort of sound like the cause could be teeth grinding. You wouldn’t necessarily even know you’re doing it if it’s happening while you’re asleep.

If that’s the cause, a simple mouthguard could be just the solution for you. Your dentist can custom design one to fit comfortably in your mouth while you sleep. If you start to grind your teeth, the mouthguard will absorb the pressure, protecting your teeth and your joint.

This will also protect your teeth from damage. The grinding can cause your teeth to become loose or cracked, causing you to need a dental crown.

This blog is brought to you by Dr. Randall Burba.

Why Do I Need an Occlusion Specialist?

I’m a little confused. My dentist has been treating me for TMJ for almost a year. We’ve tried a couple of things, but now he wants to send me to something called an occlusion specialist. Is he just trying to pawn me off?

Elle W. – California

Elle,

I don’t think he’s trying to pawn you off. It’s more likely he realized the cause of your TMJ problems are from your bite and wanted you to see someone who had more training in that area. To me, that means he cares more about getting you the right care than he does about taking your money.

If your bite is off, it really can be the cause of your TMJ. It can throw your temporomandibular joint completely out, that can cause jaw pain, migraines, popping, even lock jaw.

Getting your bite in line can give you the relief you’ve been seeking.

This blog is brought to you by Dr. Randall Burba.

Is TMJ Really a Big Deal?

My sister keeps saying she has TMJ like it’s a whole big thing. Is it really a big deal or is she making a mountain out of a mole hill?

Joe L. – Louisiana

Joe,

TMJ can be quite serious. Not only can it cause severe migraines, but it can also cause your jaw to lock up so you can’t open and close your mouth anymore.

It’s caused by a disorder of the jaw joint. A dentist with TMJ training can help her to know how to repair the joint disorder.

The best treatment can sometimes be difficult to figure out, so be patient with your sister if she’s struggling with headaches and muscle pain. It’s always better to start with the least invasive treatment first.

Though we don’t know all the causes of TMJ, we do know that sometimes behaviors, such as grinding your teeth or clenching your jaw can lead to TMJ.

This blog is brought to you by Dr. Randall Burba.

I’ve had some degree of dental anxiety ever since I was a child, but I did a fair job of keeping up with appointments until I was in my early 20s. At that point, I was having some minor jaw pain and the doctor also found a couple of cavities that needed to be filled. He knew about the jaw pain, but told me there wasn’t any cause for concern over it. He felt it was related to grinding at night. My experience with the fillings, however, was horrific. He must have made me keep my mouth open for about two hours straight. It hurt so bad and I kept telling him I needed a break, but he kept going and telling me it would only be a minute or two more. By the end of it, tears were streaming down my face and he basically told me I was acting like a child. It really hurt! I couldn’t eat normally for weeks after that and I haven’t been back since. Now, I know my teeth have some issues going on, but my jaw pain is really flaring up again too. I think I should see a TMJ dentist for that, but where do I go first? Can he treat me before I get my cavities filled, so I can get through the treatment or do I need to start with my teeth and then address my jaw? I don’t think I can do more fillings before fixing my jaw pain.

Marie E. – Pittsburg

Dear Marie,

See the TMJ dentist first. It sounds like you’re already familiar with how one can help you. A TMJ dentist can address the root cause of your jaw pain and hopefully get it to settle down so you can be comfortable getting your other dental needs seen to.

With that said, something about what you said jumped out. You mentioned that your prior dentist said you grind your teeth at night and that’s what was causing your jaw pain. If this is the case, getting a simple night guard made might be all you need to address the sore jaw. Undoubtedly, the TMJ dentist will discuss this with you if you’re a good candidate for one. However, what’s striking is that your prior doctor didn’t mention this. It was cause for concern and should have been treated back then.

Continuous grinding not only strains your jaw and muscles, but wears down your teeth. If wouldn’t be too surprising to find that you’ve weakened the biting surface of your teeth enough that they’re either sensitive or highly susceptible to decay. In extreme circumstances, you can wear them down enough or crack them so that they’ll require crowns, but most of the time fillings can repair the damage.

Although this doesn’t matter in terms of getting you out of immediate pain, you may want to keep this in mind for when you go in for a full diagnosis. It’s not the end of the world by any means. You’re on the right path and will get your dental concerns addressed, but it could take some time to restore the damage that’s occurred over years of grinding. Best of luck to you.

This blog is brought to you by Dr. Randall Burba.