Defeating Headaches

With a Dentist’s Help

Understanding TMJ/D and How it Can Affect

Your Health and Comfort

Headaches are rarely “cured” with two aspirin. Sometimes there is more at risk. Do your headaches:

• Recur several times each week?
• Sometimes progress into full-blown migraines?
• Come back after taking medication?
• Begin near or around your ears?

In this new report, “Defeating Headaches With a Dentist’s Help – Understanding TMJ/D and How it Can Affect Your Health and Comfort,” I will help you better understand your headaches and what could be the cause behind the pain. Medications won’t solve the problem, but there is a solution!

You Can Be Free of Pain!

We’ll answer your questions by covering the following topics within this report:

• What Symptoms Point to a Jaw Condition?
• What Could be Causing Your Pain?
• How Does Your Dentist Make a Diagnosis?
• What to Do When Temporary Fixes Aren’t Enough.
• How to Ensure That TMJ Dysfunction Stays Away.

Recurring headaches really are a reason for concern. Don’t spend your life popping pills when there is a much better solution that’s just a dental appointment away. Continue reading to gain insight into the world of your temporomandibular joint and how it could be the reason for your pain and discomfort.

An Introduction

When most people experience a headache, they assume that the old take a couple of aspirin and call me in the morning approach will work like a charm. Most of the time, this will take care of a headache brought on by stress or a lack of sleep, but what happens when that headache comes back again and again and again? What happens when that headache turns into something more serious, like a migraine?

The next logical step is to call your general practitioner. You might receive some stronger medication or a whole lot of testing, but will you get a solution for your headaches? Maybe. Maybe not. It’s at this point that many people don’t know where else to turn. They don’t want to be tied to a bottle of pain pills, but they also can’t deal with the constant headaches. It’s time to turn to an unlikely candidate: the dentist.

That’s right. The dentist. I realize that the dental office is probably not your favorite place to go. Most of the population avoids the dental office and will only come in if they are in excruciating pain. Constant headaches and migraines definitely count as excruciating pain. When you can’t find a solution in medication or your doctor’s office, I will be ready to see you.

With one appointment, I will be able to determine if I can help. There’s no need to be poked, prodded, and annoyed by medical testing. I can offer you a thorough examination and know for sure if I hold the solution to your pain.

So, why not get started on a path to a happier, healthier life right now? Let’s dig a little deeper into the world of temporomandibular joint dysfunction (TMJ/D).

Signs That Something Could Be Wrong

The top symptom of TMJ/D is recurring headaches or migraines, but that’s not the only symptom. Sometimes TMJ/D takes other forms, so you could be missing the warning signs right now, even as you read this. Below are a few more signals that something in your jaw is going terribly wrong.

• Recurring head, jaw, or neck pain
• Frequent popping or clicking of the jaw
• The jaw grinds together or locks
• Pain similar to an ear infection with none of the other symptoms
• Eye, tooth, throat, facial, or shoulder pain
• Sinus congestion
• Unexplained dizziness or swelling
• Unable to open the mouth all the way
• Difficulty chewing and swallowing
• Stuffiness or ringing in the ears
• Tingling sensation in the fingertips
• Temperature sensitivity at the gumline area of teeth
• The face feels tired

Any of these things by itself might not even catch your attention. When you begin to experience these symptoms in pairs or groups, you’ll be looking for a solution. You don’t need to look any further than the dental office.

What Caused This to Happen?

When you are in pain, it’s very normal to want to know why. The truth is that even dentists highly experienced in treating TMJ issues often have a difficult time pinpointing the reason for your pain. Most of those dentists stick to the BIG FOUR areas of TMJ/D: Injury, bruxism (more commonly known as teeth grinding), arthritis and jaw movement.

All of these areas of emphasis can be contributing factors to your TMJ pain. For instance, there’s no doubt that grinding or clenching your teeth can cause you serious joint pain and even emotional distress. It’s obvious that bruxism causes the pain, but have you ever wondered what causes bruxism?

At Greenstein Dental, we take a deeper look at your symptoms and address that very question. For us, the answer is in gneuromuscular dentistry. You may have been treated for TMJ problems before and not heard of gneuromuscular dentistry. That’s because only a handful of dentists in Miami – and the entire country for that matter – are using this revolutionary approach to resolve TMJ issues.

Gneuromuscular dentistry is a comprehensive dental approach that looks at your lower and upper jaw, jaw muscles and the positioning of your teeth. When those joints and muscles are not in synch, patients often experience debilitating pain in their head, neck, and jaw – more commonly known as TMJ/D.  

Traditional TMJ dentists have a tendency to treat TMJ symptoms differently so many different ways that often times, patients are left confused and still in pain. However, gneuromuscular dentistry brings everything back to the relationship between your bite and the upper and lower jaw joint and muscles.

At Greenstein Dental, we run through specific diagnostic tests uncommon to most practices before recommending any type of treatment. The tests monitor your mandibular joint, as well as head and neck muscles, and collectively pinpoint the exact cause of your TMJ/D.

Our goal is to heal your joint pain once and for all and allow you to get back to your regular life! This begins with a confirmed diagnosis of TMJ/D, which we can take a closer look at in the next section.

How is TMJ/D Diagnosed?

To diagnose your TMJ issues, I will first sit down with you and discuss your symptoms and concerns. Our office will never launch into “treatment mode” without first explaining the pros and cons of each option and making sure you fully understand every step of the process.

I’ll begin with a simple exam of your face and jaw. I will listen for clicking, popping and grinding as you open and close your jaw and move it from side to side. I also will be feeling for any signs that your jaw is locking or limited in movement. Then I will check your bite for signs of shifting.

If you have clear signs of TMJ/D, I’ll encourage you to schedule further computerized diagnostic testing with my office. Years ago when I first began my training in gneuromuscular dentistry, I invested in the best technology to better diagnose and treat my patients. I now have an entire section of my practice dedicated to this equipment.  

Finding the Root of Your Problem – To find the source of your TMJ pain, I use two very important tools: the J5 Myomonitor TENS unit and K7 Evaluation System. When used together, these two devices track the range of motion in your jaw, identify the tightened muscles that are causing the pain and determine if you have a problem with your bite. During the testing, you will wear a device around your neck and head – as well as jaw muscle electrodes  – so I can use joint sonography and electromyography on your muscles.

The test takes a little of your time – and you will be asked to open and close your jaw several times – but I can track up to eight muscles at once and pinpoint the exact location of your discomfort.  

By tracking your jaw with the K7 Evaluation System’s three different modalities, I can see the quality of your mandibular range of motion in three dimensions, hear irregularities in your joint and assess your bite.

Electromyography measures the tension in your muscles at rest and during function as well as when biting and clenching. When your muscles are under stress, they send out abnormally high or low electrical currents. With the help of our K7 Evaluation System, we can map the location of those currents while using that information to improve your bite.

Electrosonography allows us to hear any improper sounds in the joint when opening and closing, which gives us an indication of the anatomy and mobility of the condyles and discs.

Computerized Mandibular Scanning tracks a variety of jaw movements from swallowing to opening, closing, lateral movements and the velocity of each. We collect that data by placing a small magnet inside your mouth so we can monitor movement and find a healthier location for the jaw to reduce the tension in these strained jaw muscles and improved the ability of your disc to move freely and properly within the fossa.

After we have reviewed the condition of your jaw joint and muscles, we’ll apply an ultra low frequency electrical stimulation to your jaw to relax these muscles. This is commonly known as TENS therapy and it has been used in TMJ treatment for years.

The J5 Myomonitor TENS unit works alongside the K7 Evaluation System by stimulating the neck and jaw muscles. By using these low-level electrical pulses, we relax those muscles, increase blood flow and oxygenation of the tissue, which helps increase your mandibular range of motion. To get an accurate reading, I ask my patients to wear the TENS unit for about 45-60 minutes.

Once your muscles are relaxed, I will again run through the sonography, jaw tracking and electromyography testing to the compare results. If there are significant differences between the data collected from your normal jaw compared to your relaxed jaw, your bite most likely is the root problem of your TMJ pain.

The good news is that there are ways to ensure you don’t have to endure those excruciating TMJ pains ever again. At Greenstein Dental, we custom design a TMJ orthotic mouthpiece and fine tune your bite on the surface of this appliance. When your TMJ pain is resolved, we then employ orthodontics to fix your bite or restorative dentistry to rebuild the worn down tooth surface to keep your TMJ pain for good.

When Temporary Fixes Aren’t Enough

When I speak with new patients who already have had TMJ treatment elsewhere, they tell me about the long list of so-called remedies they’ve tired. Most of them have tried painkillers, relaxation techniques, nightguards or even switched to eating softer foods.

In some cases, my patients have told me they were recommended for surgery. TMJ dentists consider surgery an absolute last resort. It can be very painful, requires a lengthy recovery and is unpredictable when proper tooth contact is left out of the equation.

We would love for simple relaxation techniques and lifestyle changes to cure your TMJ pain, but the fact is these methods rarely help our most severe TMJ patients – and they are never permanent solutions.

You may have noticed the strange spelling to the word “gneuromuscular” throughout this report and that is intentional. The added “G,” coined by Dr. Clayton Chan, represents the addition of very specific occlusal (bite) principles inherent to the science of “gnathology” or the study of chewing. It is the combined approach of these two disciplines that very few dentists use to identify and eliminate the root causes of your TMJ problems.

Gneuromuscular Dentistry is the process by which specially trained dentists carefully and methodically correct your bite through specific protocols and scan interpretations including final orthodontic and/or restorative treatments. My GMN treatment is a two-step process. It takes some time, but it ends with you having a beautiful smile and no more TMJ pain.

Finding the Solution - Using the findings from your TENS and K7 Evaluation System tests, I’ll first craft an orthotic mouthpiece for my TMJ patients. The clear device perfectly fits on your lower teeth and simulates a set of teeth that are properly positioned. Unlike many popular bite guards made for the upper jaw, this lower functional appliance actually allows you to wear it  24 hours a day – even while you eat. This is important because, as we learned from the TENS stimulation, properly positioned teeth balance your jaw muscles and neck muscles, not just at night when you sleep, but during daily function such as swallowing, chewing or even clenching during physical activity, let alone whenever you may find yourself stressed. And you can speak normally while wearing it – try to do THAT with acrylic all over your upper teeth!

The removable orthotic device works wonders for my TMJ patients. Sometimes within two days of wearing the device patients tell me their TMJ pain is gone. While the orthotic can eliminate your pain and retrain your jaw muscles and joints, it does not align your teeth.

The second phase of your TMJ treatment aligns your teeth. That can be done through restorative dentistry or traditional orthodontics. I usually encourage patients to consider braces to correct their bites, but some can use porcelain veneers or crowns – though those options can quickly become much more expensive than braces.

As part of our two-step TMJ treatment plan, my orthodontic treatment is carefully planned to ensure that we maintain the proper jaw positioning that we worked so hard together to achieve while you wore the orthotic.  

Treating TMJ with Orthodontics

I know what you’re thinking, “Orthodontics? Braces? No thanks. I’m too old for braces.” I understand that braces, especially for adults, are a huge commitment and investment, but consider what you’re gaining. It goes far beyond fixing your TMJ issues.  

• Your Dream Smile – Imagine waking up in the morning, looking in the mirror and seeing the most beautiful smile of your dreams looking right back at you! The tools and techniques we offer today can make this a reality.

• Improved Self-Confidence – Flashing your gorgeous smile will make you feel incredible and more confident. Both children and adults can benefit from the improved sense of self-worth that corrective orthodontic work can bring. 

• Reduced Risk of Future Problems – With a small correction to your teeth now, you could save having to deal with far more serious problems in the future. This is the time to sort out any alignment issues that you might have, no matter how small and seemingly insignificant they may seem 

• Long-Term Health – Correcting misaligned teeth will help to keep your mouth healthy by allowing you to keep your teeth cleaner. Both the closing of gaps as well as eliminating tightly crowded teeth will stop dangerous bacteria from building up around your gums. This also can help to prevent you contracting gum disease that could, in turn, lead to far more serious health conditions.

The list of advantages could go on and on. Perhaps the biggest benefit is finally kicking your TMJ pain to the curb.

Many of my TMJ patients are hesitant to correct their smiles with braces, but those same patients are always blown away by the transformation once their treatment is complete. They walk away with a beautiful smile and pain-free!

Here’s what to expect:

Braces

Although braces certainly aren’t our only orthodontic tool, they still are regularly used to correct the most serious alignment issues and are very predictable.

Braces are specifically designed to align and straighten teeth into the positions in which they should naturally fall by themselves. Using metal brackets fastened to the teeth and a piece of wire attaching the brackets together, a gentle pressure can be applied causing teeth to very gradually move into the correct positions. The time this treatment takes obviously depends on the severity of the condition, but some small alignment problems can be tackled these days with braces in a matter of weeks or months.

Don’t be fooled! Despite the reputation that braces can only be fitted to teenagers, more and more adults are now taking advantage of this technology to achieve the smile of their dreams.

Modern materials now offer you the chance to use clear brackets that are extraordinarily cosmetic as compared with the metal brackets traditionally used – and self-ligating technology (rather than the colorful rubber bands of yesteryear) can hasten tooth movement as well as reduce the number of visits. While the use of older bracketing systems has earned a reputation for being a painful procedure, today’s orthodontic treatment is simply not the case. The technology to fit and remove braces including the use of advanced, flexible wires has drastically improved, meaning your teeth can be perfectly straightened with a minimum level of discomfort.

And you can even carry on having a normal life! Even with braces in place, you can still play sports, play a musical instrument and even kiss. Aside from a few foods to avoid during the process, which your dentist will advise you of in more detail, there is absolutely nothing that you won’t be able to do.

Invisalign

 If braces sounds a bit too imposing and obvious, then you will be happy to hear about the technology called Invisalign.

It consists of a series of plastic trays called aligners. They look similar to whitening trays that most people have at home. Every two weeks you change into your new aligners. Each aligner moves the crooked teeth ever-so-slightly until after a few months – WOW, your teeth are straight!

Invisalign is not a solution for major bite problems, but it works for many other orthodontic problems and it has some terrific advantages:

• They don’t show in your mouth! No metal! Instead, wear a clear material that can hardly be seen.
• They are quick – many cases can be finished in just a few months.
• They are less expensive than braces in many instances.
• They are removable for cleaning and eating. What does this mean? You can remove your aligners and go out on Friday night. Then go home, brush and put your aligners back in! Try doing that with metal braces!!!

There’s no reason for you to suffer any longer. Whether you regularly deal with headaches or hear a funny sound when you chew or speak, it’s time to make an appointment.

I hope this report has helped you better understand your TMJ/D and what can be done to end it once and for all!

Let me take one look at your jaw and see if TMJ/D could be the cause of your discomfort. Contact my office today by calling 305-290-2293 or requesting an appointment at www.greensteindental.com.

I cannot wait to see your smile very soon!

Dr. Bruce Greenstein

Greenstein Dental

305-290-2293

www.greensteindental.com