TMJ Symptoms

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The many faces of TMJ

TMJ is often called THE GREAT IMPOSTER

tmj-symptoms-chicagoTMJ symptoms can be wide ranging, complex and difficult to understand.  Frequently patients go from doctor to doctor looking for answers to these problems only to be frustrated again and again.  This is why the name  The Great Imposter is so accurate.  Patients are treated for symptoms not underlying causes.

If you experiencing any of the following common symptoms:

  • facial pain and soreness
  • Tension headaches or tmj and/or muscle headaches
  • migraines and other vascular headaches
  • ear pain …otalgia
  • ear ringing
  • sinus pain or pressure
  • ear stuffiness or pressure
  • distorted hearing
  • eye pain
  • pain behind the eye..retro-orbital pain
  • eye sensitivity
  • neck pain
  • back pain
  • tender jaw muscles
  • muscle tightness
  • MPD or Myofascial Pain and Dysfunction
  • Fibromyalgia
  • Sleep Disordrs
  • Morning Headaches
  • muscle pain
  • pain when biting, chewing or yawning
  • difficulties closing and opening the mouth
  • popping or clicking sounds when opening the mouth
  • sensitive teeth
  • excessive tooth wear
  • numbness in the fingers, hands & arms

and you can’t seem  to find a way to resolve them, they could be caused by a dental problem known as Temporomandibular Joint Disorder or Dysfunction (TMD).

TMJ is often ignored by the medical community.

If you’ve sought medical treatment with no results, the next logical step to finding out what is at the root cause of your pain or discomfort is to seek a consultation with a dentist trained in physiologic dentistry.  Dr. Shapira has over 30 years experience in physiologic dentistry and pain treatment.

How could your TMJ be the cause of your unexplained chronic pain?

The Trigeminal Nerve Connection

Often, unresolved chronic pain or discomfort is associated with the temporomandibular (TMJ) joint. You use this important joint to eat, chew, talk or yawn. The successful working of these joints depends on the smooth interaction of ligaments, muscles, bones and discs that make up the TMJ.

The largest input to our brain is the Trigeminal nerve, it is amplified by the reticular activating system which gives it incredible influence on all head and neck pain or disorders. Differential diagnosis of orofacial pains is crucial in treating all TMJ patients.

Computers users are familiar with the phrase “Garbage in…Garbage out”   Our brain is our computer and if it is flooded with painful (Nociceptive) input from the Trigeminal Nerve the Garbage out is perceived as PAIN!

If there is any misalignment in your bite painful or uncomfortable symptoms can result, as:

  • the components of your TMJ encounter friction spots
  • the jaw muscles become overworked sometimes radiating pain to other body parts or
  • the underlying nerves become compressed sending pain signals to your brain.
  • Excessive muscle contraction increases friction in the TMJ’s


Balance your jaw and ease your TMJ symptoms

tmj-treatment3If your jaw disorder symptoms are caused by a misaligned bite, you have a good chance of easing or even eliminating them with TMJ dental treatment. A dentist trained in physiologic dentistry can diagnosis TMD to determine an effective course of treatment to realign your bite.

  1. The dentist will first check your medical history to ensure that there is nothing else that could be causing your unexplained symptoms.
  2. The next step is to assess the misalignment of your bite that can cause so many uncomfortable symptoms.  A complete examination includes muslce palpation and takes close to an hour or more
  3. If misalignment is detected, the dentist will measure your jaw function and relax your jaw muscles by massaging them with a TENS machine – an extremely low frequency electrical stimulator, which activates blood flow.  Physiologic Dentistry utilizes sophisticated diagnostics that track jaw movement and function and can evaluate muscle function and muscle symetrr
  4. When the tension in your muscles has been relieved, the best position for your bite will be found. This is then kept in the right place by positioning a non invasive orthotic device over your teeth. If successful, longer term stabilization can be achieved by dental restorations or othodontics.
  5. The first step is the Diagnostic Physiologic Orthotic.  The orthotic is an integral part of the diagnostic process.  It is our trial appliance that determines a three dimensional not stressed position of the mandible.  It is adjusted to reflect changes in posture that occur during treatment.  These changes are the result of healing and take time to occur and stabilize.
  6. Miraculous instant relief and slower relief are difernet versions of that healing process.  There are many factors that affect the pathways of healing.

Once your bite is in a healthier more comfortable position, you should find your pain fading away.  These results with the diagnostic orthotic are used as a blue print for long term treatment.

Full Mouth Reconstruction

Dr. Shapira Smile Rejuvenation and Health 1 Comment

What is a full mouth reconstruction?

full-mouth-reconstruction-chicagoA new smile is a wonderful often giving people sef confidence and a sense of well being.  For many patients there are numerous benefits connected to reconstructing a smile.

Correcting TMJ disorders, often leads to dramatic changes in appearance far beyond the teeth.  The results can be so dramatic it is often called a virtual facelift or a dental facelift.  Patients with overclosed dentitions look and feel older than they really are and are more prone to sleep apnea and poor posture.

Did you know that those sleepless nights, migraine headaches and back pains that you feel might be the result of your TMJ? Often caused by some sort of trauma to your mouth, the condition can also occur because of an eroded disk, missing cartilage or misaligned teeth. It can cause symptoms that range from a jaw that locks or pops when you move your mouth to pain in your shoulders and neck.

The treatments available for TMJ often relate to whether your doctor determines that the cause of your TMJ is related to the muscles, joints or a combination of factors. Mouth rejuvenation refers to a series of different procedures, including caps, crowns and bonding that restore damaged teeth, and this type of rejuvenation can also significantly reduce your symptoms.

How it helps your TMJ

TMJ affects multiple areas and systems in the human body. When you suffer from back or neck pain, you often don’t realize that it’s a sign of a more serious problem. TMJ can prevent your muscles, joints, nerves and tissues from working well together.

The primary cause of the condition is usually some type of trauma that can be due to an accident or event  or ongoing micro trauma but it can also occur because of other health conditions.  Grinding your teeth at night keeps your teeth from being aligned in your mouth, and undergoing any type of trauma to the mouth can result in crooked or damaged teeth.

TMJ full mouth reconstruction, also known as smile rejuvenation, uses a series of products to improve your smile and better align your teeth. Caps, crowns and other procedures restores damaged teeth and rebuilds your mouth, which reduces your symptoms.  The single biggest change is in Vertical Dimension.  As we age and our teeth wear down our face shortens.

Types of procedures

Dental crowns for TMJ are one of the more common types of restorative dentistry. Dentists can use this procedure to keep a dental bridge from slipping, to restore a damaged tooth or to hide a filling placed in a significantly damaged tooth. Made from a strong and durable material, a doctor will often use a crown after performing a root canal on a tooth that has so much decay that you might otherwise lose it.

If you have a significant number of teeth missing, or you have a number of damaged teeth, the dentist can use a dental bridge as a TMJ treatment. A bridge consists of one or more false teeth that you hold in your mouth after the application of a dental cement. Dentists can use permanent bridges or temporary bridges that you can take out later.

Other smile rejuvenation methods include veneers and dental bonding. With veneers for TMJ, the dentist will apply a type of durable material to your tooth that reduces the appearance of decay. If you opt for dental bonding, the dentist applies a resin material to damaged or broken areas to fill in gaps and strengthen your teeth.

Restore your smile and reduce your TMJ symptoms

smile-rejuvenationThere are multiple ways that you can restore your smile and reduce your TMJ symptoms at the same time. This condition affects the nerves and joints in your face, and as those nerves connect to other nerves, you’ll likely experience some pain in your back, shoulders or neck as well.

Dental bonding for TMJ is one type of mouth rejuvenation. Your dentist applies resin and a stronger material that bonds the resin to your teeth and saves a broken or damaged tooth. Other procedures can keep you from grinding in your sleep and hide gaps and spaces in your mouth.

In my e-book, you’ll find other types of TMJ treatment options and what to think about before talking to your dentist. Download your copy today.

TMJ Treatment

Dr. Shapira Chicago, Deerfield, Evanston, Highland Park, Kenilworth, Lake Bluff, Lake Forest, Libertyville, Lincolnshire, Mettawa, Morton Grove, Northbrook, Northfield, Skokie, Treatment of TMJ, Vernon Hills, Wilmette, Winnetka 4 Comments

How TMJ is treated by a dentist

tmj-treatment3Finding the reason behind the pain that you feel is the best method for a dentist to determine how to treat your condition. Though many patients assume that all type of TMJ treatment are the same, treatments vary significantly from patient to patient.  There are a wide variety of TMJ disorders and frequently there are multiple factors to account for.  Your TMJ problem may be as individual as you are.

The discomfort that you feel typically relates to the way your condition affects your body.

With TMJ, a patient’s nerves, muscles, ligaments and tendons all function in less than ideal ways that causes the patient to feel uncomfortable or in pain. Your dentist will work with you to determine which combination of  remedies and treatments will bring you the most relief.  Dr Shapira is your partner in finding your path to the life you deserve.

TMJ treatment phases

When Dr Shapira determines your diagnosis of TMJ or associated disorders, he will describe the three different phases of treatment. The first phase is the most important phase which is to restore your quality of life as quickly as possible.  It involves non-invasive procedures that do not require surgery. Those treatments can include orthotics, physical therapy and other non surgical TMJ treatment options as well as minimally invasive procedures such as trigger point injections, prolotherapy or SPG (spenopalatine ganglion ) blocks. Orthotics may include a diagnostic physiologic orthotic, nocturnal bite splints, pivotal appliances for TMJ locking or other modalities such as an Aqualizer that uses a basic law of physics to equalize pressure on both joints and relax the musculature.  The second  phase is long -term management after pain relief is accomplished.  It is all about maintaining comfort for life.

Phase 1

Fotolia_35843554_XS2This phase of TMJ treatment is all about restoring your quality of life.  Dr Shapira will dissect your problems to answer each of the problems that make up your specific issues.  The mainstay of Physiologic Dentistry is a diagnostic orthotic, a device that lets you experience the life improving results before committing to extensive treatment.  Patients are told to expect 50-80% improvement within just 2-3  visits.  There is no “ultimate cure” for TMJ but many patients experience almost miraculous cures while other patients have a longer road to reach their goals.  The use of behavior modification, which teaches you how to do simple daily activities without causing additional pain or discomfort is often needed initially but are goal is a complete return to normal function.  Dr Shapira will make you his partner as the guardian of your health and welfare putting you in charge of your future health!

Simple TMJ jaw exercises can  provide relief for some patients but others require guided treatment to relieve the pressure on your nerves can lead to increased pain. Just  strengthening  the muscles in your jaw is not a promise of success.  The creation of an environment where healing occurs is actually the most important aspect of treatment.  We use our jaws twenty-four hours a day for breathing, eating, talking, kissing and to maintain proper postural health.  Dr Shapira builds that healthy bite into your diagnostic orthotic.

Phase 2

Phase two is embarked on when you are feeling good and your body has had a chance to heal.  There is no “Cure” for TMJ because you have changed due to your months or years of pain.  A cure would entail a do over on the part of your life lost to pain.  I want you to have the best life possible moving forward where TMJ and MPD do not adversely affect your life.  Many patients feel as if they are “Cured” but they are not the same as if they never had a problem to begin with.

This phase of TMJ treatment includes the use of occlusal equilibration or coronoplasty for some patients.  This is minute adjustments to the bite to make it function better.  Other patients may require orthodontics or reconstruction to achieve long term stability.  Dental implants can be used to replace missing teeth when necessary.  Phase two can utilize cast onlay orthotics, partials or dentures.

Bruxism which occurs when you grind your teeth at night may require treatment with a night appliance to protect the muscles, joints, teeth as well as the restorations.

The use of other orthodontics can reduce your discomfort and give you a healthier bite.  This can be through standard orthodontic procedures.  The DNA Appliance is an exciting and more comfortable alternative to braces that is worn during sleep and a few additional hours a day.  It allows us to grow your jaws to a more ideal size and shape while permanently correcting your bite.

Crowns, also known as caps, let the dentist repair damaged teeth and reduce the gaps between teeth, while braces are a good option for those with healthy teeth who still suffer some pain.  A full mouth restoration can restore your entire mouth in just a few visits and is an exceptional treatment for many cases.  Due to the cost many patients feel they cannot afford this treatment but financing can make it available in affordable monthly payments.

Phase 3

The majority of patients never need this phase.  The goal of phase 1 and 2 treatment is to avoid temporomandibular joint surgery whenever possible.  Orthognathic surgery is also a phase 3 treatment that can create an ideal situation but carries significant risk.  The DNA appliance can comfortably create orthopedic growth without surgical intervention in may patients.

This phase of TMJ treatment is the most invasive option and typically requires some form of surgery. If the dentist can determine the root cause of your pain, the doctor can do microscopic TMJ surgery, which lets the dentist carefully repair a damaged joint or nerve from an incision made in an out of the way spot.

If you suffer from lock jaw, which is one of the more common symptoms of the condition, your dentist may recommend arthrocentesis. With this procedure, the doctor places needles inside the affected joint and pushes a saline solution through the needles. The liquid slowly works its way through the jaw and loosens the joint and surrounding cartilage. Other forms of surgical intervention can give you some pain relief.

Need to know more?

tmj-questionsA TMJ orthotic is almost alway the starting point for therapy.  Surgery is rarely the first option but in the case of severe degenerative changes it must sometimes be considered.  TemporalMandibular Joint surgery should always be approached cautiously.  Almost all patients can be managed without surgery.  The longer that you live with your condition, the more work you need to do towards repairing your mouth and jaw. While surgery is one option, it’s often the last resort.

Remember Quality of life is your most important outcome.

Your dentist will suggest that you use jaw strengthening exercises, bite plates and other remedies before recommending jaw surgery, braces, tooth grinding or crowns. To learn more about TMJ and the best treatments for the condition, download a copy of my e-book today.