Temporomandibular Disorder (TMD)

Millions of Americans suffer from chronic facial and neck pain as well as recurring headaches. In some cases, this pain is due to Temporomandibular Disorder, or TMD.

Your temporomandibular joints (TMJ) connect your lower jawbone to your skull. These joints get a lot of use throughout the day as you speak, chew, swallow, and yawn. Pain in and around these joints can be unpleasant and may even restrict movement.

Symptoms of TMD include:

• Pain in the jaw area
• Pain, ringing, or stuffiness in the ears
• Frequent headaches or neck aches
• Clicking or popping sound when the jaw moves
• Swelling on the sides of the face
• Muscle spasms in the jaw area
• A change in the alignment of top and bottom teeth
• Locked jaw or limited opening of the mouth

Should you notice any of these symptoms, let your doctor know. Your dentist can help indicate the presence of TMD and create an effective treatment just for you.

There are a few simple steps you can take at home or work to prevent TMD from becoming more severe, or to prevent it from occurring:

• Relax your face — remember the rule: "Lips together, teeth apart"
• Avoid grinding your teeth
• Avoid constant gum chewing
• Don't cradle the phone receiver between your head and shoulder — either use a headset or hold the receiver in your hand
• Chew food evenly on both sides of your mouth
• Do not sit with your chin rested on your hand
• Practice good posture — keep your head up, back straight, and shoulders squared

Are you drowsy during the day with no explanation? Do you snore loudly or wake up breathless in the middle of the night? If you're experiencing any of these symptoms, you may be one of more than 12 million Americans who are affected by sleep apnea.

What is sleep apnea?

Sleep apnea is a condition in which your breathing stops periodically during sleep, as many as 20-30 times per hour. Each time you stop breathing in your sleep, the resulting lack of oxygen alerts your brain, which temporarily wakes you up to restart proper breathing. Since the time spent awake is so brief, most people with sleep apnea don't remember it, and many believe they are getting a good night's sleep when, in fact, they are not. The constant wake-sleep, wake-sleep cycle prevents those with sleep apnea from achieving deep sleep, resulting in a constant drowsy feeling during the day.

What are the signs of sleep apnea?

The following symptoms can indicate the presence of sleep apnea. If you notice one or more of these, contact our practice.

• Insomnia or difficulty sleeping
• Loud snoring at night
• Waking up at night short of breath
• Snorting or choking sounds during the night (indicating a restart of breathing)
• Headaches upon waking in the morning
• Falling asleep unintentionally during the day
• Extreme drowsiness throughout the day

Are there different types of sleep apnea?

There are three categories of sleep apnea. The most common is called obstructive sleep apnea (OSA), and occurs due to a physical blockage, usually the collapsing of the soft tissue in the back of the throat. Less common is central sleep apnea (CSA), in which breathing stops because the muscles involved don't receive the proper signal from the brain. And some people suffer from "mixed" or "complex" sleep apnea, which is a combination of obstructive and central.

What are risk factors for sleep apnea?

Obstructive sleep apnea is more common in males than females, and more common in older adults (40+) than younger adults and children. However, anyone — regardless of gender or age — can suffer from sleep apnea. Other risk factors include obesity, smoking, drinking, use of sedatives or tranquilizers, and family history. Central sleep apnea strikes most often in people with heart disorders, neuromuscular disorders, strokes, or brain tumors.

Is sleep apnea dangerous?

Sleep apnea is considered a serious medical problem and if left untreated it can lead to high blood pressure, increasing the risk of heart failure and stroke. The ongoing state of fatigue caused by sleep apnea can lead to problems at work or school, as well as danger when driving or operating heavy machinery. Sleep apnea can also cause complications with medication or surgery; sedation by anesthesia can be risky, as can lying flat in bed after an operation. If you know or suspect you suffer from sleep apnea, let your family doctor know before taking prescribed medication or having surgery.

How is sleep apnea treated?

Treatments for sleep apnea depend on the severity of each individual case, and the type of apnea. Basic treatment can be behavioral — for instance, patients are instructed to lose weight, stop smoking, or sleep on their sides instead of on their backs. Beyond that, oral devices can be used to position the mouth in such a way that prevents throat blockage. In more severe cases, surgery may be the best option.

What should I do if I suspect that someone in my family suffers from sleep apnea?

Contact our practice, and we can refer you to a sleep apnea specialist. The specialist may recommend a sleep study to diagnose the precise extent of the problem, and can prescribe appropriate treatment. Depending on your situation, treatment may involve an oral device that we can custom-create for you.

Does snoring or sleep apnea keep you up at night? The Thornton Adjustable Positioner (TAP) might be your key to a snore-free, restful night of sleep. It treats sleep-disordered breathing without the need for surgery, a CPAP mask, or medication, and is recommended for use by the American Association of Sleep Medicine (AASM).

The TAP appliance is non-invasive and fully adjustable to create the jaw position that best treats your symptoms. The device holds your lower jaw in a forward position so it does not fall open during the night and allow the airway to collapse. The TAP is clinically proven to treat high upper airway resistance syndrome as well as all levels of obstructive sleep apnea, including severe sleep apnea.

Why choose the TAP?

• Comfortable, custom fit
• Durable construction
• Easy to use
• Adjustable while in the mouth
• Patient can adjust at home and achieve maximum treatment results from night to night
• Smaller and less bulky than other oral appliances
• Convenient for travel
• No masks or straps