Frequently Asked Questions
Finance/Insurance
It’s important to note that dental and major medical insurance benefits are not accepted in our office. We are an out-of network-provider and will provide you with acceptable insurance claim forms for filing with your insurance company to allow you the best possible chance of coverage. Your insurance may or may not consider your treatment a covered benefit as exclusions could exist in your policy.
We accept all major credit cards, Care Credit, and offer a 3% prompt pay discount for cash or check.
Treatment
There are over 40 different types of TMD. Some can be cured; others can be managed. For all TMD patients, the first stage of treatment involves controlling TMJ-related pain and dysfunction for a period of time sufficient to determine stability. The second stage involves either correcting the problem (if it can respond to a cure) or managing it. Our goal is to make it to where our patients never need our services again. And we prefer the least invasive, most simplistic approach possible to achieve maximum improvement and enhance your quality of life.
TMD is often progressive. The earlier it’s diagnosed, the greater the likelihood it can be treated relatively inexpensively and without surgery! Early treatment of TMD can also help prevent further damage to your jaw joint and its related structures. Only you can make the decision that is right for you. Just know that waiting to begin treatment can have serious consequences, particularly if you are experiencing intermittent or continuous clicking and/or occasional locking. Once therapy has begun, delaying or canceling scheduled appointments can also compromise the success of your treatment. Before making any decision to postpone or delay treatment, we strongly urge you to discuss the risks and benefits with a qualified dentist or another trusted healthcare provider.
To achieve maximum improvement, your appliance must be carefully customized and precisely fitted just for you. When you cross your legs, it turns your pelvis, which, in turn, unbalances your entire skeletal and muscle alignment. To mark and balance your appliance correctly, your posture must be proper.
There is often no single cause of TMD and no two patients are alike. Our goal is to wean patients off daytime appliances rather than having to wear them indefinitely. However, any decision to reduce or eliminate the use of a daytime appliance can only be made after 6 months of active treatment has been completed. We generally suggest that patients wear their nighttime appliance "forever," as a precautionary measure to prevent symptoms from reoccurring. This is because we all clench and grind our teeth to some extent when we sleep, which can put 2x - 3x the normal amount of pressure on your TMJ. Think of using your nighttime appliance like wearing a knee brace or taping your ankle when you play a sport. You do it to add stability and safeguard against further injury.
This depends on the stability of your TMJ and the type of appliance that has been prescribed for you. More specifically: If you are using a repositioner so that we can stabilize your joint and can control dysfunction, the answer is "Yes." Chewing puts tremendous stress on your TMJ, so it's important to wear your appliance whenever you eat. It may take a few days for you to get used to it. However, eating with your repositioning appliance in place is critical to a successful outcome at this stage of your treatment. If you are using a deprogrammer to manage your TMD, the answer is "No." You should not eat with a deprogramming appliance in place.
Patients spend a lot more time away from our office than they do in it. That's why the diet and exercises we outline for our patients under self-care are so important. Self-care is an essential part of rehabilitating your jaw joint (just as it would be if you needed to rehabilitate your knee, your ankle, or any other joint in your body). Through self-care, you'll learn about things you can do, and things you should avoid, throughout your normal day to facilitate healing. More specifically, self-care will help to enhance the effectiveness of therapies you receive at our office so that you can regain mobility of a compromised jaw joint and restore full range of motion. Self-care also helps to establish a healing and wellness pattern which will pave the way for you to manage your TMJ-related pain and dysfunction, and sustain the results of treatment once completed, without having to continue to visit our office.
Yes, that is very normal but it's only temporary. The reason this happens is because of the changes in your jaw position that take place during treatment. In a nutshell, your appliance teaches your muscles to close your jaw in a new position - a position that may not be aligned with your bite. After you complete your treatment, we will slowly reduce the amount of time you use your day appliance and your bite will return to normal. In some cases, orthodontics may be needed but this is not true for the vast majority of our patients.
Sleep
Sleep is more than a time out from daily activities. It is an active state, essential for physical and mental restoration. Individuals who do not get sufficient amounts of restful sleep each night put themselves at increased risk for hypertension, heart attack, stroke, diabetes, plus workplace accidents and injuries. The good news is that much can be done, through technology and advances in dental sleep medicine, to enable patients who suffer from sleep disorders find relief.
Men suffer most often from non-restful sleep. In addition, according to both the National Institutes of Health and the American Academy of Family Practice, the rates of obstructive sleep apnea (OSA) and other airway-related sleep disorders are 2x-4x higher after the age of 50. Since the health of women and children may also be affected by sleep-disordered breathing problems, we urge anyone who does not wake in the morning feeling rested and relaxed after a full night's sleep to discuss their sleep concerns with their family physician, a dentist with expertise in dental sleep medicine, or another trusted health provider.
Sleep is as important to good health as diet and exercise. Despite this, there appears to be an epidemic of daytime sleepiness in this country. According to the National Sleep Foundation (NSF):
- Newborns aged 0-3 months need between 14 and 17 hours of sleep. This includes daytime naps, since newborns rarely sleep through the night. Older infants, 4-11 months, need about 12 to 15 hours of sleep each day.
- Toddlers between the first and second year of life need between 11 and 14 hours of sleep each night.
- Children aged 3-5 years should get 10 to 13 hours, while school-age kids 6-13 years should strive for nine to 11 hours each night.
- Teens aged 14-17 years require about 8 to 10 hours of nightly sleep.
- Adults between the ages of 18 and 64 should aim for seven to nine hours of nightly sleep. If you’re older than 65, you may need a little less; seven to eight hours is recommended.
Mild to moderate sleep apnea patients are among the largest groups of patients that are not screened. However, dentists with advanced training in dental sleep medicine can be a patient’s first-line of defense against the potentially devastating cardiovascular, neurologic, and interpersonal consequences of undiagnosed and untreated sleep-disordered breathing problems. In our office, we measure your airway volume, determine whether or not your airway collapses, and evaluate your nasal turbinates (small, bony structures covered by mucous membranes that protrude into the nasal airway and help to warm, humidify and cleanse air as it is inhaled and before it reaches the lungs). Enlarged turbinates and nasal congestion can contribute to headaches and sleep disorders such as snoring and obstructive sleep apnea, as the nasal airway is the normal breathing route during sleep. In addition to screening for sleep disorders, qualified dentists can provide dental sleep medicine therapies to patients that suffer from snoring, sleep apnea and other sleep-disordered breathing problems. These therapies can often enable sleep patients to find effective alternative or adjunct therapies to traditional treatments for sleep disorders, including CPAP or surgery.
In addition to making time for sleep, here are some sleep tips from the National Sleep Foundation (NSF) that may help you improve the quality of your sleep:
- Maintain a regular bed and wake time schedule including weekends.
- Establish a regular, relaxing bedtime routine such as soaking in a hot bath or hot tub and then reading a book or listening to music.
- Create a sleep-conducive environment that is dark, quiet, cool and comfortable.
- Sleep on your side, on a comfortable mattress and pillows.
- Use your bedroom only for sleep and sex, and take work materials, computers and televisions out of your sleeping environment.
- Finish eating at least 2-3 hours before your regular bedtime.
- Exercise regularly and complete your workout routine at least a few hours before bedtime.
- Avoid nicotine. Used close to bedtime, nicotine can lead to poor sleep.
- Avoid caffeine close to bedtime. It can keep you awake.
- Avoid alcohol close to bedtime. It can lead to disrupted sleep later in the night.
Snoring is no laughing matter and should be taken seriously. It can disrupt your sleep as well as your partner's sleep. Snoring can also lead to sleep apnea by changing the structure of tissues. However, not everyone who snores has sleep apnea. If you've been told that you snore, or you suffer from excessive daytime sleepiness or shortness of breath upon awakening, consult your doctor. Today, patients with mild to moderate sleep apnea are among the largest groups of patients not screened. That said, the only way to determine with certainty if you have sleep apnea is by referral to an overnight sleep lab for a diagnostic sleep study. Upon request, We are happy to provide you with names of sleep physicians and sleep labs that we work with.
For simple snoring and mild to moderate obstructive sleep apnea (OSA), oral appliance therapy is an excellent alternative to CPAP and/or surgery. Both the American Academy of Sleep Medicine and the Academy of Dental Sleep Medicine endorse it. When they are well made and used as directed by a qualified health professional, dental sleep appliances can put an end to snoring in the majority of patients. However, the success of these splint-like devices for any given patient cannot be determined without a complete dental sleep examination. In our practice, we use a variety of FDA-approved oral appliances to successfully treat snoring as well as other types of sleep-disordered breathing problems. To achieve maximum results, each of these splint-like devices must be customized and precision-fit to each patient. One size does not fit all, which is why you should be evaluated and treated for snoring by a dentist with advanced training and expertise in dental sleep medicine.
We cannot determine with certainty whether or not you are a candidate for a dental sleep appliance without a comprehensive sleep evaluation by our office. However, we can tell you that increasing numbers of patients are successfully using oral sleep appliances as both alternatives and adjuncts to standard therapies, including CPAP and surgery.
We cannot answer this question without your being fully evaluated by one of our doctors. However, we do know that development of your airway can be diminished by improper development of your jaws and/or an inability to breath through your nose. This explains, in brief, why we carefully examine the airway of every patient we see as a routine part of every new patient examination.
Nighttime repositioning devices that are properly customized to help maintain your airway during sleep rarely ever cause TMD problems. The same is true of appliances that are worn to prevent "bruxism" (that is, grinding of your teeth during sleep). If you are experiencing jaw-joint pain or dysfunction and you are using a nighttime sleep appliance, we recommend that you make an appointment to see a dentist with expertise in TMD, craniofacial pain, and dental sleep medicine immediately.
The only way to determine with certainty if you have sleep apnea is by getting a referral from your physician to an overnight sleep lab for a diagnostic sleep study. Upon request, we are happy to assist you in that process by providing you with names of sleep physicians and sleep labs that we work with.