Dr. Kate Brayman treats the pain of temporomandibular joint disorders at her practice, Kate Brayman DDS in New York City. If you experience pain in the jaw, difficulty chewing, pain while chewing, or aching facial pain, contact us for an appointment. The doctor can evaluate the problem and determine if a night guard will relieve your pain.
What Our Patients Say
What is TMJ treatment?
There is a joint in your mouth called the temporomandibular joint, or TMJ. This joint functions as the hinge that connects the skull with the jawbone. The two temporomandibular joints in front of your ears connect the jawbone to the skull. The joints move like a hinge so you can open and close your mouth, while also sliding so the jaw can move side to side. This combination of motions lets you chew, talk, and yawn. It also makes the temporomandibular joints some of the most complex joints in the body.
There is a TMJ on each side of the jaw. Many patients every year are diagnosed with a TMJ disorder which requires treatment of some kind. Usually these disorders cause pain and they may limit the movement of the jaw.
It’s usually hard to determine exactly what is causing someone’s TMJ disorder. There are several things that could possibly cause pain and stiffness. In some cases it’s genetic. It could also be a sign of arthritis, or it could be the result of an injury as well. One of the major probable causes is from teeth grinding (bruxism). This is often caused by stress, which makes people habitually tense their muscles, including the muscles in the jaw.
In the vast majority of cases, a TMJ disorder is temporary, and you can relieve it with treatment at home. However, if the pain lasts too long and at-home treatments are not sufficient, then surgery is a last resort option.
TMJ disorders can present themselves in several ways. Pain and discomfort might be felt on either side of the face or both, and women tend to have TMJ disorders more often than men, and it most commonly affects those between the ages of 20 and 40.
Common symptoms include pain or tenderness in the jaw, neck, face, or even shoulders. In some cases the pain could be in the ears, especially when chewing, speaking, or opening the mouth wide. In other cases it might be difficult to open the mouth wide, or the jaw could get stuck in place. When the TMJ gets stiff, it can cause noises from your jaw, such as clicking or popping. Even swelling can be a sign of a TMJ disorder. Other common symptoms include headaches, earaches, toothaches, and tinnitus.
Temporomandibular joint disorder (TMJ) occurs when you have pain and dysfunction in the joints or in the muscles controlling them. TMJ falls into three categories:
- Pain or discomfort in the muscles that control the jaw
- Dislocated jaw or injury to some part of the joint
- Arthritis affecting the temporomandibular joint
People can have one or more of these conditions at the same time. For some, the symptoms improve or disappear in weeks or months. For others, TMJ turns into a long-term condition with debilitating pain.
If any of these symptoms present themselves, there are several things you can do before bringing concerns to the dentist. A cold or warm compress can help alleviate tension and reduce pain. Sometimes simply resting the jaw can help, which means not opening it wide, and eating soft foods that are easy to chew. Massage of your jaw muscles can work, too. A relaxed jaw means having your teeth and your lips just a little bit apart. Your tongue should be resting comfortably, and your teeth should be slightly separated.
If you try these and your pain and stiffness continue to bother you, then it might be appropriate for an intervention from your dentist. A dentist will examine your jaw and possibly take x-rays to determine what might be wrong with your TMJ. After, they may suggest some further treatment at home, such as extra relaxation techniques, or possibly outside help such as from a chiropractor or a physiotherapist. They also prescribe some medicine to help with any inflammation or pain. In some cases they will suggest treatments to help with sleep, since TMJ disorders are known to disrupt sleep for many people.
If the cause of your TMJ disorder is determined to be bruxism, then a night guard might help. A night guard is a clear plastic splint that fits over your teeth to protect the bottom and top from touching each other. This will prevent your teeth from being tense and will allow the joints and muscles to relax.
If you are still suffering, then your dentist will most likely refer you to a specialist, such as a pain specialist, an oral surgeon, a periodontist, an orthodontist, or a prosthodontist. At this point, it may be that surgery is a possibility, even though it is rare. Surgery is required if your TMJ disorder has gone beyond pain and discomfort, such as if you have chronic difficulty opening your jaw, which can affect your eating and nutrition.
What are the symptoms and causes of TMJ?
If you experience any of these symptoms, you may have TMJ:
- Pain in the jaw
- Limited movement or locking of the jaw
- Difficulty chewing or pain while chewing
- Aching facial pain
- Stiff jaw muscles
- Painful clicking, popping, or grating in the jaw when opening or closing the mouth
Grinding or clenching your teeth while you sleep can cause TMJ. Another possible cause is trauma, like a blow to the head. The temporomandibular joint has shock-absorbing disks at the end of each bone. If the disks deteriorate or become dislodged, it would cause TMJ. In older adults, the cause may be arthritis in the temporomandibular joint.
How does Dr. Brayman treat TMJ?
The most common and effective treatment for TMJ is a plastic dental night guard that fits over the upper or lower teeth. The night guard stops the teeth from grinding and keeps the jaw from clenching while you sleep. Dr. Brayman makes NTI-type night guards, which were originally developed to prevent migraine pain, but also help relieve TMJ. The NTI only covers your front teeth, which makes it more comfortable than night guards that cover all the teeth. The NTI is also just as effective as the full guard and it can be completed in one appointment.
How Long Does TMJ Treatment Take?
How long your TMJ treatment takes depends on which treatment you need to alleviate your pain. You should be able to get relief in a couple of days with your at-home treatments, such as cold compress and massage.
Medicine can improve your symptoms almost immediately. Surgery will also alleviate pain, but it could take several months for the full reconstruction to be complete.
This would involve the potentially several procedures and healing time. While surgery may provide permanent or long-term relief, at-home treatments may need to be repeated if your symptoms recur. This can be especially common for people experiencing extreme stress who grind their teeth and have tense jaw muscles.
How Much Does TMJ treatment Cost?
What your TMJ treatment ends up costing can depend on several factors. What is causing your TMJ pain can have an impact on how much your treatment costs.
If you only need a mouth guard, then it will be relatively inexpensive. Medication is also a lower-cost way of treating a TMJ disorder.
If your dentist is more experienced and has extra training, then your treatment may cost more as well.
If your TMJ disorder requires mouth reconstruction or jaw surgery, then you can expect to pay up to $50,000.
Does Health Insurance Cover TMJ Treatments?
If you have dental or medical insurance, then there’s a good chance that you are covered for several TMJ treatments and procedures. TMJ disorder treatments are not cosmetic procedures. If there are several procedures that you need, then you may be covered for several things, but not covered for others. It’s important to discuss with your dentist’s insurance specialist to see how to make the best use of your coverage.
Oral surgery is usually covered under medical benefits, for instance, while you can use your dental benefits for other treatments. It’s important that you discuss your options so that you can have a good idea of what your out-of-pocket expenses will be.
There is always a chance that even if your insurance provider authorizes a procedure that they do not pay out for it. This doesn’t happen often, but it is something for which you should prepare. If that happens, the dental office staff can work with you on solutions, such as using credit or financing plans.
Major Insurance Providers Accepted
At Kate Brayman DDS, we accept most major insurance plans. Here is list of some of the plans we accept. Please contact our office if you do not see your insurance provider listed. Please note we do not participate with DMO/HMO insurance.