FAQs
TMJ & SLEEP THERAPY CENTRE OF CLEVELAND

You have questions, and we have answers. Here are some of the questions we get most often, and what we want you to know.

Everyone experiences headaches from time to time. However, seemingly ordinary headaches can be a sign that something is wrong, especially if they are chronic headaches. In many cases, chronic head pain is symptomatic of a sleep-breathing disorder or TMJ injury.

TMJ and sleep apnea are two separate conditions, but in many cases, patients will experience them at the same time. Having one makes it more likely the other will develop. Since the appliances we use can treat both, offering treatment for TMJ and sleep disorders just makes sense.

The condition cannot be self-diagnosed. However, signs that there might be a problem include:

  • Headaches – recurring or chronic
  • Earache or ear symptoms of stuffiness or ringing
  • Facial Pain or Jaw Pain
  • Neck pain or stiffness
  • Jaw joint sounds – clicking, popping or grating noises
  • Limited ability to open or close mouth
  • Jaw locking (open or closed)
  • Sensitive, loose or worn down teeth
  • Difficulty swallowing
  • Difficulty sleeping

The appliances we use are customized to the anatomy of the patient. We also only utilize appliance that rely on the only peer-reviewed bite technique for healing. These appliances are used in the short term to decompress the joint and help rehabilitate it.

The goal is to heal the jaw joints and for that, stability is needed. We use our jaws differently during the day and at night, so two separate appliances are needed.

Eating is what the jaw joints are designed for, but when the joints are injured, just having a meal can cause significant pain. Wearing an appliance when eating helps to support the joints to eliminate irritation or making the condition worse.

We are happy to offer an appliance for snoring—as long as it is determined that snoring is the only issue there is. In many cases, snoring is a symptom of sleep apnea, which is a potentially fatal condition. A sleep study is needed to determine if the snoring is the condition itself or if there is something more to it.

Night guards are not an appliance for TMJ pain or sleep-breathing disorders. They do a great job of protecting the teeth, but nothing more than that. Our appliances address behaviors and breathing issues that cause pain and poor sleep, which means they will help with conditions that night guards cannot address.

Mild to moderate sleep apnea can be addressed with oral appliances. If someone has severe sleep apnea, it is possible that a CPAP or surgery will be required.

If your child only snores on occasion, do not panic. However, if it is chronic, a sleep study should be conducted. 70 percent of children who snore on a regular basis have sleep apnea.

For some patients, surgery is the only option. However, this is rare. In the majority of cases, conditions can be addressed through appliances, lifestyle changes, and physical therapy.

Many sleep and behavior conditions have their roots in sleep-related breathing disorders. When this is the case, the night terrors and behavior concerns are just symptoms of the underlying condition. Once that condition is treated, they can be eliminated.

Chronic headaches are often a symptom of undiagnosed conditions of sleep-related breathing disorders or an injury to the temporomandibular joint and surrounding structures. The doctors of TMJ & Sleep Therapy Centre of Cleveland are able to find the primary cause and provide effective treatment for thousands of headache patients.

The doctors are dental physicians (DDS or DMD) who evaluate and treat these conditions. They are all certified in craniofacial pain and dental sleep medicine.

First, TMJ is the term patients are most familiar with, and it is the most common component of Craniofacial Pain. Second, both TMJ and Sleep Apnea can be successfully treated non-surgically with oral appliance therapy, and these two conditions are often comorbid (interrelated). Our doctors are skilled in identifying and addressing the primary problem for the best treatment direction and successful long term results.

While the symptoms will vary from person to person, some of the most common symptoms include:

  • Headaches – recurring or chronic
  • Earache or ear symptoms of stuffiness or ringing
  • Facial Pain or Jaw Pain
  • Neck pain or stiffness
  • Jaw joint sounds – clicking, popping or grating noises
  • Limited ability to open or close mouth
  • Jaw locking (open or closed)
  • Sensitive, loose or worn down teeth
  • Difficulty swallowing
  • Difficulty sleeping

If any of these symptoms affect your daily life or you are regularly taking pain or sleep medications, you should be evaluated by a trained professional.

Unlike splints, the orthotics (orthopedic appliances) we use are individually designed and fabricated using the only peer reviewed bite technique to provide the best position and fit for healing. They are used short term (approximately 12 weeks) to provide decompression to the joint during the rehabilitation process.

To treat and successfully heal the TM joints, it is necessary to provide stability, support and protection both day and night. Our body functions differently during the day when we are upright and conscious than it does during the night when we are lying down and not conscious. Daytime appliances are designed for treatment during the waking hours and normal activities like speaking, chewing, swallowing.  Nighttime appliances are used to protect and support the joint during sleep when patients are not conscious and cannot control any activities (oral motor movement) that can potentially harm the joint, slow the healing process and prevent successful results.

Although eating is a normal function, when there is a TM joint disorder, chewing and swallowing without support and protection aggravates the condition preventing and prolonging the healing process.  The daytime appliance supports and protects the joint.  The TMJ joints are not unlike any other joint in the body; when rehabilitating the knee or ankle, would you expect to remove the brace each time you walk?

If it is truly ‘just snoring’, you can! But neither you nor the doctor can be certain the snoring is not a symptom of sleep apnea without proper diagnosis. Treating a patient for snoring when it is really sleep apnea can have life threatening results.

A night guard is typically made to protect teeth that are being worn down due to unconscious behavior during sleep. Often that behavior is due to a breathing problem the patient is not aware of – it makes them unconsciously move the jaw around all night to get a better airway. A sleep appliance is specifically designed to maintain an open airway helping you get a better night sleep and feel more rested in the morning.

Yes, oral appliance therapy is one of the recommended treatment options for patients with a diagnosis of mild to moderate sleep apnea. The oral appliance is worn in the mouth to keep the airway / throat open during sleep by controlling the position of the tongue and lower jaw. For severe cases, oral appliances can also be used with CPAP to make it more tolerable to wear.

Snoring is an indicator of a possible sleep apnea condition. Sleep apnea has no boundaries for age or size. In fact, there is a 70% overlap between snoring and apnea in children. These are staggering numbers and the reason the American Association of Pediatrics ‘Practice Parameter’ states that all children should be screened for snoring. An affirmative response for snoring should be followed by a more detailed evaluation.

The standard of care is always to attempt non-surgical rehabilitation before invasive surgical procedures. The percentage of patients who need surgery is extremely low.

Night terrors and mood swings in children can indicate a sleep-related breathing disorder due to improper or insufficient skeletal development resulting in insufficient airway. This can create a form of suffocation causing night terrors and moodiness. Insufficient airway and lack of oxygen has also been associated with ADHD (attention deficit hyperactivity disorder). Children with OSA are frequently misdiagnosed as having an ADHD and placed on unnecessary medication.

It is a dental physician (DDS or DMD) who evaluates and treats these conditions. Our doctors are certified in both craniofacial pain and dental sleep medicine. It is important that the dentist selected has completed specific education and training for these complex conditions.

We are a private pay office. However, we will do all we can to assist you in getting reimbursement from your health insurance carrier.

If your dental plan has benefits for evaluating or treating TMJ conditions, we will bill for your reimbursement. However most dental plans only cover dental treatments and TMJ and Sleep conditions are medical in nature.

Contact us today for an evaluation!