Tag: TMD

Types of TMD Appliances

By: Dr. Elizabeth Eggert

A hot/cold compress can provide temporary relief from TMJ discomfort but realigning the jaw and bite often requires a bolder approach. If Dr. Elizabeth or Dr. Jeff determines that your jaw discomfort is the result of TMD, they will create a customized treatment plan for you. More than likely this plan will include a TMD appliance, usually called a splint. Let’s explore the different types of TMD appliances and the benefits of each one.

Common TMD appliance choices include:

Over-the-counter mouthguard

Because they’re available over the counter, these mouthguards can be an affordable option. Unfortunately, because they’re not custom-fit for your mouth, they usually are uncomfortable and difficult to wear while you sleep. They tend to be very bulky and many people find that these mouthguards cause them to grind their teeth more. An OTC mouthguard might be ok as a very short term or emergency alternative to more therapeutic options.

Custom-fit mouthguard or softguard

A custom-fit softguard is fit to your specific teeth and is soft and squishy to bite into. While they can provide some jaw support and are appropriate in certain situations, they are very easy to clench into and can make muscle issues worse.

Essix retainer

After orthodontic tooth movements, it is ideal to wear a retentive device to help keep your teeth in position. An essix retainer is a thin, clear, plastic appliance that is custom-made to your teeth (shown above). At Eggert Family Dentistry, we take impressions of your teeth and fabricate an essix for you within just a few days. Essix retainers do not provide much support for the joints or muscles and therefore do not typically help manage TMD, however, they can be the right choice for some situations. In cases of severe bruxism, these may wear out quickly.

Custom nightguard

Custom nightguards are thicker than Essix retainers and are effective in helping with severe clenching and grinding problems. Because they’re custom-made, they are more secure than over-the-counter mouthguards. These nightguards have a hard exterior and are especially helpful in protecting the teeth against bruxism.

Anterior deprogrammer

This acrylic appliance helps keep your muscles more relaxed and therefore allows a healthy TMJ to also find a relaxed position. An anterior deprogrammer keeps all contact on the front teeth so the strong chewing muscles can’t fire as intensely. This allows for a deprogramming of muscles and can be especially effective at managing headaches and other muscle maladies.

TMD (sometimes called neuromuscular) orthotic

This acrylic appliance helps reposition the jaw by not only supporting the muscles, but also damaged TMJ(s), and is effective in alleviating TMD symptoms. In some cases, this appliance even moves the mandible into a new, more comfortable position. The neuromuscular orthotic can be worn all day and night, but generally not during mealtime.

Seattle protocol appliance(s) for sleep and airway issues

The Seattle Protocol is a method to determine if sleep and airway play a role in your TMD symptoms. It is common for stress hormone to build in the body if you’re not getting good air exchange and/or if your body isn’t getting the restorative sleep it needs. At Eggert Family Dentistry, the Seattle Protocol starts with baseline sleep information. Then, we work you through trial splints to open the airway space available in the mouth, both horizontally and vertically. Once your sleep improves, we often see improvements with TMD symptoms as well. Most often, you then have a final splint fabricated based on trial splint results.

Sleep appliance for apnea or other sleep related breathing disorders

A sleep appliance for apnea typically pulls the jaw into a forward position to increase airway space. These appliances can change the bite with long-term use and therefore are only fabricated after careful consideration and often after conversations with your medical doctor and after moving through the Seattle Protocol at Eggert Family Dentistry.

At Eggert Family Dentistry, we treat TMD cases with the appropriate appliance for you. This not only can lessen the effects of teeth grinding and deprogram incorrect muscle patterns, but can improve your overall quality of life. We may also integrate behavioral and muscle therapies that help you use your jaw muscles differently. Often after managing the TMD, we can also make changes to the teeth for full-time relief of your symptoms. This may include suggestions from Dr. Elizabeth or Dr. Jeff for full-mouth reconstruction, orthodontic treatment, or equilibration.

Do you still have questions about TMD? Are you concerned you’re experiencing symptoms of TMD? Give us a call at 651.482.8412. Dr. Elizabeth or Dr. Jeff would be happy to speak with you or see you in our office!

How Are TMJ Disorders Diagnosed?

By: Dr. Elizabeth Eggert

In our previous blog, we took the time to clear up confusion over the two terms, TMJ and TMD. Now we’re going to dive into TMD, or temporomandibular disorder, and how it is diagnosed.

When a you come into Eggert Family Dentistry and are complaining of jaw discomfort, Dr. Elizabeth or Dr. Jeff will ask you several questions and perform an oral evaluation—this is all part of our records process and often part of our new patient experience. Here are some of the most common TMD symptoms that drive people into our office:

  • Pain when opening or closing the mouth
  • Difficulty chewing
  • Jaw becomes stuck open or shut
  • Headaches, migraines, ear pain, ringing in the ears, double vision
  • Clicking or popping sounds when opening the mouth
  • Teeth grinding
  • Wearing down or breaking of the teeth

After our thorough evaluation, if we determine that you are dealing with TMD, we will find the treatment or combination of treatments that are right for you. This may mean splint therapy, exploration into sleep and airway, changing the bite, or seeking out consultations with the right medical physicians. Jaw discomfort can be associated with other health issues and we want to make sure to help you get to the root of the problem.

You don’t have to live with the discomfort of TMD. If you’re experiencing any of these symptoms, contact the professionals at Eggert Family Dentistry. Dr. Elizabeth Eggert and Dr. Jeff Eggert have vast experience diagnosing and treating this jaw disorder and can be reached at 651.482.8412. Remember Eggert Family Dentistry for all of your dental needs!

What’s the Difference Between TMD and TMJ?

By Dr. Elizabeth Eggert

Our upper and lower jaw bones help our bodies perform many important functions. They help us speak, chew, and yawn. Consequently, our quality of life is directly impacted when our jaw is even slightly irritated or inflamed. When it comes to jaw disorders, there is often confusion between the terms TMJ and TMD. This post will help you decipher between these two terms.

What is TMJ?

TMJ refers to the temporomandibular joint itself, a joint that acts like a sliding hinge, connecting your jawbone to your skull. The lower jawbone (mandible) has two condyles that fit at the base of the skull. This joint can be found on both sides of your head, in front of each ear. The TMJ allows the jaw to open and close so you can speak, chew, and yawn. While many people claim to suffer from TMJ, this term actually refers to the joint as opposed to the joint disorder.

What is TMD?

TMD on the other hand, stands for temporomandibular disorder, a disorder of the temporomandibular joint. This joint is easily irritated by stress, jaw clenching, teeth grinding, and arthritis and is susceptible to misalignment, dislocation, or permanent changes as a result of crooked teeth or blunt trauma. Depending on the cause, discomfort can range from mild to severe. However, just because you’re not experiencing severe pain in your jaw doesn’t mean you should just “ride it out.” Ignoring even mild jaw discomfort can result in deterioration of the TMJ.

In our next post, we will cover the signs and symptoms of TMD and discuss how TMJ disorders are diagnosed. Stay tuned!

If you have any questions about TMD/TMJ or would like to schedule a recare visit with us, you can call our office today at 651.482.8412. Dr. Elizabeth, Dr. Jeff and our amazing team at Eggert Family Dentistry are here and ready to address all of your dental concerns and needs with our vast experience, the latest technology and all of the comforts to make each of your visits a great experience!

Sleep Apnea: Signs to Watch For

By: Dr. Elizabeth Eggert

At Eggert Family Dentistry, we know that sleep apnea is no laughing matter. It can go undetected for years and has serious side effects. Take a few minutes to consider the warning signs, when to discuss signs with us or your doctor and some effective treatment options to consider.

What is obstructive sleep apnea?

Obstructive sleep apnea is an intermittent blocking of the airway during sleep. This often occurs when the muscles in the back of the throat relax too much, causing soft tissue to collapse into the airway and resulting in partial or complete blockage.

When obstructive sleep apnea occurs, breathing can be restricted for 10+ seconds, decreasing oxygen to your brain and causing a buildup of carbon dioxide. This cycle of airway blockage can repeat many times a night, leading to fitful sleep and many serious side effects. Side effects include glaucoma, increased blood pressure, heart disease and unfortunately, even death.

What signs should I watch for that may indicate sleep apnea?

You or your loved one may be battling sleep apnea if the following signs are present:

  • Loud snoring
  • Night sweats
  • Extreme daytime fatigue
  • Gasping or choking upon awakening
  • Dry mouth or sore throat upon awakening
  • Reduced daytime concentration
  • Mood swings and irritability

The symptoms of pediatric sleep apnea can be very different from sleep apnea symptoms in adults. Learn more here.

When to see your dentist or doctor

If you’re experiencing any signs of sleep apnea, it’s important to make an appointment with Dr. Elizabeth Eggert or Dr. Jeff Eggert and with your primary doctor. While there can be other causes behind some of these signs, obstructive sleep apnea is a common and serious condition. If, upon evaluation, we think you might be struggling with sleep apnea, you may find success with one of these treatment options: CPAP or Oral Appliance Therapy.

CPAP: A mask that covers the nose and/or mouth, connected to a tube and machine, that delivers continuous air pressure all night long, allowing the airway to remain open.

Oral Appliance Therapy: A custom-fit mouthguard that keeps the airway open by supporting the jaw in a forward position. This is something that Dr. Elizabeth and Dr. Jeff can fit you for in our office.

To learn more about obstructive sleep apnea, check out our Sleep Apnea FAQ’s.

You’re in good hands at Eggert Family Dentistry! If you are concerned that you or a loved one may be struggling with sleep apnea, schedule an evaluation with us at 651.482.8412.

Reasons We Might Refer You to or Collaborate with an ENT

By: Dr. Elizabeth Eggert

There are certain situations at Eggert Family Dentistry when we need to collaborate with other physicians to provide the best possible care for our patients. Especially as we have worked to integrate more airway into our practice, many of you have been asked to seek out care with a board-certified ENT for a more integrated approach to dentistry.

In this article, we will provide information about how certain medical conditions may be linked to your airway and therefore situations where it may be best to collaborate with an ENT. We will also launch into more specific information about some of these conditions below.

  • Sleep – if you have trouble snoring, falling asleep, staying asleep, trouble with restless sleep, you wake up feeling unrefreshed, or issues with nighttime urination, these can all be linked to airway issues.
  • Other Health Conditions – ADHD, allergies, anxiety, birth defects, cardiovascular disease, chronic head and neck pain, chronic pain, daytime fatigue, depression, digestive issues, emotional problems, frequent colds, sinus problems, sore throats, or tonsillitis, grinding or clenching of teeth, headaches, high blood pressure, jaw locking, large tonsils or adenoids, memory loss, mouth breathing, neck aches, obesity, pain or clicking in jaw joint, previous orthodontics, PTSD, speech problems, sucking habits, tonsillectomy, adenoidectomy, or type II diabetes can all be linked to airway issues.
  • Dental Observations – there are many dental conditions that can be linked to poor airway flow as well such as crowded teeth, deep overbite, forward head position, head tilted back, mouth breathing, narrow dental arches, recessive lower jaw, scalloped tongue, tongue thrust, tongue tie or tooth wear.

Snoring and sleep apnea

Sleep apnea is a serious condition that can lead to several other serious medical conditions. In cases where our patient is struggling with sleep apnea, Dr. Elizabeth or Dr. Jeff can often link what they see with the teeth, jaw, and muscles (like the tongue) to aid in determining the cause. Does our patient have inadequate space for the tongue based on the size of the jaw? Is the root of their condition the size or shape of their soft palate? How does the alignment of the teeth play in? Once this is determined, the best course of treatment is pursued. It is often helpful both during the diagnostic phase as well as during the treatment phase to collaborate with an ENT. This allows us to look at the situation from all facets and choose the best course of treatment.

Beyond sleep apnea itself, there are other sleep disordered breathing diagnoses or simply disordered breathing at all times, that can be detrimental to overall health. ENTs or other medical professionals can often help us navigate through treatment options.

Enlarged tonsils and adenoids

Enlarged tonsils and adenoids in children can cause facial and jaw deformities as a child grows. When Dr. Elizabeth or Dr. Jeff notice enlarged tonsils or adenoids and determine that the enlargement is not simply due to a virus, we will often refer our patient to an ENT for a consult.

Sinus problems

If a patient comes into our office with jaw pain, Dr. Elizabeth or Dr. Jeff evaluate many things, including the patient’s teeth and jaw. Because sinus problems can be a contributing factor to teeth and jaw discomfort, if their examination is inconclusive, Dr. Elizabeth or Dr. Jeff will refer our patient to an ENT for further evaluation.

In some cases, mucus can build up in the sinus cavity, causing sinusitis and leading to halitosis (bad breath). If halitosis is present (often in combination with jaw discomfort), this is another situation where Dr. Elizabeth or Dr. Jeff will most likely refer our patient to an ENT.

TMJ disorder

Another common cause of jaw pain is a disorder of the temporomandibular joint (TMJ). At Eggert Family Dentistry, we most commonly treat TMD by providing our patient with a splint or night guard. In severe cases, full-mouth reconstruction may be necessary. However, if we are unable to make a dental determination for the jaw pain, we can refer our patient to an ENT for a CT scan or an MRI to rule out bone and joint issues.

At Eggert Family Dentistry, we go above and beyond to make sure each one of our patients receives superior care. This often means referring our patient to or collaborating with a board-certified ENT for further investigation. If you’d like to schedule an appointment with us, give us a call at 651.482.8412!

 

Pain When You Chew? It Could Be TMD

By: Dr. Elizabeth Eggert

There are a variety of factors that can contribute to jaw discomfort. From chewing on hard foods to facial tension from stress, jaw discomfort is a miserable, often debilitating experience. While there can be many contributing factors, there are at least as many great treatments. At Eggert Family Dentistry, we have hands-on experience diagnosing and treating TMD, one of the most common jaw disorders. Understanding what TMD is as well as its symptoms is crucial to proper diagnosis and treatment.

What is TMD?

Although people often refer to this jaw disorder at TMJ, the correct reference is TMD. TMJ refers to the joint itself – the temporomandibular joint – which is responsible for controlling many jaw functions like chewing and talking. TMD is a disorder of this joint, a condition which can stem from a variety of behavioral, psychological and physical issues.

Causes

TMD has many possible causes some of which include stress, jaw clenching, teeth grinding, arthritis, jaw dislocation, injury to the jaw and poor jaw and tooth alignment. Teeth grinding is particularly problematic because it can lead to further problems, many tooth related. Prolonged grinding can cause enamel to wear off teeth and expose dentin, making teeth more susceptible to decay. It can also increase a person’s sensitivity to hot and cold.

Signs and Symptoms

There are many symptoms of TMD that mimic other medical issues. This can make TMD difficult to pinpoint. TMD symptoms include:

  • Pain when opening or closing the mouth
  • Difficulty chewing
  • Jaw becoming stuck open or shut
  • Headaches, migraines, ear pain, ringing in the ears, double vision
  • Clicking or popping sounds when opening the mouth
  • Teeth grinding
  • Wearing down or breaking of the teeth

Diagnosis

The above-listed symptoms can be attributed to a variety of health problems. If you’re experiencing any of these symptoms it’s best to start by visiting a medical professional for a whole body physical to rule out possible medical conditions. Keep in mind, however, that many medical professionals don’t fully understand how TMD can be a large part of your issue because they haven’t always been trained to make that connection. Especially if there is no concrete medical diagnosis, it is best to make an appointment with Dr. Elizabeth or Dr. Jeff for a consultation. We can screen you for TMD with our comprehensive records process and offer relief for your symptoms through the treatment option that’s right for you!

Treatment

If, upon completion of your consult, we determine that you’re dealing with TMD, we have numerous avenues of treatment that can provide you with relief and alleviate your symptoms. Some common treatment options include:

  • A custom night guard/splint that can help lessen the effects of teeth grinding and deprogram muscle patterns
  • Behavioral treatments and muscle therapies that change the way you use your jaw and muscles
  • Full-time splint therapy to provide full-time relief
  • Appliances to improve your airway
  • Full-mouth reconstruction to improve tooth position
  • Orthodontic treatment that may or may not include oral jaw surgery

Dr. Elizabeth or Dr. Jeff will also talk with you about some easy ways you can partner with us to get to the root of your symptoms and experience relief. Ideas include practicing relaxation techniques to alleviate stress, avoiding chewing gum or nail-biting, eating softer foods and incorporating hot/cold compresses to the jaw.

At Eggert Family Dentistry, mouth comfort is one of our highest priorities. If you think you’re experiencing the uncomfortable effects of TMD, schedule an appointment with Dr. Elizabeth or Dr. Jeff by calling us at 651.482.8412!