Expert: Susan Tannenbam - 8/26/2004

Question
what can  any of the folowoing speciaties  do for tmj?

regular dentist
oral surgeon
tmj specialist
what is the technical term for a tmj specialist
can they really help or r the treatments cumbersum ofr the bruxism
what came first the tmj or the teeth grinding?
if the former   maybe there is help
if the latter  , bak when i wen to dentists for  bruxism they didnt seem able to do much for me but then agin i didn't go to a specialist

Answer
I use a regular dentist who also treats TMJ.  he's in NYC and his name is Dr. B. Rozenberg.  I would never go to an oral surgeon for TMJ.  Surgery can make it worse.   My dentist fitted me for a very good nightguard. It's hard and fits over the bottom teeth.  I never sleep without it, and it really helps.  He also gave me ultrasound treatments which a physical therapist who specializes in TMJ can do, also.  I have numbing gel and pads that you put over the painful area, altho I don't need them anymore.

I found accupuncture to be very good.  I use someone good in NYC, Dr. Kim Tsao.  You  might have to search around a little to find a good accupunturist, but it's worth  it as it can really help.

Here are some exercises that are very good:
l.  open the jaw  wide, hold, repeat
2. Press, with a blunt objeccdt, or your knuckle into the painful area on the cheek, hold, release,r epeat.
3. hold the neck to one side and feel the stretch and repeat on the other side.
The above help to loosen up the tight muscles which are caused by grinding the teeth, and thus you get pain in and around the TMJ joint. The clencing is what causes TMJ.
It helps to learn to relax the muscles in the face near and around the jaw joint, as pain feeds on anxiety and stress, thus causing tight muscles  that  eventually hurt.

You can get a prescription for a muscle relaxant .  This is extremely helpful for TMJ.  Any general doctor can give this to you.  Flexeril is one, Konopin another, and I'm sure there are others.

I  found that  most of the doctors and dentists I went to were not good at treating TMJ.  I am lucky to have found Dr. R., who finally understood everything about it, and gave me the nightguard, physical therapy, and good advice.  He told me NEVER to eat bagels or chew  gum, and so I don't!  Bagels are horrible for TMJ, as is gum. Most other food is soft, so  you can eat most anything else.

If I were you I'd get a muscle relaxant just to get relief, then do the exercises, and relaxation exercises also, and also make  sure you have a good nightguard.  The soft ones are no good no matter what any dentist will tell you,unless you have a mild case.

There is no way to stop the clenching (bruxism) itself, but you can keep this condition under control.

A word about Advil: recent studies haveshown that taking too much of it,  can actually cause the pain to  increase, so I'd  stay away from that.

You should be aware, also, that TMJ pain can radiate into the teeth and make it feel like something is wrong with the teeth,  but that's not the case at all.  Many dentists dont  know this,  and perform unnecessay root
canals and  extractions.  

If you have any further questions, you can email me at  suelliot2@earthlink.net

I hope I  have been helpful.  GoodLuck, and feel good.