Phase 1 vs. Phase 2 TMJD Treatment - Priya Mistry, DDS (the TMJ doc)
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- Опубліковано 3 чер 2024
- Hello Friends! This video is about Phase 1 TMJD Treatment and how it differs from Phase 2 TMJD Treatment. The differences are drastic and it's important to follow a sequential series of steps when it comes to treating TMJD in order to get the best results.
Common TMJD signs and symptoms include headaches, jaw pain, neck pain, ear pain, stuffy ears, vertigo, hearing loss, shoulder pain, and numbness/tingling in the face or fingers, clicking/popping & crackling noises in the joints, episodes of the jaw locking or catching.
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Links for Images:
Orthodontia Image:
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FACEBOOK: / priyamistrydds
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#tmd #temporomandibulardisorder #temporomandibulardysfunction #tmjd #headaches #neckpain #earpain #jawpain #stuffyears #vertigo
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This channel is all about TMJ disorders - what they are, how they manifest, what to do about them and how they relate to other issues that may be going unnoticed in the body such as tongue tie, sleep apnea, ADHD, and more! I will also be posting about being a dentist and a working mommy to two wonderful children. Thank you and I hope you enjoy my videos! - Наука та технологія
If only all doctors were this good at communicating all the important details! ❤
Thank you for your kind words! 😊🙏🏼
You have simplified the phases .
Thanks doc ☺️
You’re welcome!
Great informational Video on Phase 1 and Phase 2 Treatment for TMJD.
thank you!
This is a great video! Helps me understand the significance if the bite change, which i wasnt expecting and had me a little concerned.
It's also a relief to hear my current treatment fitting within your model if stage one. The first time i had my clicky, painful jaw investigated, the practitioner immediately suggested surgury 😳 That freaked me out and I didn't seek any further treatment, despite the pain, until years later when my new GP asked me about it. He told me there were other treatment options out there. Thank goodness i didnt take the surgury in the first instance. Now i have an understanding of my case, I believe i would have destroyed any surgical reconstruction without including any physical therapy.
Finally i can see a path to recovery!
wonderful! Best of luck to you!
You are the BEST DOCTOR MISTRY ❤❤❤
Thank you for your kind words! 😊🙏🏼
You are best with best mentor.
Thank you!! 😊
Excellent excellent explainations, compliments my current treatment in Malaysia. Thank you Dr Mistry.
Do you mind sharing who you are seeing in Malaysia?
hi I'm from Malaysia too, apparently there's no doctors who can treat tmj effectively in Malaysia. I'm 15 years old and I've had my jaw lock for 3 months now. Would really appreciate it if you could share where you're having your treatment.
Extremely helpful!
Glad to help!
Priya Mistry thank you for explaining this my new dentist tried to explain this to me but I had so much pain with my twisted jaw and squashed discs I couldn't focus on what she said
You're welcome!
Just got my TMJ orthotic yesterday. I'm already feeling a difference in my ears.
Great! I'm so glad to hear this :)
Do you mind telling me how much this is costing you as I have been quoted about $38000.00 Phase 1 and Phase 2. I have one tooth crossed bite and I was told my lower jaw need to come forward 2mm. My joints, bones and disks are healthy. Teeth are in good health too. just wanted to get an idea
You've convinced me to look for a local myofunctional practitioner. With so many TMD 'specialists' and approaches out there, its a relief to find a method of treatment that makes sense to me.
Great! Best of luck to you!
I need you in my life!! Nobody this knowledgeable in the UK 🇬🇧 😕
Where abouts in the UK are you? I've been referred to a TMJ clinic in Manchester and man called Dr Stephen Davis x
keep going, Doctor ..
from syria, all the love ♥️🌷
Thank you!
Hi! I'm so glad I came across your video today! I've been trying to find a video like this for the past year but didn't. I've had TMJD for the past 5 years and I ended up getting braces by an orthodontist for my TMJD 1.5 years ago. My teeth are less crooked now but my TMJ still clicks and hurts (A LOT). My treatment isn't over yet though. Should I stop my treatment and go visit a doctor who specializes in TMJD instead?
I cannot make specific recommendations for your treatment over the internet and without examining you in person. Sorry!
Thank you for the excellent explanation. Is there a resource to find a practitioner in other parts of the country?
No resource that I know of but I’m happy to help! Where do you live?
do you know anyone in NY or CT? I haven’t been able to find one. Also do you think arthrocentesis is worth it?
Your video is very informative. I live in NY and currently in phase 1 which is very expensive for locked TMJ with lower jaw to the right about 10 mm based on the test performed. I have a temorary glued on orthotics on my lower teeth and at night I wear a splint on lower and upper teeth that are one piece to help with bruxism during the night. The dentist recommends phase 2, full mouth reconstruction for correct bite. She wants to build up my teeth because I ground them so much. I am concerned that I will continue to grind my teeth at night because I believe the FMR will not stop me from grinding and I feel that I will have to wear the splints forever. I know that you cannot give an opinion without seeing me. Thanks again for the video.
Sorry you’re going through this and best of luck to you!! 💝
Hi Priya, great video. So, you mention in phase 1 that you ask patients to take out their tmd splint during eating and drinking, so to not adjust the bite position.
I am in my first week of using a tmd splint permissive splint (i think) though it was made without software. The dentist took a bite imprint only.
Do some dentists create splints in this way, and make corrections along the way? Can it still be affective?
I really can't tell you over the internet and without examining you if the treatment you are undergoing will be effective. Sorry and best of luck to you.
Great video Priya! In case someone decides to proceed with phase 2, does he continue to use a splint while wearing braces in order to keep the joint and other tissues in their correct place?
You cannot wear the orthotic while in braces :)
Thank you Dr Mistry. Your videos are always so helpful!
I’ve completed phase 1 (for TMJ dislocation with reduction), about 3 months ago and my dr has told me to wean off the day orthotic. My back teeth do not touch and I feel like the top of my head has nothing to rest on. It’s like the one pain has been replaced by a new one. My dr has told me repeatedly that my back teeth will simply rupture naturally to come together. I really don’t think I believe that. Is that possible?
There's really no way I can answer this thoroughly without follow up questions and discussion. if you'd like you can email my office to set up a zoom meeting with me: patientcare@tmjdentaldoc.com
Great video! I was wondering what happens if the bite is changed during Phase 1, but the patient can't or won't undergo Phase 2? Are they improved in terms of their TMD and doing well on that front, but just look funny aesthetically or have a totally non-functional chewing system?
The bite changes in Phase 1, if they even occur, are typically very minor and don't result in looking "funny" aesthetically or impacting chewing. I lower the risk of the bite changing because I wean my patients off of the daytime orthotic in a timely manner AND I always ask them to remove the daytime orthotic when eating or drinking. For those that have to wear the orthotic 24/7, the bite changes can be much more drastic.
Very nicely explained
Please add some information about Occlusal Stability in your upcoming videos
Dr Manish Mistry here from Ahmedabad, Gujarat, India 🇮🇳
I'm a Prosthodontist and Implantologist from GDCH, CIVIL HOSPITAL
Hi Doc, thanks so much such educational vids. Wanted to clarify what you mean when the muscles and joints are in a healthy functioning state. Does this include still wearing a nighttime orthotics daily but no pain during the day? Just thinking about whether Im in the right phase before considering braces. Thanks so much
Yes, this means wearing nighttime orthotic and no pain/dysfunction during the day.
@@theTMJdoc Thank you for clarifying!
So if sometimes the nighttime orthotic is not worn/ less hours worn, it will start clicking again though - does this still mean the jaw is in a healthy functioning state? (It's usually fine/no pain if I do wear the night orthotic, just sometimes slides out of place, just have to pop it back-no pain but just a pop sound).
@@theTMJdoc i can only dream of those days after so much bad dentistry & stress I'm very messed up
Hi. Do you recommend any dentists for this kind of work? I live near the Twin Cities in Minnesota. Thanks
Dr Mora Cervenka is really great. She’s near St Paul I think..
Great video! I have a few questions if you wouldn't mind answering:
-- If I want to do maxillary expansion (eg MSE) should I do this before starting phase 1 treatment? Or is it possible to do it afterwards? or after phase 2? What about if I choose to of FMR; can I still do palate expansion after that?
-- Is it possible to do jaw advancement surgery afterwards (either mandibular advancement or MMA)?
Thanks :)
These questions are not simple or possible to answer without discussion and follow up questions. If you’d like you can email my office to set up a zoom meeting with me:
Patientcare@tmjdentaldoc.com
@@theTMJdoc fair enough
Do you have any doctors in VA? Or do you offer any virtual consultation/treatments? I’ve been dealing with TMJ for years and it’s gotten worse after Invisalign in 2019 for gaps in lower teeth, bite feels tense all the time!
I’m sorry but I don’t know anyone there. You can email patientcare@tmjdentaldoc.com to set up a Zoom meeting.
I'm just about to start expanders on the top and bottom, with the orthotic still keeping my jaw in the happy new position. Do you recommend expanders and is that usually part of phase 1 or 2 treatment? Thanks
I usually recommend this as phase 2 treatment.
Please show us a picture of night and day splint that you use in your practice
The picture will not help with visualization. It looks like many other appliances. It's not really about how the splints look, it's more about the prescription that's built into them. A good analogy is reading glasses vs. prescription glasses.
Hello,
After having a dental crown procedure I was left with TMJ pain. I think when I was having the dental procedure I opened too wide and displaced the joint because I remember hearing the pop. After that I have had pain and my jaw would shift to the right side when I opened. I started Invisalign treatment and the orthodontist said my bite looked good but I mentioned my jaw still shifts to the side when I open my mouth (snap snap crack shift). She agreed and said se would start another treatment. Now I am in the process of getting braces because I was not able to stay consistent with the Invisalign. She placed spacers in my teeth about a week ago and I’ve been experiencing vertigo ever since. I also had my chiropractor take a look at my jaw and he was able to pop it back into place because I can open my mouth without it shifting. However I have ear fullness and vertigo still. I don’t know if I should still go ahead with the braces or if I should ask my orthodontist anything specifically? I feel she is not as well informed about TMJD as a specialist.
I'm sorry but I really can't advise you on your course of treatment over the internet and without examining you in person.
Hi I ‘got a specialist night guard about 5 months ago and it’s really helped with my grinding I’m thinking about getting braces/Invisalign to fix my uneven teeth on my right side (where my tmj is worse) I’m scared that if I get my braces I’ll start grinding heavily again and it will affect the myofunctional therapy I’m going through at the minute do you think it’s worth getting the braces as my right side feels so uneven when my teeth rest on each other
I’m sorry but I can’t answer your question without examining you in person.
Thank you for the video! What happens after successful Phase 1 treatment, if patient doesn't want to undergo Phase 2? Does the person have to wear an orthotic for the rest of the life?
My patients wear the nighttime appliance indefinitely.
Can you show us what an orthotic look like ? Thanks !
We follow the design of a MORA - Mandibular Orthopedic Repositioning Appliance. Having said that, it's not really about how the splint looks, it's more about the prescription that's built into it which is specific for each individual.
Hi priya. What do you think of breaking a patient's jaw to fix their bite? Or could this weaken it over for them in the future? Thanks
That's difficult to answer without evaluating the patient in person.
Hey Priya, do you know of any good TMJ/d dentists in the London area? I've searched the ICCMO (no results near me) and not sure how to find a good one. Any help would be most appreciated
Dr Jaz Gulati is wonderful!
@@theTMJdoc thankyou Priya! Have a nice evening
Hi!! What is the difference between the daytime and nighttime orthotic? Are they shaped the same or is the nighttime orthotic just a typical night guard?
Please watch my video “dental nightguard vs tmj orthotic” and lmk if you have any questions. the daytime orthotic is thinner than the nighttime one.
@@theTMJdoc I just watched and I still have a question. I received a daytime and nighttime orthotic. My nighttime one has wings in the front so my back teeth don’t touch st night. Is that how they are supposed to be designed?
Hi Priya do you take out of state medi-cal
No we do not. Sorry!
So in phase 1 with the orthotic and you get the muscles and joints in a more comfortable position and have eliminated the pain and the popping has stopped during phase 1 . Does that mean the disk has recaptured?
Yes 🙌🏼
Oh, thank for your response ❤
Can you tell me how you keep the jaw from falling back when you’re sleeping? I completed phase 1 and I’m in phase 2 Orthodontics and my jaws in a good position I don’t have any pain or poppy, but I’ve noticed when I’m sleeping when I wake up in the morning, there are days when I do have some popping and my jaw feels off and then it resets and it’s fine again, is this unusual? Have you ran into this before?
Thanks again for your response. I appreciate your thoughts. 😉
Is it normal to develop a posterior open bit with TMJ splint therapy phase 1? And if so are braces needed or do you refer these patients out for braces after phase 1 to correct it ?
the Bite changes can definitely occur. As for posterior open bite specifically, that depends on your pre-treatment bite and where the splint is holding your jaw. Some patients do need braces after treatment, others don't.
Hi, is it normal to have asymmetrical face during the first week of splint(Phase 1)? Also, I read that when you start Phase 1, it should bring your jaw and muscles into the proper relax position? I kinda feel a little pressure/tightness on my one side of jaw.
It can be normal, yes.
is it better to do Invisalign first, or t!j treatment first? the orthodontist told me to finish Invisalign before getting tmj treatment, what are your thoughts?
please watch this video:
ua-cam.com/video/ZFVYD3ul6iM/v-deo.html
After completing phase 1, if the bite hasn't changed and the patient doesn't have to do phase 2, how long do the good results obtained from phase one last? Do your patients usually stay pain and symptom Free for the long term? Thanks!
Hi! We get long lasting results if the patients continue to wear then nighttime appliance indefinitely.
My dentist referred me to a local orthodontist that has proposed Phase 1 & 2. I am inclined to begin with Phase 1 and see if Phase 2 is needed. However, the cost will be greater if Phase 2 is not chosen from the start of treatment. One joint is bone on bone due to years of clenching and grinding. (I've worn a nightguard for years and I have had traditional braces as a teen and Invisalign as an adult.) The previous Invisalign treatment was to correct my bite and TMJD so signing up for expensive aligners (again) gives me pause. However, protecting my joint from further destruction is of greatest importance. Would it be short-sighted to believe Phase 1 could be sufficient as long as I wore the GELB appliance at night forever?
Hi there! I cannot easily answer your question without follow up questions and discussion. If you'd like you can email my office to set up a Zoom meeting with me: patientcare@tmjdentaldoc.com
GUESS HOW I got TJD? from dysfunctional BRACES !!!!!
my teeth straightened but MY JAW IS CROOKED. I'm now 72 & can't eat without constant pain. phase 1 is all ANYBODY needs.
@@yarazooomdid you have phase 1 before the braces
@@suzannevasquez2137 no. I got braces in 1964. half my teeth fell out 2 yrs later then b/c I had no dental care I lost half my teeth with no regard to what rehab therapy I would need to be healthy again. but if I could do phase 1 I would. its all about the muscles & bones.
for my self I am doing CHI GONG, massage and keep walking & eat soft foods. work on relaxing my jaw to keep migraine away. I have no medical care where I live. good luck with your health journey
When the rights time to under go phase 2? Im wearing dental splint for 5 weeks and i still have minimal clicking
It’s best to ask your tmj dentist that question as it varies from person to person. :).
Hello. I am slightly confused. I was of the understanding the cause of TMJ/D symptoms maybe due to jaw misalignment and incorrect bite and so the goal of the first phase is to find the optimal bite which relaxes the muscles. Why then would we want to avoid the bite changing in Phase 1 if we want an optimal bite?
Because changing the bite will make the muscles and joints more dysfunctional. The muscles and joints must be addressed and brought to health first.
My TMD seemed to result from sleep clenching and/or heavy retractive muscular pull against the discs (eg: hyoid clenching). I saw an oral medicine specialist who said that what you describe as "Phase 2" sounds unnecessary in my case because there wasn't a problem with my bite to begin with. That sounded well-reasoned to me, but I'm just a layman - what do you think about cases like that?
I'm sorry but I cannot tell you what I think about your specific case over the internet and without examining you.
Dr. If a person have a tmjd, is there a possible that her vision will be affected too?
Yes, it is possible. Please watch this video:
ua-cam.com/video/iTS9ypsNKuE/v-deo.html
Do you know any good orthodontists who appreciate understanding of TMJ in relation to bite? I’m looking for one in Texas or houston area
I’m sorry I don’t.
What is the orthodontists name you work with? If you don’t mind sharing please
@@lizz9640 I don’t have an orthodontist I work with currently.
Dr Mistry, what is a flattened condyle? Is that a TMD issue? My x-ray shows left side condyle flattened .please reply
It means there have been bony changes in the jaw joint - osteoarthritis - wear and tear.
@@theTMJdoc Thank you kindly
@@theTMJdoc is it reversible? Can anything help this? I am suffering
Hello ma'am , do you know any good TMJ doctor and upper cervical chiropractor in India . Please it's urgent.
I don’t. Sorry!
Hello Mam, How many adjustment are needed during phase 1 of orthotic?
I do many. It can vary a lot patient to patient.
so question- why do I hear from people that orthodontia made their Tmjd worse or caused it? what would cause this?
If there's an underlying issue with the muscles and joints that is UNTREATED, orthodontia can make it worse. If the issue is treated (Phase 1), orthodontia can be done safely.
After phase 1 treatment do we still have to wear splint if not then is the tmjd fixed permanently
Did you watch the video completely? After phase 2, you technically don’t need an orthotic.
Hi doc, if the bite of a patient is slightly off is it possible that phase one resolves the issue?
It typically does not.
.
Does this guard also change cervical spine position to normal
It can’t do that on it’s own but it can help chiropractic adjustments to last longer
Are dentists required to know about TMD? I was shocked that my previous dentist doesn't recognize TMD symptoms.
We don’t learn much about it at school unfortunately :/
Can anyone recommend me a dentist in the UK that does phase 1 and 2 treatment please????
Dr Jaz Gulati does phase 1. Not sure about phase 2.
Hi!! Do you have any doctors you can recommend in the Atlanta or Georgia area? Or even nearby states. Also are the splints you use for treatment maxilla or mandibular. Thank you!
I'm sorry I don't. We typically fit our orthotics on the lower arch.
Thanks doc, I have a question. Are there more patients who doesnt get their bite changed after the splint/othotics or are there more patients who get their bite changed, speaking from your experience
With the way I do it, most patients do not have their bite changed.
@@theTMJdoc Thanks for answering doc ❤
@@fovos7359 you’re welcome!
@@theTMJdoc Doc what if the disc snaps back into its normal position when opening then displaces when closing. how is that treated
@@fovos7359 we treat this with orthotics, myofascial release and osteopathic manual jaw manipulation. Even with this it takes 4-6 months of treatment with weekly or biweekly appointments.
If we do not choose phase2 treatment , is there chances that we might get Tmj again ?
Great question - my patients do not relapse if they continue to wear their nighttime orthotic.
How can i contact you ....?
You can set up a Zoom Meeting by emailing Alex at patientcare@tmjdentaldoc.com
I wish I lived near you, I don't trust any dentist near me anymore.
I'm sorry to hear this.
the dentists here in australia are just overpaid psycho butchers!
what if the bite changes but feels better after phase 1
It's hard to answer that question. I'd have to see the bite afterwards to make a good recommendation.
Hi Dr. Priya, I have been given a Gelb appliance for my phase 1 treatment and it has reduced the symptoms. I wear it 24/7 as prescribed and it has been over 4 weeks since I have started. I notice that I am clenching on the orthotic. Is this because my muscles are being stretch? Is this normal and would my clenching reduce over the course of my phase 1 treatment base from your experience? Thank you.
I don’t know of a good solution to decrease nighttime clenching activity unfortunately.
can jaw cause anexity?
Jaw pain can cause anxiety.
Can level 2 patients treat with braces
Hi there! Did you watch the video? I believe I answer your question in the video.
And how much approx this all process cost
It varies highly depending on severity of symptoms.
@@theTMJdoc so day and night orthotics how much it cost ?
@@Dupinder_bajwa I do not discuss my fees over the internet. If you'd like to schedule a Zoom meeting with me, you can email my assistant Alex at patientcare@tmjdentaldoc.com
@@theTMJdoc ok perfect thanx
@@Dupinder_bajwa you’re welcome!
Is TMJ life long ??
it doesn't have to be.
Can wisdom teeth cause TMJ please inform
Wisdom teeth erupting cannot cause TMJ directly.
Hi doc this is simple, can misaligned tooth cause tmj?
Potentially yes but generally it’s due to a number of factors not only a misaligned tooth :)
GUESS HOW I got TJD? from dysfunctional BRACES !!!!!
my teeth straightened but MY JAW IS CROOKED.
sorry to hear that!
Sameee!!! Please tell me how your doctor treat this
I have tinnitus and I think my tmd is causing it maybe 🤔
Sorry to hear that!
R u indian origin....????
Yes
Can u talk about deviations
Deviation of the jaw? Yes, I can make a video on that.
Hi I ‘got a specialist night guard about 5 months ago and it’s really helped with my grinding I’m thinking about getting braces/Invisalign to fix my uneven teeth on my right side (where my tmj is worse) I’m scared that if I get my braces I’ll start grinding heavily again and it will affect the myofunctional therapy I’m going through at the minute do you think it’s worth getting the braces as my right side feels so uneven when my teeth rest on each other
I really cannot make recommendations or suggestions regarding your treatment without examining you in person. Best of luck to you!