1st- because of your recommendation, I went to a TMJ specialist and was fitted for top and bottom orthotics. I believe they have helped. I still can’t sleep with the top one (I can’t breathe) but I’ll wear it watching TV and such. I use the bottom one while driving or working at the office. I need to seek out some manual manipulation help. 2nd- yowzers! Great way to start my morning. 😂 Anyways… thanks for everything you do Doc!
TMJ suffers, in my experience, Prolotherapy has helped me to correct my facial imbalances, relaxed my facial muscles and pain reliefs. After 9 treatments, no pain and I can eat even nuts and chips. Hope this help. Hi from Canada
Ma’am thankyou thankyou very much for the videos you make. They are probably the only ones on UA-cam about a lot of details of tmjd. Here in India, there are only 2 or 3 docs for tmj in the capital city, and this being so unheard of, it’s difficult to know if we are being treated right. Your videos are a guide, they help me, assure me and let me rest peacefully. Keep making them. Wish you all the good things. You are the rainbow in the rain for me 🌈🙏🏻
MRI TEMPORO MANDIBULAR JOINTS Protocol: MR examination of the temporo mandibular joints was performed in open and closed mouth positions. Oblique sagittal PD/T2 FS, coronal T1/STI sequences and axial T2 sequence. OBSERVATIONS: The study reveals normal anatomical configuration / signal morphology of the bilateral temporo mandibular joints. No subluxation / dislocation is seen. Condylar fossae appear normal. Condyles & the necks of mandible under view appear normal No demonstrable focus of altered marrow signal is seen involving the bones under view. No marrow edema / cortical erosion / destruction is seen. Right TM joint: Intra articular disc appears normal in thickness with presence of mild intrasubstance hyperintensity. The retro-discal tissues appear normal, No disc thickening/crumpling or abnormal displacement seen. Closed mouth: Both mandibular condyles and fibrocartilaginous disc are noted in the fossa. The position of junction of posterior disc and retrodiscal tissue remain in normal position in relation to mandibular condyle. Intermediate zone remains between mandibular condyle and articular eminence. Open mouth: There is abnormal suboptimal anterior translation of the mandibular condyles on mouth opening. The articular disc remains stuck in position in open mouth position. Left TM joint: Intra articular disc appears normal in appearance with presence of intrasubstance hyperintensity. The retro-discal tissues appear normal. No disc thickening/crumpling or abnormal displacement seen. Closed mouth: Both mandibular condyles and fibrocartilaginous disc are noted in the fossa. The position of junction of posterior disc and retrodiscal tissue remain in normal position in relation o mandibular condyle. Intermediate zone remains between mandibular condyle and articular eminence. Open mouth: There is abnormal suboptimal anterior translation of the mandibular condyles on mouth opening. The articular disc remains stuck in position in open mouth position. Joint spaces are normal. No effusion is seen. No demonstrable soft tissue mass / collection is seen. Soft tissues and the muscles under view appear normal & bilaterally symmetrical. Hello sister. I'm from India Gujarat. I'm suffering tmj pain near right side ear around last 5 months. Priya sister I'm also Mistry.. Please help me what am I do now Pain is not extremely. But continues.. I'm very upset and tired now. Please help me.. 🙏
Hi there. I’m being flooded with like this and cannot thoroughly answer them all. If you’d like you can email my office to set up a zoom meeting with me so I can better evaluate whether or not I can help you - patientcare@tmjdentaldoc.com
Dentists are trained in making nightguards, not TMJ orthotics. We have zero training in how to make an orthotic . If you’re dentist made you something that’s not helping, I really don’t think they’re trying to cheat you. It’s likely more about a gap in their knowledge.
This is very interesting. Cause I have no idea what I am currently wearing. I was made a guard by a gnatologist. Those are the tmj specialists in my country. I live in Europe. It's for my lower teeth. And I should wear it during the day and night. And it pushes my lower jaw a tiny bit forward. But it does get worse when Ive worn it. But it also does feel good while I have it in. So I'm pretty puzzled if I should keep using it or if it's just getting used to it. It was custom made for me and I was told my tmj will get worse before getting better. In the beginning. I saw a different gnatologist yesterday who adjusted the guard completely and I don't know if I should've let her done that. It was not hers but she wanted to help me when I told her I'm in a lot of pain. No one has ever told me about the differences in these guards. And I really wanna know. So I can be more comfortable knowing I have the right one. I feel like seeing another gnatologist who can explain it to me more. Cause I've become reluctant to wear it because I don't know what I'm dealing with. She's adjusted it and shaved it and I had to bite on these pieces of red see trough paper but I wasn't explained what was exactely done to my guard. I feel good communication is key. Cause it can help or make me worse. And I'm already in a lot of pain.
I had a MORA type orthotic made by a TMJ dentist and unfortunately it made my issues worse. He failed to observe the primary cause of my symptoms is from clenching and grinding my teeth during sleep. The MORA gave me something to bite down on harder and also grind on which promoted the bruxism even more. I'm now trying an anterior deprogrammer. If it doesn't help I'll be moving on to some kind of self invented biofeedback device. This issue really sucks, not much help out there for bruxism. Your videos are great though, very informative and thorough.
@@theTMJdoc I do have sleep apnea but it's well controlled. My most recent sleep doc visit showed I'm having less than one episode per hour. For me, all these issues started not long after I took on a much more stressful position at work. Stress/anxiety are also well known to cause bruxism which I think are the root causes in my case. Gotta manage my stress better. Thanks for the reply.
@@theTMJdoc It is impossible for me not to subscribe to your channel. Your information is very wonderful and useful, and your style of presentation is charming. Thank you very much for the wonderful content you provide.
I have exactly these appliances. As far as my understanding, I have to wear the MORA during the day and the ARA at night. But you’ve said that both are to be worn at night. So, now I’m a little confused. Did I misunderstood my doctor?
Great information Dr. Mistry. I went to a TMJ specialist, and before making an orthotic, he asked me to have an apnea test which showed some apneas during the night. So he said I cannot wear an orthotic because the apneas will get worse. So now I don’t have the option of an orthotic and continue to have pain on my 3 last upper teeth (all with root canals) for the past 10 months. I wonder if you had such cases in your practice. Thank you very much for your time.
I have tmj and osteoarthritis in my jaw. My tmj specialist quoted me $3500 for custom fit orthotic. I just want to make sure that that price is right for this appliance. want to make sure before i spend $$ for a pricey tmj orthotics that I think I need. Thanks
Hi Dr Priya, I went to a " tmj specialist " and unfortunately got swindle out of close to 12,000$ 😢 when you are in pain you will pay almost anything to help you feel better. I went to this Dr and she " diagnosed " me with sleep apnea. Instead of treating my tmj she was focused on sleep apnea that I don't even think I have. She made me a sleep appliance not a tmj orthotic. That appliance has done nothing but caused me more cheek pain and the kicker I am now 10,000 in debt. If the right appliance would have been given then the money would not have mattered, but unfortunately, her appliance did nothing but put in me in debt and cause me more unnecessary pain. This has made me go down a bit of a depression spiral as I don't know where or what to do next. Unfortunately I do not have the means to go to another tmj specialist because it's not covered by my insurance. I guess this is me just venting. Anyway, thank you for your tips you give us to help those of us with this horrible condition. It is much appreciated ❤
A similar experience happened to me! Ugh, what is going on?! I am sure there is a correlation between the two but I don't understand assumptions being made that you must have sleep apnea if you are coming in primarily with jaw complaints vs. sleep-related complaints. Sorry this happened to you, and I wish there were more real deal specialists out there for us.
@devoidcolors from what I've read sleep apnea can contribute to tmj. But in my case, I don't think I had sleep apnea. I think she misdiagnosed me. Thank you, I hope for those of us that suffer this horrible condition there is at least more honest tmj specialist and that the almighty insurance covers payments
Is there a website where we can find skilled providers trained in proper fitiing of these devices? I would love to visit you, but the distance is prohibitive
Hi doctor thank u so much for replying my questions previously 😇I went for checkup and the specialist is suspecting i might have myofascial syndrome based on symptoms doc..Pain on cheek bone,one side headache,shoulder pain and neck pain,pain behind ear too..And also upper teeth sometimes sensitive hard to open wide..This is why i thought it might be TMJ disorder anyway thank u so much doc now taking medicine hopefully it helps and everyone who read my comment can learn also.
@@theTMJdoc hi doctor when i open my month my done teeth go to the right cross bite. I canot chee properly.i did potocks and it was ok only for 3 month and go again the same. I had this proplem for two years what is the treatment for my proplem please
Dr Priya. What if I have an implant crown , but my bite was off before the crown was placed and got even worse after the crown was placed and I do have TMJ problems, would I still be able to treat my bite and dislocation of the jaw with your orthotics having an implant crown ?
Do you have any advice or guidelines for how to identify a TMD doctor who knows what they are doing? It's difficult as a layman to know the difference. I went to an oral medicine specialist who wasn't interested in doing any imaging, be it CBCT, MRI, or anything else. I thought it was weird for someone handling a delicate and precise treatment not to want all the possible information available, but I figured he knew what he was doing. His orthotic shifted my jaw right because my jaw opened with a leftward slant. Soon my right side TMJ disc audibly shattered and drove the joint into my ear. I now live with hearing loss and intense reactive blasts of tinnitus in response to the faintest sounds. So, any tips on what signs to look for that a practitioner might be equipped (or unequipped) to properly treat TMD could save lives.
Hi Dr. Priya.... May I ask how long do we need to wear the orthotic usually ??? And have you seen any case where after stopping the orthotic the TMJ symptoms re-appear ??
What patients do you recommend a day time orthotic for and for how long do patients typically need a day time appliance? I saw a doctor who recommended the MORA and to wear it day and night for 1-2 years depending on patient response to treatment.
@@theTMJdoc Dear Dr. Priya, we also want you to have an explanatory video on mandibular dislocation and subluxation and how to treat these problems without surgical intervention. If you have a prior explanatory video on this topic, please send the link. Thank you very much.💓
I’m in agony and have so many missing bottom teeth that I can’t be fitted for an orthotic. There are no teeth on the lower right except for 7 teeth in the front and a removable temporary bridge. I’m desperate.
Do you take into consideration the posture when doing an orthotic ? Did your patient notice some improvements or modifications in their posture ? (especially in the head/neck area) If the orthotic works, do you have to wear it for the rest of your life ? How many months, or year can the orthotic last before having to change it ? Thanks a lot Dr. Mistry.
Hi Doctor! Thank you for the excellent information . I have been dealing with migraines that popped up about 4 years ago. Im 61 and never had headaches before. I have been put on a migraine med but dont think that is what I really need. I feel its probably stress related. I live in San Antonio area and am having a hard time finding a TMJ doctor. I feel an orthodic would benefit me because I have been wearing a night guard for 25 years and dont think it helps. DO you know of any in my area I could go see to get one made? I have tried 2 and one only does corrective surgery and the other wont see anyone until August when school is out. Thank you for all your exercises and advice I am trying!
@@theTMJdoc Thank you Doctor, for what reasons specifically? I live in France and this device is offered (I wear a classic occlusal splint at night without much effect). Thanks a lot for your videos and advices
Hi Dr. Mistry, I had an unsuccessful arthrocentesis 1 year ago for my jaw locked closed. I’m still searching for help and came across you. Would it be safe to say that an unsuccessful arthrocentesis procedure make the probability of the orthotic (if you made me one) unsuccessful too? Running out of options but it’s very expensive! Thank you for your time! -Tori
I wouldn’t say that an orthotic would be unsuccessful. It depends on many different factors. If you’d like, you can email my office to set up a Zoom meeting with me so I can better evaluate your condition.
Thank you so much for your educational videos! Question: do you find that those with an overbite suffer more with TMJD issues? and that the orthotic with the front flange (disc displacement without reduction) is best for that?
I had a day guard 10 years ago to straighten everything out, and it worked beautifully. However, now I’m getting more TMJ symptoms back, does it make any sense to have to do the correction guard again?
Hello Dr Mistry. A question for you. I've been wearing a daytime orthotic appliance for seven weeks. When I’m wearing the daytime appliance (on bottom teeth) I am often dizzy, lightheaded and foggy-headed, a bit nauseous and often have ringing in my ears. As soon I take the daytime appliance out, those symptoms will gradually go away. I would like to know if this is a normal side effect of wearing the daytime appliance? Thank you. (Hard reach the doctor who created the appliance for me - or get an answer quickly from him, so I'm reaching out to you. Thank you!!)
I just got a MORA type orthotic on my lower teeth. When resting with my jaw closed, am I supposed to conciously close my jaw so that my upper teeth contact the orthotic? My typical resting state is lips closed, tongue at roof of mouth behind upper front teeth, and upper and lower teeth(/orthotic) not contacting.
Hi Dr Mistry! I have started seeing a dentist that specializes in my area for TMJD who wants to make me both a day time orthotic to wear for 16 weeks and a night time orthotic (both top and bottom) to wear forever. Is there questions to ask to ensure it is the right treatment for me? Dentist did a CBCT scan and some physical tests
Just found you - LOVE your content! Do you have a preferred antidepressant/antianxiety medication for patients with TMD and bruxism? My doctor said SNRIs are better but they are difficult to get off of so I'm a bit worried about trying various ones. Any advice is appreciated!
@@theTMJdoc Totally understand that.Thank you for your response! Do you accept patients who travel to you from out of state? I have complicated issues from bad dental work :( and I'm tired of taking pills to get by.
Dr. Mistry, I have an orthotic that is a daytime wear but it was created without the K7. I had my teeth scanned and the orthotic was created. My dentist would use the blue bite sheet to check where I am hitting on it. They do calls this a neuromuscular orthotic. My question is, is this truly a NM orthotic then? I just got this not long ago and when I wake up I am still locking in it… I am supposed to get a night time orthotic that is both an upper and lower wear. Do you know what this could be? Thank you for such great videos!
Thank you so much for your information. I was changing my sheets and pulled a neck muscle. Now I click! I’ve been going to PT for jaw massages. I’m waiting to get my night guard from UCLA Dental School. They are on break. Question: how do you feel about using Oral B night guard in the meantime. It gets shaped to your teeth by heating in microwave . I’m worried I will clench down in wrong position and cause more problems.
I will never recommend an over the counter nightguard, no matter what. They will often make TMJ issues worse. Also keep in mind that a dental nightguard is NOT the same as a tmj orthotic.
So I have minimal cartilage and bone spurs and I was told that a MORA cannot be used on adults but ca be used on young people. They instead told me to do Invisalign since my skull and mandible are already developed. Do you give the MORA to adult patients?
quick question - my ARA like NTI splint causes me to clench more using my median and lateral pterygoid muscles instead of the other muscles is that normal. Can any splint eliminate or reduce nighttime clenching?
Are there any providers in Europe that use the mora system? I hope, so now I have to wear a nightguard doesn't do anything for my muscles. No one uses this system in my country (belgium) they always give night guards. I have no choise i got tmj after bad orthodontis. I have so much pain because of it I also had a root canal treatment because my tooth gave up. I'm also scared that my nightguard (only top teeth marks) will damage my muscles. I do MYO therapy and I try to do my daily exercises but it's not enough i can't control what I do in my sleep.
I am wearing an ARA device as I am typing this. I've had disk displacement without reduction, which unfortunately, after my symptoms got a lot better by wearing the ARA at night every night and then later every 3rd, suddenly turned into a displacememt without reduction. I can manually reposition my disk and am wearing the ARA for like 3 days for 24hours after that, but I'm not sure if that's enough time. Can it be said at what duration of wearing the ARA the open bite might become a problem? I am aware of this risk but I found studies where people were wearing the ARA for 3 month or even longer for 24h. Would it be unlikely to become a concern if I wear the ARA max. 7 days in a row for 24h?
I don't feel comfortable making a recommendation on how much you should wear the ARA over the internet and without examining you. Sorry and best of luck to you!
Hi my ENT doctor I have tmj so I go to Tmj specialist and I have splint now I will wear in the evening..Because I do clench my teeth every evening and I have ear pain,tinnitus and vertigo, neck pain amd throat pain..I hope it will help my situation its hard to deal because I have work🤔
Try putting lavender- a couple of drops -essential oil on a very small piece of cotton ball and placing in outer ear canal. I Promise you can still hear too. I read about that on one of these sites and it saved my ear and neck pain. I was desperate for pain relief and tried everything. It worked and I only wear it during the day.
I feel like my bite is totally different lying down (back sleeper). Do you create the nighttime prescription for a patient specific to a lying down position.
Hi Doctor, I (22yr) was recently diagnosed with TMD. Doctors suggested a bite guard(to get my teeth grow downwards, making space in joint) or a deprogrammer to address it. Which one do you recommend? MRI shows mild bilateral TM joint dysfunction and minimal disc subluxation on the right, with some edematous changes. Thank you so much!!
I’ve been told orthotics cause an open bite- do you have to wear them permenantly, when you stop wearing would it come back? do you know anything about palate expansion? Thanks :) Also how much do they cost usually?
I’m sorry but there’s no way I can answer this without follow up questions and discussion. If you’d like you can set up an online consultation with me using this link 😊🙏🏼 tmjdentaldoc.janeapp.com/#/staff_member/1/treatment/8
@theTMJdoc thanks for your reply. I have an overbite. The doctor has suggested me that GNM orthotic will be used for the lower jaw to come forward. It will correct the overbite and open the airway for better breathing. I don't have sleep apnea, but I feel comfortable when I do some breathing exercises. When I don't do breathing exercises that day, I feel uncomfortable.
It doesn’t change shape necessarily but it can fracture over time where the clenching force is the hardest. Given enough force, anything can break unfortunately.
I’m having a flare up after about 20 years of good Tmj health. I really like your approach, and wish I could see you. I’m in Melbourne Fl and wonder if there is a directory of sorts that would allow me to find a practitioner that espouses your methods?
how do you keep the tongue from falling back and blocking the airway? My orthotic has a place wherem y tongue can relax t the roof of my mouth so it doesn't fall back
the orthotics are to treat muscles and joints that cause TMJ pain and dysfunction. These are not to treat sleep apnea or prevent the tongue from falling into the airway.
Hi, my daytime orthotic was thickest on the canines. It looks like the one in your video is as well. Why is that? Could that cause an open bite? Thanks!
HI Priya, i have tried everything stretches,posture and orthotics but nothing has changed--given this would your recommend botox and if so what i should be aware of?
I cannot make a recommendation for your specific treatment over the internet and without examining you. If you'd like to discuss your condition, you can email my office to set up a zoom meeting with me.
@@theTMJdoc okay thanks, but ill rephrase so its not a reccomendation and rather a pros and cons question- would you say muslce relaxants help tmj, or more physio or botox and which order.
Hello! I’ve been following your videos for several months now and find your guidance and information to be a life saver. I’ve had joint trouble caused by clenching at night. I’m using a mora but still clenching. My upper front teeth have become hyper sensitive and can’t have any pressure on them at all. My endodontist checked out my front teeth and they are healthy but hypersensitive. My TMJ dentist removed the contact points on my mora device for my upper front. My upper front teeth have settled down…and I’m hoping this will work for me. I’ve also tried an anterior device but run into the same problem….my front teeth are so sensitive to pressure that I can’t have contact on them. Have you come across this problem and what do you use in your practice for patients experience hypersensitivity to pressure.
I have a video recommendation that I'm not sure if you've done before. Can you make a video about TMJ and how that leads to facial asymmetry. I have gotten fitted with an orthotic from my TMJ dentist and I've noticed that the joints have stabilized but my masseters differ in size from years of dysfunction that probably needs more time to recover. I've seen some people online who share their TMJ journey sometimes develop severe facial asymmetry that mainly noticeable in their masseter muscles, thankfully mine isn't that severe. If someone has clicking and popping on one side of their face does it make sense that the muscles of mastication on the affected side will grow or shrink more relative to the properly functioning side. Also, are there exercises that help bring back the muscles to equal size and strength quicker once the joints have stabilized or is it just something that just needs time to balance out the muscles with the new proper bite. Thanks!
I don’t feel comfortable making a video about asymmetry because the causes for it are largely not understood. If you’d like to speak about your specific condition you can email my office to set up a zoom meeting with me. Patientcare@tmjdentaldoc.com
@@theTMJdoc not exactly, i will do! I thought i could solve it with chiropractor and physical therapy since i have neck pain too! I really appreciate your reaponse! Your videos are so helpful for pain realease for me! 🥰
This cannot be "ordered" :) It takes a skilled and experienced TMJ dentist to find the correct prescription to build into this appliance. Hope that helps!
1st- because of your recommendation, I went to a TMJ specialist and was fitted for top and bottom orthotics. I believe they have helped. I still can’t sleep with the top one
(I can’t breathe) but I’ll wear it watching TV and such. I use the bottom one while driving or working at the office. I need to seek out some manual manipulation help.
2nd- yowzers! Great way to start my morning. 😂
Anyways… thanks for everything you do Doc!
Do you mind if I ask what the final cost of everything was?
I’m so glad you’ve been able to find help!!
TMJ suffers, in my experience, Prolotherapy has helped me to correct my facial imbalances, relaxed my facial muscles and pain reliefs. After 9 treatments, no pain and I can eat even nuts and chips. Hope this help. Hi from Canada
I’m glad you found help and pain relief!
Ma’am thankyou thankyou very much for the videos you make. They are probably the only ones on UA-cam about a lot of details of tmjd. Here in India, there are only 2 or 3 docs for tmj in the capital city, and this being so unheard of, it’s difficult to know if we are being treated right. Your videos are a guide, they help me, assure me and let me rest peacefully. Keep making them. Wish you all the good things. You are the rainbow in the rain for me 🌈🙏🏻
Thank you for your kind words!!!
MRI TEMPORO MANDIBULAR JOINTS
Protocol:
MR examination of the temporo mandibular joints was performed in open and closed mouth positions. Oblique sagittal
PD/T2 FS, coronal T1/STI sequences and axial T2 sequence.
OBSERVATIONS:
The study reveals normal anatomical configuration / signal morphology of the bilateral
temporo mandibular joints. No subluxation / dislocation is seen.
Condylar fossae appear normal. Condyles & the necks of mandible under view appear normal
No demonstrable focus of altered marrow signal is seen involving the bones under view. No
marrow edema / cortical erosion / destruction is seen.
Right TM joint:
Intra articular disc appears normal in thickness with presence of mild intrasubstance
hyperintensity. The retro-discal tissues appear normal, No disc thickening/crumpling or
abnormal displacement seen.
Closed mouth: Both mandibular condyles and fibrocartilaginous disc are noted in the
fossa. The position of junction of posterior disc and retrodiscal tissue remain in
normal position in relation to mandibular condyle. Intermediate zone remains
between mandibular condyle and articular eminence.
Open mouth: There is abnormal suboptimal anterior translation of the mandibular
condyles on mouth opening. The articular disc remains stuck in position in open
mouth position.
Left TM joint:
Intra articular disc appears normal in appearance with presence of intrasubstance
hyperintensity. The retro-discal tissues appear normal. No disc thickening/crumpling or
abnormal displacement seen.
Closed mouth: Both mandibular condyles and fibrocartilaginous disc are noted in the
fossa. The position of junction of posterior disc and retrodiscal tissue remain in normal position in relation o mandibular condyle. Intermediate zone remains
between mandibular condyle and articular eminence.
Open mouth: There is abnormal suboptimal anterior translation of the mandibular
condyles on mouth opening. The articular disc remains stuck in position in open
mouth position.
Joint spaces are normal. No effusion is seen.
No demonstrable soft tissue mass / collection is seen.
Soft tissues and the muscles under view appear normal & bilaterally symmetrical.
Hello sister.
I'm from India Gujarat.
I'm suffering tmj pain near right side ear around last 5 months.
Priya sister I'm also Mistry..
Please help me what am I do now
Pain is not extremely. But continues..
I'm very upset and tired now.
Please help me.. 🙏
Hi there. I’m being flooded with like this and cannot thoroughly answer them all. If you’d like you can email my office to set up a zoom meeting with me so I can better evaluate whether or not I can help you - patientcare@tmjdentaldoc.com
@@theTMJdoc OK.. Mem...
Thanks..
I send to you my mri report no your mail id.
Tomorrow.
I feel like I’ve been cheated by my dentist. I’ll be talking to them on my next appointment. Thank you for posting.
Dentists are trained in making nightguards, not TMJ orthotics. We have zero training in how to make an orthotic . If you’re dentist made you something that’s not helping, I really don’t think they’re trying to cheat you. It’s likely more about a gap in their knowledge.
My TMJ started after tooth extractions and it keeps getting worse, no matter what I do. I don’t understand why it keeps getting worse?
This is very interesting. Cause I have no idea what I am currently wearing. I was made a guard by a gnatologist. Those are the tmj specialists in my country. I live in Europe. It's for my lower teeth. And I should wear it during the day and night. And it pushes my lower jaw a tiny bit forward. But it does get worse when Ive worn it. But it also does feel good while I have it in. So I'm pretty puzzled if I should keep using it or if it's just getting used to it. It was custom made for me and I was told my tmj will get worse before getting better. In the beginning. I saw a different gnatologist yesterday who adjusted the guard completely and I don't know if I should've let her done that. It was not hers but she wanted to help me when I told her I'm in a lot of pain.
No one has ever told me about the differences in these guards. And I really wanna know. So I can be more comfortable knowing I have the right one. I feel like seeing another gnatologist who can explain it to me more. Cause I've become reluctant to wear it because I don't know what I'm dealing with. She's adjusted it and shaved it and I had to bite on these pieces of red see trough paper but I wasn't explained what was exactely done to my guard.
I feel good communication is key. Cause it can help or make me worse. And I'm already in a lot of pain.
Sorry you’re going through this and I hope you find relief soon!
I had a MORA type orthotic made by a TMJ dentist and unfortunately it made my issues worse. He failed to observe the primary cause of my symptoms is from clenching and grinding my teeth during sleep. The MORA gave me something to bite down on harder and also grind on which promoted the bruxism even more. I'm now trying an anterior deprogrammer. If it doesn't help I'll be moving on to some kind of self invented biofeedback device. This issue really sucks, not much help out there for bruxism. Your videos are great though, very informative and thorough.
Sorry you went through all that. The #1 reason for nighttime bruxing is sleep apnea. Have you been evaluated by a sleep doctor? Best of luck to you!
@@theTMJdoc I do have sleep apnea but it's well controlled. My most recent sleep doc visit showed I'm having less than one episode per hour. For me, all these issues started not long after I took on a much more stressful position at work. Stress/anxiety are also well known to cause bruxism which I think are the root causes in my case. Gotta manage my stress better. Thanks for the reply.
Thank you very much for this wonderful video
You’re welcome! Don’t forget to Subscribe!!
@@theTMJdoc It is impossible for me not to subscribe to your channel. Your information is very wonderful and useful, and your style of presentation is charming. Thank you very much for the wonderful content you provide.
@@user-Abdulkawi thank you for your kind words 😊🙏🏼
I have exactly these appliances.
As far as my understanding, I have to wear the MORA during the day and the ARA at night. But you’ve said that both are to be worn at night. So, now I’m a little confused.
Did I misunderstood my doctor?
nice video i am so use to using a stack pull forward on lower generated off a k7 thanks for your videos great for learning .
👍🏼
Great information Dr. Mistry. I went to a TMJ specialist, and before making an orthotic, he asked me to have an apnea test which showed some apneas during the night. So he said I cannot wear an orthotic because the apneas will get worse. So now I don’t have the option of an orthotic and continue to have pain on my 3 last upper teeth (all with root canals) for the past 10 months. I wonder if you had such cases in your practice. Thank you very much for your time.
an orthotic can still be made provided you’re treating the sleep apnea with a CPAP.
Thank you kindly for your answer Dr. Mistry❤
I have tmj and osteoarthritis in my jaw. My tmj specialist quoted me $3500 for custom fit orthotic. I just want to make sure that that price is right for this appliance. want to make sure before i spend $$ for a pricey tmj orthotics that I think I need. Thanks
I've seen prices range from $5000-$10,000.
Hi Dr Priya, I went to a " tmj specialist " and unfortunately got swindle out of close to 12,000$ 😢 when you are in pain you will pay almost anything to help you feel better. I went to this Dr and she " diagnosed " me with sleep apnea. Instead of treating my tmj she was focused on sleep apnea that I don't even think I have. She made me a sleep appliance not a tmj orthotic. That appliance has done nothing but caused me more cheek pain and the kicker I am now 10,000 in debt. If the right appliance would have been given then the money would not have mattered, but unfortunately, her appliance did nothing but put in me in debt and cause me more unnecessary pain. This has made me go down a bit of a depression spiral as I don't know where or what to do next. Unfortunately I do not have the means to go to another tmj specialist because it's not covered by my insurance. I guess this is me just venting. Anyway, thank you for your tips you give us to help those of us with this horrible condition. It is much appreciated ❤
I’m so sorry to hear that you’re going through this :(
A similar experience happened to me! Ugh, what is going on?! I am sure there is a correlation between the two but I don't understand assumptions being made that you must have sleep apnea if you are coming in primarily with jaw complaints vs. sleep-related complaints. Sorry this happened to you, and I wish there were more real deal specialists out there for us.
@devoidcolors from what I've read sleep apnea can contribute to tmj. But in my case, I don't think I had sleep apnea. I think she misdiagnosed me. Thank you, I hope for those of us that suffer this horrible condition there is at least more honest tmj specialist and that the almighty insurance covers payments
Is there a website where we can find skilled providers trained in proper fitiing of these devices? I would love to visit you, but the distance is prohibitive
Not that I’m aware of!
My same problem. I’m 84 and on the east coast.
Hi doctor thank u so much for replying my questions previously 😇I went for checkup and the specialist is suspecting i might have myofascial syndrome based on symptoms doc..Pain on cheek bone,one side headache,shoulder pain and neck pain,pain behind ear too..And also upper teeth sometimes sensitive hard to open wide..This is why i thought it might be TMJ disorder anyway thank u so much doc now taking medicine hopefully it helps and everyone who read my comment can learn also.
Best of luck to you!
What medications are you using or what is your treatment plan?
@@theTMJdoc hi doctor when i open my month my done teeth go to the right cross bite. I canot chee properly.i did potocks and it was ok only for 3 month and go again the same. I had this proplem for two years what is the treatment for my proplem please
Dr Priya. What if I have an implant crown , but my bite was off before the crown was placed and got even worse after the crown was placed and I do have TMJ problems, would I still be able to treat my bite and dislocation of the jaw with your orthotics having an implant crown ?
Yes you would :)
@@theTMJdoc thank you. And then after the treatment I might need to make some changes with the crown?
Do you have any advice or guidelines for how to identify a TMD doctor who knows what they are doing? It's difficult as a layman to know the difference.
I went to an oral medicine specialist who wasn't interested in doing any imaging, be it CBCT, MRI, or anything else. I thought it was weird for someone handling a delicate and precise treatment not to want all the possible information available, but I figured he knew what he was doing. His orthotic shifted my jaw right because my jaw opened with a leftward slant. Soon my right side TMJ disc audibly shattered and drove the joint into my ear. I now live with hearing loss and intense reactive blasts of tinnitus in response to the faintest sounds. So, any tips on what signs to look for that a practitioner might be equipped (or unequipped) to properly treat TMD could save lives.
Sorry you went through this! Please watch this video for the answer to your question:
ua-cam.com/video/n4MhVgUeKSI/v-deo.html
Hi Dr. Priya.... May I ask how long do we need to wear the orthotic usually ???
And have you seen any case where after stopping the orthotic the TMJ symptoms re-appear ??
What patients do you recommend a day time orthotic for and for how long do patients typically need a day time appliance? I saw a doctor who recommended the MORA and to wear it day and night for 1-2 years depending on patient response to treatment.
I recommend a daytime for almost everyone. the amount of time it's worn varies a lot from patient to patient.
Please, we want you to explain how TMD problems affect the throat and cause throat problems
Yes I’ll make a video on this
@@theTMJdoc 💓
@@theTMJdoc Dear Dr. Priya, we also want you to have an explanatory video on mandibular dislocation and subluxation and how to treat these problems without surgical intervention. If you have a prior explanatory video on this topic, please send the link. Thank you very much.💓
I’m in agony and have so many missing bottom teeth that I can’t be fitted for an orthotic. There are no teeth on the lower right except for 7 teeth in the front and a removable temporary bridge. I’m desperate.
Do you take into consideration the posture when doing an orthotic ?
Did your patient notice some improvements or modifications in their posture ? (especially in the head/neck area)
If the orthotic works, do you have to wear it for the rest of your life ?
How many months, or year can the orthotic last before having to change it ?
Thanks a lot Dr. Mistry.
Yes I do. I always have my patients sitting straight up with their feet planted firmly on the ground.
Hi Doctor! Thank you for the excellent information . I have been dealing with migraines that popped up about 4 years ago. Im 61 and never had headaches before. I have been put on a migraine med but dont think that is what I really need. I feel its probably stress related. I live in San Antonio area and am having a hard time finding a TMJ doctor. I feel an orthodic would benefit me because I have been wearing a night guard for 25 years and dont think it helps. DO you know of any in my area I could go see to get one made? I have tried 2 and one only does corrective surgery and the other wont see anyone until August when school is out. Thank you for all your exercises and advice I am trying!
I’m sorry, I don’t know anyone there!
I live in Houston. Apparently there's 2 good doctos here but it sounds super expensive.
@theTMJdoc Hello Doctor Mistry, What do you think of the NTI TSS device ?
Generally speaking I don’t think it’s appropriate to treat TMJ/TMd
@@theTMJdoc Thank you Doctor, for what reasons specifically? I live in France and this device is offered (I wear a classic occlusal splint at night without much effect). Thanks a lot for your videos and advices
Hi Dr. Mistry,
I had an unsuccessful arthrocentesis 1 year ago for my jaw locked closed. I’m still searching for help and came across you. Would it be safe to say that an unsuccessful arthrocentesis procedure make the probability of the orthotic (if you made me one) unsuccessful too? Running out of options but it’s very expensive!
Thank you for your time! -Tori
I wouldn’t say that an orthotic would be unsuccessful. It depends on many different factors. If you’d like, you can email my office to set up a Zoom meeting with me so I can better evaluate your condition.
Thank you so much for your educational videos! Question: do you find that those with an overbite suffer more with TMJD issues? and that the orthotic with the front flange (disc displacement without reduction) is best for that?
Hi Dr. Mistry! Love all your videos. On average, how many millimetres does an orthotic pull your jaw forward?
It depends on your TMJ condition. Sometimes it doesn’t move it forward at all.
Sounds like the $500 upper night guard was a rip off then. It sure doesn't seem to do anything.
Yes nightguards are not appropriate for treating TMD
I got the same thing. Wasting money. I can't find anyone in my area that makes this orthotic though
I had a day guard 10 years ago to straighten everything out, and it worked beautifully. However, now I’m getting more TMJ symptoms back, does it make any sense to have to do the correction guard again?
Hello Dr Mistry. A question for you. I've been wearing a daytime orthotic appliance for seven weeks. When I’m wearing the daytime appliance (on bottom teeth) I am often dizzy, lightheaded and foggy-headed, a bit nauseous and often have ringing in my ears. As soon I take the daytime appliance out, those symptoms will gradually go away. I would like to know if this is a normal side effect of wearing the daytime appliance? Thank you. (Hard reach the doctor who created the appliance for me - or get an answer quickly from him, so I'm reaching out to you. Thank you!!)
This is not something I experience normally. Sorry you’re going through this!
I just got a MORA type orthotic on my lower teeth. When resting with my jaw closed, am I supposed to conciously close my jaw so that my upper teeth contact the orthotic? My typical resting state is lips closed, tongue at roof of mouth behind upper front teeth, and upper and lower teeth(/orthotic) not contacting.
I’d recommend speaking to your TMJ dentist about it :) sorry but I don’t feel comfortable advising you without being your practitioner.
Hi Dr Mistry! I have started seeing a dentist that specializes in my area for TMJD who wants to make me both a day time orthotic to wear for 16 weeks and a night time orthotic (both top and bottom) to wear forever. Is there questions to ask to ensure it is the right treatment for me? Dentist did a CBCT scan and some physical tests
It's really hard to know which questions to ask. Honestly, it depends on your practitioner's experience and skill level.
Just found you - LOVE your content! Do you have a preferred antidepressant/antianxiety medication for patients with TMD and bruxism? My doctor said SNRIs are better but they are difficult to get off of so I'm a bit worried about trying various ones. Any advice is appreciated!
I’m sorry, I don’t. Because I don’t prescribe them or treat anxiety, depression, etc - I don’t feel comfortable making recommendations.
@@theTMJdoc Totally understand that.Thank you for your response! Do you accept patients who travel to you from out of state? I have complicated issues from bad dental work :( and I'm tired of taking pills to get by.
Dr. Mistry, I have an orthotic that is a daytime wear but it was created without the K7. I had my teeth scanned and the orthotic was created. My dentist would use the blue bite sheet to check where I am hitting on it. They do calls this a neuromuscular orthotic. My question is, is this truly a NM orthotic then? I just got this not long ago and when I wake up I am still locking in it… I am supposed to get a night time orthotic that is both an upper and lower wear. Do you know what this could be? Thank you for such great videos!
I really can’t tell you whether or not it’s an NM orthtoic over the internet and without examining you and the orthotic. Sorry
Thank you so much for your information. I was changing my sheets and pulled a neck muscle. Now I click! I’ve been going to PT for jaw massages. I’m waiting to get my night guard from UCLA Dental School. They are on break. Question: how do you feel about using Oral B night guard in the meantime. It gets shaped to your teeth by heating in microwave . I’m worried I will clench down in wrong position and cause more problems.
I will never recommend an over the counter nightguard, no matter what. They will often make TMJ issues worse. Also keep in mind that a dental nightguard is NOT the same as a tmj orthotic.
Thanks for the video doc! quick question - if the MORA is worn at night, won't the upper teeth hurt when bitting down on it?
So I have minimal cartilage and bone spurs and I was told that a MORA cannot be used on adults but ca be used on young people. They instead told me to do Invisalign since my skull and mandible are already developed. Do you give the MORA to adult patients?
Yes I definitely give MORAs to adult patients.
quick question - my ARA like NTI splint causes me to clench more using my median and lateral pterygoid muscles instead of the other muscles
is that normal.
Can any splint eliminate or reduce nighttime clenching?
Are there any providers in Europe that use the mora system? I hope, so now I have to wear a nightguard doesn't do anything for my muscles. No one uses this system in my country (belgium) they always give night guards. I have no choise i got tmj after bad orthodontis. I have so much pain because of it I also had a root canal treatment because my tooth gave up. I'm also scared that my nightguard (only top teeth marks) will damage my muscles. I do MYO therapy and I try to do my daily exercises but it's not enough i can't control what I do in my sleep.
I’m sorry but I don’t know the answer to that question!
Nice informative video i didn't know there were so many different type of mouth guards
in a friendly tone no need to highlight me👩⚕
This isn’t a mouthguard. It’s a TMJ orthotic. There’s a huge difference 😊🙏🏼
I am wearing an ARA device as I am typing this. I've had disk displacement without reduction, which unfortunately, after my symptoms got a lot better by wearing the ARA at night every night and then later every 3rd, suddenly turned into a displacememt without reduction. I can manually reposition my disk and am wearing the ARA for like 3 days for 24hours after that, but I'm not sure if that's enough time. Can it be said at what duration of wearing the ARA the open bite might become a problem? I am aware of this risk but I found studies where people were wearing the ARA for 3 month or even longer for 24h. Would it be unlikely to become a concern if I wear the ARA max. 7 days in a row for 24h?
I don't feel comfortable making a recommendation on how much you should wear the ARA over the internet and without examining you. Sorry and best of luck to you!
Hi my ENT doctor I have tmj so I go to Tmj specialist and I have splint now I will wear in the evening..Because I do clench my teeth every evening and I have ear pain,tinnitus and vertigo, neck pain amd throat pain..I hope it will help my situation its hard to deal because I have work🤔
Best of luck to you!
Thank you doc
You’re welcome!
Try putting lavender- a couple of drops -essential oil on a very small piece of cotton ball and placing in outer ear canal. I Promise you can still hear too. I read about that on one of these sites and it saved my ear and neck pain. I was desperate for pain relief and tried everything. It worked and I only wear it during the day.
If a posterior open bite is formed as explained during the ARA segment. What happens after? How would a posterior open bite treated?
I would like to know as well
Orthodontia :)
I feel like my bite is totally different lying down (back sleeper). Do you create the nighttime prescription for a patient specific to a lying down position.
No, but it guides your jaw to the optimal position
What happens if the ARA changes the bite? What would be the next steps if you have a posterior open bite from the appliance?
Braces or crowns typically.
I had the issue. Changed my bite and get headaches now, which I never had
Would the Mora for example be warn 24/7, meaning it’s just not a temporary correction guard?
I usually recommend 22/7
How to properly diagnose tmjd? Is there any imaging accurate enough to determine if the patient really has tmjd?
Please watch the video below for more information :)
ua-cam.com/video/j2yixq5AgTM/v-deo.htmlsi=slvZnLLM9Odiym8r
Hey. Do you prescribe a cream for TMJ relaxation for your patients? Have you ever used CBD oil too?
I don’t but I just found out about one that I may try out. It’s prescription only though
Hi Doctor, I (22yr) was recently diagnosed with TMD. Doctors suggested a bite guard(to get my teeth grow downwards, making space in joint) or a deprogrammer to address it. Which one do you recommend? MRI shows mild bilateral TM joint dysfunction and minimal disc subluxation on the right, with some edematous changes. Thank you so much!!
I'm sorry but I cannot make specific recommendations for you over the internet and without examining you.
@tanmayagrawal6869 hello brother.... what tests/scans did the doctor perform on you ?? Where did you get treatment from ??
What if I have developed TMD w/o reduction after orthognathic surgery for a class 3 underbite? Do the orthotics result in a relapse of the underbite?
It’s impossible to say with certainty where the bite will be after orthotic treatment.
I’ve been told orthotics cause an open bite- do you have to wear them permenantly, when you stop wearing would it come back? do you know anything about palate expansion? Thanks :)
Also how much do they cost usually?
I’m sorry but there’s no way I can answer this without follow up questions and discussion. If you’d like you can set up an online consultation with me using this link 😊🙏🏼
tmjdentaldoc.janeapp.com/#/staff_member/1/treatment/8
Do orthotics can be wear through out the day and night except while eating or just day time or night time
I ask my patients to wear the daytime one as much as possible throughout the day except when eating. And then nighttime one at night when sleeping.
Do you know if anything like this is available in the uk? I’m struggling to find a TMJD specialist in the uk that does anything similar.
Dr Jaz Gulati does things differently than I do but he’s had some success treating TMd! He’s in the UK.
Thank u fr information
You’re welcome!
Is GNM orthotic of lower jaw good option for making lower jaw forward and open the airway for better breath.
A GNM orthotic is not the same as a sleep apnea oral appliance and should not be used to open the airway.
@theTMJdoc thanks for your reply.
I have an overbite. The doctor has suggested me that GNM orthotic will be used for the lower jaw to come forward. It will correct the overbite and open the airway for better breathing.
I don't have sleep apnea, but I feel comfortable when I do some breathing exercises. When I don't do breathing exercises that day, I feel uncomfortable.
Does a TMJ guard survive extreme clenching? In other words, does it go out of shape under that much force? Thank you!
It doesn’t change shape necessarily but it can fracture over time where the clenching force is the hardest. Given enough force, anything can break unfortunately.
Which one of all of these is/are most suitable for osteoarthritis for someone in their 20s?
It’s not that one is suitable for osteoarthritis and another is less suitable. It’s more about the prescription built into each orthotic.
Hi! Are myobraces a good treatment for TMJ pain, malocclusion, uneven bite?
I don't recommend Myobrace for treating TMD.
I’m having a flare up after about 20 years of good Tmj health. I really like your approach, and wish I could see you. I’m in Melbourne Fl and wonder if there is a directory of sorts that would allow me to find a practitioner that espouses your methods?
Not that I know of! Sorry!
My dentist wants me to get a deprogrammer to find out the next steps on how to treat my TMJ. Does this sound correct?
there’s no way I can answer this over the internet and without examining you. Sorry!
@@theTMJdoc I understand. What are your thoughts on them?
how do you keep the tongue from falling back and blocking the airway? My orthotic has a place wherem y tongue can relax t the roof of my mouth so it doesn't fall back
the orthotics are to treat muscles and joints that cause TMJ pain and dysfunction. These are not to treat sleep apnea or prevent the tongue from falling into the airway.
do you have an orthotic that treats both at the same time?@@theTMJdoc
This is extremely helpful! How long on average is the orthotic treatment?
It depends on the severity of the TmJ issue :)
Hi, my daytime orthotic was thickest on the canines. It looks like the one in your video is as well. Why is that? Could that cause an open bite? Thanks!
No it cannot :)
Thanks. Why is the canine part of the daytime orthotic so high?@@theTMJdoc
@@ronlichterman7534 because it needs to make contact with the opposing canine.
Hello Doctor, would these prthotics hel with tinnitus if you believe its from TMJ ?
Tinnitus does not respond predictably to treatment unfortunately
HI Priya, i have tried everything stretches,posture and orthotics but nothing has changed--given this would your recommend botox and if so what i should be aware of?
I cannot make a recommendation for your specific treatment over the internet and without examining you. If you'd like to discuss your condition, you can email my office to set up a zoom meeting with me.
@@theTMJdoc okay thanks, but ill rephrase so its not a reccomendation and rather a pros and cons question- would you say muslce relaxants help tmj, or more physio or botox and which order.
@@FM-dm8xj I wouldn’t say any of those really help TMJ problems long term
@@theTMJdoc thank you very much for your suggestions-do you do foreign video calls by the way for treating tmj?
Hi doctor when i open my moth it go to write.what can i do. What the problem please help me its for 3 years
I'm sorry but I cannot answer this over the internet and without examining you.
i just got a nightguard made 🥹🥹🥹 it was expensive but now I don't know if I want to wear it because it's been 3 days and my pain is even worse
A nightguard is very different from a tmj orthotic and it’s not appropriate for treating tmj/tmd. Sorry you’re in pain!
Hi, Are MRI scans safe for your patients who have metal dental crowns?
Yes!
@@theTMJdocThanks for reply. Even 20 year old metal crowns?
Hello! I’ve been following your videos for several months now and find your guidance and information to be a life saver. I’ve had joint trouble caused by clenching at night. I’m using a mora but still clenching. My upper front teeth have become hyper sensitive and can’t have any pressure on them at all. My endodontist checked out my front teeth and they are healthy but hypersensitive. My TMJ dentist removed the contact points on my mora device for my upper front. My upper front teeth have settled down…and I’m hoping this will work for me. I’ve also tried an anterior device but run into the same problem….my front teeth are so sensitive to pressure that I can’t have contact on them. Have you come across this problem and what do you use in your practice for patients experience hypersensitivity to pressure.
yes I've seen this and typically removing the pressure on the front teeth by adjusting the MORA solves the issue :)
@@theTMJdoc really appreciate your quick response.
Mam where are you from? I am struggling to find TMd specialist in India😢
I’m in vancouver, Washington - USA.
I have a video recommendation that I'm not sure if you've done before. Can you make a video about TMJ and how that leads to facial asymmetry. I have gotten fitted with an orthotic from my TMJ dentist and I've noticed that the joints have stabilized but my masseters differ in size from years of dysfunction that probably needs more time to recover. I've seen some people online who share their TMJ journey sometimes develop severe facial asymmetry that mainly noticeable in their masseter muscles, thankfully mine isn't that severe. If someone has clicking and popping on one side of their face does it make sense that the muscles of mastication on the affected side will grow or shrink more relative to the properly functioning side. Also, are there exercises that help bring back the muscles to equal size and strength quicker once the joints have stabilized or is it just something that just needs time to balance out the muscles with the new proper bite. Thanks!
I don’t feel comfortable making a video about asymmetry because the causes for it are largely not understood. If you’d like to speak about your specific condition you can email my office to set up a zoom meeting with me. Patientcare@tmjdentaldoc.com
Nice.
Thanks! 😊
I have my TMJ.... ma'am I am 55y. O....from Philippines
Sorry to hear this!
How do one self diagnosed as with sleep apnea
Is this a question? If so, I don’t understand what you’re asking. Can you please clarify?
How can TMJD patients do self analysis whether they have sleep apnea or not on their own ?
Can I eat with those ones? I have headache when I chew a lot 😢
I typically ask my patients not to eat with them in.
You are so sweet you always reply to me! I feel my tmj is from bite, very irregular one! I dont know what else to do
@@Krina681 have you seen a tmj dentist?
@@theTMJdoc not exactly, i will do! I thought i could solve it with chiropractor and physical therapy since i have neck pain too! I really appreciate your reaponse! Your videos are so helpful for pain realease for me! 🥰
@@Krina681 happy to help! 😊
Can i order mora from cosmetic dentist?
This cannot be "ordered" :) It takes a skilled and experienced TMJ dentist to find the correct prescription to build into this appliance. Hope that helps!
Thank you,we have dentist in my city but we don't have Tmj dentist
You’re welcome and best of luck to you!
Anyone in Mexico that you can recommend?
I don’t know anyone there - sorry.
What do you think of the gleb orthoic?
It’s not so much the type of orthotic, it’s the prescription built into it. This must be correct!
What do you mean when you say prescription?
Shounding a shlurrpy 😂
haha..