Frequently Asked Questions

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Here are some commonly asked questions people have for our doctors:

I just have headaches, why was I referred to the TMJ & Sleep Therapy Centre of San Diego?
Chronic headaches are often a symptom of undiagnosed conditions of sleep-related breathing disorders or an injury to the temporomandibular joint and surrounding structures. The doctors of TMJ & Sleep Therapy Centre of San Diego are able to find the primary cause and provide effective treatment for thousands of headache patients.
I’m confused…why is your name TMJ & Sleep Therapy Centre of San Diego?
First, TMJ is the term patients are most familiar with, and it is the most common component of Orofacial Pain. Second, both TMJ and Sleep Apnea can be successfully treated non-surgically with oral appliance therapy, and these two conditions are often comorbid (interrelated). Our doctors are skilled in identifying and addressing the primary problem for the best treatment direction and successful long term results.
How do I know if I have TMD (Temporomandibular Joint Disorder Disease)?

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

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

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

I’ve already tried splints, what’s different about your treatment?

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

Why do I have to wear appliances day and night? And why 2 different appliances?
To treat and successfully heal the TM joints, it is necessary to provide stability, support and protection both day and night. Our body functions differently during the day when we are upright and conscious than it does during the night when we are lying down and not conscious. Daytime appliances are designed for treatment during the waking hours and normal activities like speaking, chewing, swallowing.  Nighttime appliances are used to protect and support the joint during sleep when patients are not conscious and cannot control any activities (oral motor movement) that can potentially harm the joint, slow the healing process and prevent successful results.
Why do I have to wear the appliance when I eat?
Although eating is a normal function, when there is a TM joint disorder, chewing and swallowing without support and protection aggravates the condition preventing and prolonging the healing process.  The daytime appliance supports and protects the joint.  The TMJ joints are not unlike any other joint in the body; when rehabilitating the knee or ankle, would you expect to remove the brace each time you walk?
I’m sure I only snore, why can’t I just get an appliance for snoring?
If it is truly ‘just snoring’, you can! But neither you nor the doctor can be certain the snoring is not a symptom of sleep apnea without proper diagnosis. Treating a patient for snoring when it is really sleep apnea can have life threatening results.
I’ve used a night guard; it really wasn’t that helpful so what’s different about a sleep appliance?
A night guard is typically made to protect teeth that are being worn down due to unconscious behavior during sleep. Often that behavior is due to a breathing problem the patient is not aware of – it makes them unconsciously move the jaw around all night to get a better airway. A sleep appliance is specifically designed to maintain an open airway helping you get a better night sleep and feel more rested in the morning.
I thought the only treatment option for sleep apnea was CPAP, can I use an oral appliance instead?
Yes, oral appliance therapy is one of the recommended treatment options for patients with a diagnosis of mild to moderate sleep apnea. The oral appliance is worn in the mouth to keep the airway / throat open during sleep by controlling the position of the tongue and lower jaw. For severe cases, oral appliances can also be used with CPAP to make it more tolerable to wear.
I thought snoring was related to age and size, why do I hear loud, snoring like noises from my little child?
Snoring is an indicator of a possible sleep apnea condition. Sleep apnea has no boundaries for age or size. In fact, there is a 70% overlap between snoring and apnea in children. These are staggering numbers and the reason the American Association of Pediatrics ‘Practice Parameter’ states that all children should be screened for snoring. An affirmative response for snoring should be followed by a more detailed evaluation.
I have been told the only ‘real treatment’ option for my problem is surgery, is that true?
The standard of care is always to attempt non-surgical rehabilitation before invasive surgical procedures. The percentage of patients who need surgery is extremely low.
My child has started to have night terrors and is very moody, why was I referred to the TMJ & Sleep Therapy Centre of San Diego?
Night terrors and mood swings in children can indicate a sleep-related breathing disorder due to improper or insufficient skeletal development resulting in insufficient airway. This can create a form of suffocation causing night terrors and moodiness. Insufficient airway and lack of oxygen has also been associated with ADHD (attention deficit hyperactivity disorder). Children with OSA are frequently misdiagnosed as having an ADHD and placed on unnecessary medication.
Are TMJ specialists medical physicians or dentists?
It is a dental physician (DDS or DMD) who evaluates and treats these conditions. Our doctors are certified in both orofacial pain and dental sleep medicine. It is important that the dentist selected has completed specific education and training for these complex conditions.
Do you take insurance?
We are a private pay office. However, we will do all we can to assist you in getting reimbursement from your health insurance carrier.
Why can’t you bill my dental insurance?
If your dental plan has benefits for evaluating or treating TMJ conditions, we will bill for your reimbursement. However most dental plans only cover dental treatments and TMJ and Sleep conditions are medical in nature.

Learn more about what our patients have to say

about the TMJ & Sleep Therapy Centre of San Diego

jody riley
jody riley
Excellent care!! !!!I feel so much better !! Thank you!!!
Mary Prendergast
Mary Prendergast
I have been seeing the specialists at La Mesa's TMJ Centre since the mid-1990s when my dentist referred me to Dr. Smith. I am utterly please with the care. My headaches, jaw pain have majorly improved. I feel comfortable and confident in their care and am faithful wearing my appliances. Dr. Smith has retired and the new doctor has the same caring attitude.
Brittany Gasner
Brittany Gasner
Such a beautiful office, comforting, always welcomed with smiling faces. LOVE coming in weekly for my tmj therapy with Kylee, she is so knowledgeable and listens to my needs as a patient. Great team here! Thanks Dr.Brad and crew!
Renee Wilkinson
Renee Wilkinson
Wonderful staff. Clean and stylish lobby with very knowledgeable team. Genuinely cares for their patients and anyone that is there to consult with a professional on their issues. Victoria was exceptional and the doctor made me feel comfortable as I have high anxiety going to dentists/doctors.
Andrew Cross, II
Andrew Cross, II
TMJ is always friendly and very helpful. They are more concerned about “YOU” as a patient and your health, than getting you in and out quickly!
Barbara Blaney
Barbara Blaney
Doctors are smart, respectful and actually listen to patient needs. Supported by an amazing team of women, from the front desk to behind the scenes, who deal with patients in a kind,considerate way that is not often found at most dr's offices today.
Anthony Delgado
Anthony Delgado
I recently went thru treatment for some jaw pain and popping, and had great results! I didn't have a referral at first but I was looking around online to see if I could find a professional to check out the problems I was having. You start off with a consultation and go thru several exams and testing which I felt were comprehensive and convinced me to pursue the 3 month treatment. The downside is that insurance may not cover the visits and treatment regiment, but it was definitely worth the money. I would recommend this place to anyone looking for TMJ treatment. The staff and doctor are also very friendly and knowledgeable
m s
m s
Dr Sainsbury, Victoria, THANK YOU! As a fellow colleague who found herself in urgent need of help with her child, I cannot express enough gratitude or say enough about this office's mission and compassion! Although Dr Sainsbury doesn't usually see patients on Fridays, after Victoria relayed my story to him, he offered to come to the office to see my child and help in any way he could. And that he did! Dr Sainsbury was personable, clearly very knowledgeable and clear on his diagnosis and recommendations. He helped put my teen at ease immediately. Although in this case the diagnosis did not fall squarely into the TMJ realm, the attitude was not one of "sorry can't help you, bye" as is a little too often in healthcare. Dr Sainsbury clearly had a deep understanding of not only his field but the associated fields. He was sympathetic and offered pain relief services as well as take home products, self care advice and suggestions as to next steps. Everything a patient in pain (or parent of one!) would hope to find in their treating clinician! Willing and able to help! Thank you!