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.

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