Dental Nightguard vs. TMJ Orthotic - Priya Mistry, DDS (the TMJ doc)

[@lpg8518]

Thank you so much, I’ve been suffering from tmj for such a long time and I can’t believe none of the dentists I have seen ever mentioned getting a tmj splint.

[@theTMJdoc]

You're welcome. Please watch my video called "Why TMJD is Often Difficult to Diagnose & Treat" for some answers about why dentists may not recommend a splint.

[@turbo8628]

I self diagnosed myself cos my dentist is useless. Mine started when i got wisdom teeth and they dont wanna touch wisdom teeth if thry can avoid it.

[@gabrieldegraze2773]

You Never talk about artroscopy or surgery...why?

[@MunteanuAdrianXD]

@@patriciasalazar1116and you have pains anymore?

[@RogDow123]

Thank you Priya. I got a new TMJ mouth guard yesterday from my dentist but wasn t sure why it was more expensive than the normal mouth guard. This video has explained it to me. I t s strange getting used to sleeping with a lump of plastic in your lower mouth but if it helps to ease the stiffness of my lower jaw, I ll be happy. It s very difficult to chew anything lately. Anyway, thanks again.

[@theTMJdoc]

@@RogDow123 glad to help!

[@avaleonardava6139]

I find a regular Dentists don't know how to help me@ all so I'm left in pain now I know thanks to your video I need to find a orthodontic specialist. I have popping/pain-in jaw/neck,headaches,ears-tinnitus etc

[@theTMJdoc]

I didn't say to find an orthodontist :) I said to find a skilled and experienced TMJ dentist.

[@avaleonardava6139]

@@theTMJdoc ok thanks for reply and advice my mistake in not listening properly ❤

[@theTMJdoc]

@@avaleonardava6139 no worries! Don’t forget to Subscribe!!

[@noamanhussain2307]

Thank you for making videos highlighting the condition which not many dentists are good with. Being a dentist myself, I would like to sincerely request you to make videos detailing the chair side work and lab work too. That would help other dentists like me manage patients too.

[@theTMJdoc]

Hi and thank you for your comment! At some point I will have a series of courses for dentist but I cannot easily make KZbin videos about this.

[@prex327]

Great information. Thank you‼️ I'm a licenced massage therapist so I treat/massage TMJ clients. However, I just recently found out I have it as well. Your video makes perfect sense, I also wear glasses so I totally get what you're saying. Thank you, thank you, thank you‼️

[@theTMJdoc]

You’re very welcome!! :). Sorry to hear you have TMD!

[@maryappleverano4073]

This is so informative, thank you! I will start wearing my dental splint, fingers crossed no more pain for me. 💕

[@theTMJdoc]

You’re welcome and good luck to you!

[@RelishWithReCheil]

Hi there, how has your splint been helping you?

[@maryappleverano4073]

@@RelishWithReCheil my pain was reduced gradually, however I lost the 1st one so I feel I am back to square one.

[@RelishWithReCheil]

@@maryappleverano4073 oh no. I hope you are able to get another one soon!

[@jayapatil6079]

Hi Priya, Thanks for explaining the difference between the Dental Nightguard VS TMJ Orthotic. Great job as usual.

[@theTMJdoc]

Thank YOU for watching :) and for the kind words!

[@jakec5618]

i never even knew an orthotic existed until recently. really wish more doctors were knowledgable on this topic and the problems tmj/tmd can cause.

[@theTMJdoc]

Sorry to hear this :/

[@Alejandra-vj5ux]

Hello Doctor, I started treatment with a TMJ/Orofacial specialist. He mentioned when my right jaw makes a clicking sound it means the joint is popping into place. He said the treatment would consist of a custom-made night guard and stretching/moist heat. He instructed me to wear the nightguard and my top retainer every night. I began to notice I would drool excessively when I wore both appliances and actually felt myself clenching to try and make contact with both appliances. As a result, I wore the appliance inconsistently and eventually stopped wearing it for 6 weeks. When I went for a readjustment he said my teeth were contacting in the front (with the mouthguard and retainer in). I now have my front teeth making premature contact without the appliances and increased TMJ pain. I'm not so sure the night guard will really help address my issues.

[@theTMJdoc]

Sorry to hear that!

[@bonirabit4302]

I wish I could find a doctor like you in town I can't even get a dentist to take care of my bad teeth because I have such bad TMJ and I've had over 30 years of not getting the right consistent treatment and I'm a mess I could have the surgery in '09 but anyways all this makes sense and I am scheduled with an holistic dentist in town that does a whole TMJ thing but yours makes more sense and I've been hearing a lot about my fashion release I also have a very bad neck and back issues but long time with chronic pain it all started early 20s after dinner work and now remember early 50s so I need help!

[@theTMJdoc]

Sorry to hear this and best of luck to you!

[@prestonnorris9822]

Had an appointment today with an oral surgeon and he is sending me to be fitted for a TMJ splint and physiology therapy...I look forward to these hopefully helping 🙏🏼🌞

[@theTMJdoc]

Best of luck to you!!! 😊👍🏼

[@drmanishmistry3923]

TMJ OR OCCLUSAL SPLINT therapy is very helpful to my patients Sometimes they get relief within two to three days from pain which was lasting since months Nicely explained the difference between normal nigh guard and occlusal splint

[@theTMJdoc]

I’m so glad it helps your patients but. Thanks for watching 😊. Please do Subscribe and share with your colleagues if you find it helpful!

[@vincem3748]

I'm hoping that will be me next month, when I finally get to see a TMJ specialist...

[@remybelleperez4444]

@@theTMJdoc would you be in the Sf bay area

[@v4ursmile]

Very easy and simple way explanation for such a complex topic

[@turbo8628]

Seeing that you have replied to everyone (even if it is to explain that you cannot help without seeing them - best thing to do btw) i cannot express how refreshing it is to see. Truly altruistic. Thank you for being you.

[@theTMJdoc]

What a kind comment! Thank you! 🙏🏼💕

[@jerimandel9607]

Very helpful, thank you. Headed in that direction and now I know what i need to seek.

[@theTMJdoc]

You’re welcome! Be sure to subscribe and reach out with questions any time :)

[@Demonstrably]

Why does nobody mention pain & damage below the neck right down to the feet (often caused by orthodontics) ?

[@theTMJdoc]

I don’t think a lot of people make the connection that it can be related.

[@Demonstrably]

@@theTMJdoc It is extremely common in adult orthodontics. Many butchered by childhood orthodontics don't realise early back pain in their 30s is related :(

[@theTMJdoc]

@@Demonstrably I totally agree!

[@Demonstrably]

@@theTMJdoc What do you think about Paletal Expanders to bring the mandible & Maxilla forward and free up the airway Priya?

[@PerfeckPT]

Very cool video. How do you determine what the optimal position for the jaw is? Is it a scan? Or just eyeballed by the dentist?

[@theTMJdoc]

I use the technology and software that's used with neuromuscular dentistry.

[@sanelprtenjaca9776]

Great lesson. I have terrible jaw muscles pain, and neck discomfort, for 8 months now, after series of stressful events and this pandemic stuff. Every single day. Maxillofacial surgeon didn't saw problems in the TMJ with orthopan, altough he said my bite is totally off and that I need a splint. Also he said maybe my wisdom teeth are making problem with my bite (and genetics). I developed terrible tinnitus practically in the same time and I am going to see experts in Zagreb for this. Thanks for the video, very well explained.

[@theTMJdoc]

Thanks for your kind words and best of luck to you!

[@sanelprtenjaca9776]

@@theTMJdoc Thanks. I have just one question. Do you know if this 3D tehnique of making TMJ splint is same in USA and in Europe (Croatia)? In other words, you mentioned neuromuscular dentistry and how with computer simulation dentist can find best position for a jaw. Here in Croatia I don't think anybody mentioned this to me. Now, does every TMJ splint is done this way everywhere or? Thank you so much.

[@theTMJdoc]

@@sanelprtenjaca9776 great question and unfortunately the answer is no - not all splints/orthotics are made the same way.

[@sanelprtenjaca9776]

@@theTMJdoc Okay, thanks for this info. It isn't a great news, but I hope it will be all right in the end. Greetings

[@MunteanuAdrianXD]

@@sanelprtenjaca9776how are you now? I’m from Romania and if you find any relief in Zagreb I would like to go there and find help

[@jacquelinedadis8842]

Thanks for sharing your video. Is there orthotics for sale in Philippines?

[@theTMJdoc]

These orthotics are not "for sale". They are custom created for each patient after a series of records are taken.

[@johnjp5883]

Thank you for this!

[@theTMJdoc]

My pleasure!

[@tristanblack1920]

Oh my gosh thank you so much for this video! I had initially gotten a mouth guard made at the dentist. It didn’t really seem to help so that’s when I saw an actual tmj specialist. As you stated, they also created a mold, however, I also noticed that they had taken measurements of my bite ect. I think they had suggested I wear a 24 hour splint because my issue has to deal with not only grinding but inflammation of the muscles. I now understand the difference and will move forward with the splint.

[@theTMJdoc]

You’re very welcome and best of luck to you! 😊

[@tristanblack1920]

@@theTMJdoc Thank you so much and I wish you the best as well!

[@theTMJdoc]

@@tristanblack1920 thank you 🙏🏼

[@freerunning2Him]

Wish me luck as I have to find a TMJ specialist in CT that takes my insurance. I've had TMJ for over half of my 30 years and am trying to get things better before I get much older. I just started wearing a basic night guard, but will probably be getting an orthopedic one once seen. Thanks for the videos!

[@theTMJdoc]

Good luck!

[@MunteanuAdrianXD]

How are you now?

[@allann7333]

Great video. I've had TMJ for 2 years now. Will it take longer than a month to notice an improvement using the orthotic splint?

[@theTMJdoc]

With my orthotics, people usually feel relief within 1-2 months.

[@redwhitebluedragon22]

@@theTMJdoc its almost two months and I havent felt any relief :(((

[@radiantedentalfacial2086]

Good stuff, Dr. Mistry. Also as an experienced TMJ/TMD practitioner, some of the best info I have seen. BTW, "Orthosis" is actually what an "orthotic" should be called but the public understands orthotic better. Best, IV

[@theTMJdoc]

yes!

[@greatlekhs]

sooo helpful & informative, wish my dentist explained all this to me! i now understand the diff bw the two, thank you, Dr. Mistry!!

[@theTMJdoc]

Glad it was helpful!

[@greatlekhs]

@@theTMJdoc hey dr. mistry, not sure if you already have vids about trigger point injections, dry needling, acupuncture, botox, etc. as various options for myofascial pain, but if you dont, would you consider making a youtube vid on info about that? your vids are tremendously helpful!

[@justinerealized]

Hi Dr. Mistry! Are you able to do a video explaining how you do those precise measurements for a splint? I just received mine yesterday and feel like there wasn’t a ton done to get the bite position precise. Thank you always!

[@theTMJdoc]

Hi there. It’s really difficult to explain that in a video. I took many courses & had many hours of training from my mentor to learn how to do that. Something that’s not as complicated and that may get you in the ballpark is my video called “How to Take an Aqualizer Bite Updated”. I hope that helps!

[@home-lovingpets8216]

Thank you for the explanation. I have a question. Is the "Michigan" a splint or a nightguard? Or it can be both depending on the measurements they take (if they measure the position of the joints, or simply the mold of the teeth) Thanks!

[@theTMJdoc]

The Michigan appliance is a nightguard and not an orthotic. :)

[@arborside242]

Thank you so much for all of your informative videos. You’re the type of dentist I need in Texas.

[@theTMJdoc]

You’re welcome!!!

[@joyd4238]

That's how I feel... Where in Texas has this...no where I've seen yet

[@godesofdnyte]

We need you in Dallas specifically. Come help us please 🥺

[@theTMJdoc]

@@godesofdnyte thank you. I wish I could come out there!

[@Rollwithit699]

@@theTMJdoc Have had migraines, TMJ and worn night guards since 1988 (tried OTC and professional custom made which caused more jaw pain because they are so hard). Have had 99% molars crowned from cracking, and have and replaced several of those crowns. Saw dentist again two weeks ago and told I need three new crowns since last year (when I had one replaced). Was told I'm microfracturing and crushing my teeth every night. I can't afford this and need to fix the root cause. Please advise! 🙏

[@mikamee5459]

I've been wearing a nightguard and still have two cracked teeth. I mentioned that I think my nightguard is not doing the job and my dentist said the nightguard wasnt the cause. He didnt even suggest a tmj orthotic.

[@theTMJdoc]

Most dentists don't know about tmj orthotics because most dental schools don't teach about them. Sorry you're going through this.

[@mar8193]

Γειά σας...έχω παρακολουθήσει πολλές εκπομπές σας κ πιστεύω στη λογική σας στην εκπαίδευση σας κ στο έργο σας...βρίσκομαι στην Ελλάδα...έχω κάνει στην οδοντιατρική σχολή ενα night guard όπως το λέτε...περίπου δύο μήνες τώρα.. στην αρχή προσπάθησα να το φοράω πιο συχνά αλλά μετά άρχισα να μην το δέχομαι στο στόμα μου σα να με ανακάτευε...Κ σίγουρα είναι πλαστικός κ με το καλούπι απ τα πάνω δόντια.. Κ ίσιος από κάτω εννοείται...όχι σαν το Mora το δικό σας...έχω μάλλον το σύνδρομο του νερού του τριδυμου παίρνω φάρμακα αντιεπιληπτικα για τους πονους...πρωί μεσημέρι βράδυ...έχουν βελτιωθεί πολύ...ωστόσο υπάρχει ένα μούδιασμα κ κάψιμο στην.πλευρα δόντια αυτί κεφάλι...πείτε μου τι μπορώ να κανω; υπάρχει αντίστοιχος συνάδελφος σας εδώ στην Ελλαδα; μπορώ να σταματήσω την αγωγη; φτιάχνοντας σωστά μασελακια; σας ευχαριστώ...έχω χαρεί πολύ που είστε τόσο εξειδικευμένο κ αγαπάτε τη δουλεια σας...

[@theTMJdoc]

I’m sorry, I don’t know anyone in Greece!

[@amaliapena2040]

Thank you for this informative video ❤️ Getting fit for a splint soon and I hope it takes my pain/numbness away 🤞🏼

[@theTMJdoc]

I hope so too!!! 😊

[@noelavalos2558]

How you feelin

[@Sbean1022]

Dr Mistry this is so helpful! May I ask who is your mentor? I’m trying to find someone to go to here in Virginia.

[@theTMJdoc]

Dr Arthur Parker is my mentor! :) Dr Jeffrey Brown is wonderful - he is in Falls Church, Virginia.

[@michelekincaid8093]

@@theTMJdoc thank you!!! ❤️‍🩹

[@theTMJdoc]

@@michelekincaid8093 you’re welcome! Be sure to Subscribe to this channel! :)

[@annea549]

Hi thanks. Is that Tscan that you're talking about? Do you have a video explaining diagnostic devices? A dentist i spoke to said they use it to test which orthotic is best for you. Thanks xxx

[@theTMJdoc]

No, it's not a Tscan :) I use the K7 Myotronics Neuromuscular system.

[@angelas.9717]

Very informative and helpful...I was given a custom-made night guard for grinding because 4 back molars were removed for orthodontia back in the 1970s. The tooth removal has caused a weird, uncomfortable bite my entire adult life. Anyway, the night guard, although very expensive at $790, is improperly made (the excess high area of plastic is clearly visible) which has caused shooting pain in my TMJ area, including eyes, cheeks, neck, etc. Going back to dentist this Thursday and will ask for help.

[@theTMJdoc]

sorry to hear that and best of luck to you!

[@tayloralisonswift9544]

Well explained! Thank you for this. I have questions. Can splint re-align jaw? Can it re-align the disc in its original position and stop the popping and clicking? Thank you!

[@theTMJdoc]

It holds the jaw in a more ideal position for the the joints and muscles. Recapturing the disk typically takes more work, in my experience, which is why we also do myofascial release and osteopathic manual jaw manipulation. All of these combined can recapture the disk and eliminate joint noises within 4-6 months.

[@tayloralisonswift9544]

@@theTMJdoc Can chiropractor recapture the disk?

[@toddwiner7072]

Hi Dr. Priya - Sorry if this a dumb question but when it comes to getting the right measurements to make the splint do you use a machine for that? Or how does that work? Thank you so much!

[@theTMJdoc]

Not a dumb question at all! Use the technology used in neuromuscular dentistry

[@toddwiner7072]

@@theTMJdocthank you!

[@bubba781000]

Hello. What is the typical cost for a TMJ orthodic? Does insurance cover? Thanks

[@theTMJdoc]

Insurance doesn't typically cover TMD treatment unless you're having surgery. And even then, it's not always covered. I don't discuss my fees online but you can email my office to set up a zoom meeting with me if you'd like more information.

[@pinkorchid333]

you are a great dentist!

[@theTMJdoc]

Thank you!

[@js4unc11]

Are you talking about recording the patient in CR? And how are you measuring this and building it into your prescription? Love your explanations; you definitely should consider a clinical CE lecture series

[@theTMJdoc]

No, I’m not talking about CR. I use Neuromuscular Dentistry methods and techniques to measure and record the optimal jaw position.

[@Tgshgkgh]

That is a great explanation of difference between splint and nightguard. Dentist gave me a nightguard but I don't clench at night :(

[@Wishbone1415]

Hi Dr Mistry, thank you for the video. Could you please advise the effectiveness of the splint without regular myofascial treatment? Thank you.

[@theTMJdoc]

If made properly, it will bring relief but will likely take longer without the myofascial release and osteopathic manual jaw manipulation.

[@taylorgeddes7075]

How would you compare this device to the anterior deprogrammer? I understand the idea of putting your jaw in a more relaxed position for the muscle relaxation, but how does this device prevent you from continuing to clench and grind your teeth is the new position?

[@theTMJdoc]

Nothing that’s appropriate for being worn long term can prevent clenching/bruxing.

[@conniel7923]

This is so interesting! Can regular dentists make TMJ orthotics or do you need to go to a TMJ specialist? If the latter, how to you recommend finding a good one in the area? TY!

[@theTMJdoc]

It’s viral that you see a skilled and experienced TMJ dentist. The ICCMO website is a good place to start with your search. You can then call the dental office you find in your area and ask how they treat TMJD. Here’s the website: iccmo.org/what-is-tmj-tmd

[@kapilyoutube]

Hello Dr. Mistry, thank you for such informative video, what do you recommend for easing in to using nightguard through the night. It's challenging to fall asleep with its bulkiness.

[@theTMJdoc]

Hi There - it can take up to 3 weeks to get used to a new appliance. Give it time and if it's just too bulky, you can always ask to see if some of the bulk can be reduced.

[@sakenu16]

Very interesting, my dentist made me a nightguard for bruxism but this explains why it may not be helping me at all for TMJD. It appears that is it not easy to find dentist who specialize in TMJD. Are there splits to wear during the day too?

[@theTMJdoc]

Yes, I make a daytime one too

[@marymalm3346]

Sorry one more question can you make a video showing what your night time appliances look like please? Would love to see them thank you Mary

[@theTMJdoc]

I won't be making a video on this because seeing the appliances won't help. they look similar to a nightguard but the difference is the prescription built into them. kind of like glasses - they all look the same way and fit the same way, but it's the prescription built into them that makes all the difference to the person wearing them.

[@rlga5571]

Thanks! I hope to find a good TMJ specialist to get this.

[@theTMJdoc]

Best of luck to you!

[@annfung7404]

Very good information! Thank you!!

[@theTMJdoc]

Thank you! Please do Subscribe!

[@farahbrookins2569]

Great video!

[@theTMJdoc]

Thanks!

[@yelinagato3211]

Thank you so much for the Information! I do have a question though. I’m just now realizing that it probably is TMJ what I have but need to find a doctor the specializes in this. Which type of doctor would you recommend I look for? Also once I find one how would I tell if they really know how to deal with this, what are usually the steps taken by the doctor to see what works for me, what the root of the problem is and what can be done? Thank you again for all the video!

[@theTMJdoc]

These are not easy questions to answer because it really depends on what your symptoms are. finding a doctor that is skilled and experienced in treating your symptoms is important. The ICCMO website is a good place to start. Iccmo.org

[@derekshaji8173]

just a follow up question. As in tmj orthotic splint we need to find where the joint and muscle are relaxed and in that position is what we want to stabilize the mandible and tmj. How do we know which is the relaxed position for the mandible and tmj?? Just arbitrarily 2mm acrylic posteriorly will do? Pls share tips

[@theTMJdoc]

no arbitrarily will not do. I use Neuromuscular Dentistry and its TENS therapy and jaw tracking software to help find this position.

[@minky114]

Detailed info! U gave doc . wonderful. I already commented and asked my problem but couldn't found any where my comment. I have jaw problem . With cracking sound. kindly help what to do. Have headache, disturb sleep 😴 , pain n ear rings . I don't grind my teeth too much .what u advice for that. I don't want any surgery.

[@theTMJdoc]

We treat this with orthotics, myofascial release and osteopathic manual jaw manipulation. Even then it takes 4-6 months with weekly or biweekly appointments for symptoms to resolve.

[@minky114]

Now Im getting ur replies one by one . thank u .may Allah bless u. Wat u teach me I'll follow in Sha Allah! if it takes tym it's ok . But I want to get rid out of pain n fix the problem.

[@angelicaperez1296]

Me again so thankful for your beautiful explanation, but I have more questions, sorry. Is an orthotic more rigid than a night guard? Is has to be used forever or just for a period of time, is it painful to use it? Correcting the bite by brackets, can help with TMJ? Thank you so, so, so much.

[@theTMJdoc]

Orthotics and nightguards can all be made from a variety of materials so it’s difficult to answer your first question. We typically recommend wearing our daytime appliance for 12-16 weeks and the nighttime one indefinitely. For most patients, they are not painful to use. We don’t recommend braces to correct TMJD - that’s considered phase 2 treatment.

[@silentsentinel1]

Doc: Someone's head crashed into my ear some 2 decades ago and I've had all these awful symptoms since (ear pain, fullness, popping, tightness, redness of ear, etc.). I had a couple adjustments since, by both chiropractors and TMJ-savvy dentists. Most recently, I had an orthotic made here in the Bay Area of Cali (they took a virtual impression with lasers), that fits on my bottom teeth only. The instructions say to wear it at all times except for eating, but is that okay or should it be worn continuously for several months so that the back teeth never touch each other even for a second as the condyle readjusts? Like if they briefly touch does the healing process get reset?

[@theTMJdoc]

I’m sorry but I don’t feel comfortable answering that question unless you are my patient.

[@Sunshine-vz2on]

How are you now?

[@laurabridson1795]

I just had an mri and I have the articulate disk displaced without reduction. I can only open ,y mouth about an inch. Was wondering how would I even get a guard in my mouth. My dentist only mentioned a night guard.

[@theTMJdoc]

Please watch this video: kzbin.info/www/bejne/foPRmayiodWdd8U

[@mrik7868]

@theTMJdoc After the last minor adjustment on my tmj appliance, I had terrible pain that night and several nights afterward & any time I clench at night. When my tmj dentist checks to do adjustments, he just has me tap my bottom teeth (with the appliance on) against my top teeth. Should he be "measuring" in some other way to know where to adjust in order to put the jaw in the best position to relax muscles? Thank you for your highly informative videos.

[@theTMJdoc]

I really don't feel comfortable guessing at what he should be doing with adjustments without examining you with and without the orthotic. Sorry! Best of luck to you.

[@jaimecockey7040]

Hi there! Thank you so much for this video. I was wondering if an orthotic is something you’ll have to wear for the rest of your life for maintenance? Or does the orthotic fix the issue totally after wearing it for the specified period of time? My daughter was really hoping for surgery for a permanent fix but our dentist said that’s a last resort….

[@theTMJdoc]

Surgery is definitely the last resort. I wean my patients off the daytime orthotic but many of them choose to or need to wear the nighttime one indefinitely 😊

[@kaylawilliamson8041]

Hello! I love to watch your videos and find that each one I watch shows me I am not getting proper treatment. My locked jaw has improved in opening slightly since September but I am still having pain and can still only eat soft foods.. Do you know of any tmj specialists in the wisconsin area? Preferably near Milwaukee, WI? Thank you so much 😊

[@theTMJdoc]

I’m so sorry but I don’t know anyone there.

[@Sunyt400]

Please, Can TMJ orthotic replace the joint in the right place? I have a subluxation of the left tmj and i wonder if it can be corrected. Thank you for your wonderful informations, you're the best 🤩

[@theTMJdoc]

Yes it can place the condyle in the right position, but that doesn't mean the articular disk will immediately go where it should be if it's displaced.

[@nickietadgell8835]

Thanks for the info, but how much do these specialized guards cost? I got a quote for $1200 which is way more than my specialized prescription glasses.

[@theTMJdoc]

I don’t list my fees online. If you’d like you can set up an online consultation with me and after that, I can provide you with a quote. My fees are higher than what you were quoted, that much I can tell you :)

[@nickietadgell8835]

Thank you! @@theTMJdoc

[@denisewhite-z8m]

Do you need to go to a special dentist for the TMJ orthotic, or should all dentist be able to have one made?

[@theTMJdoc]

A skilled and experienced TMJ dentist for sure!

[@emilypuckett6868]

Would you consider making a similar video on the difference between custom orthotics and a deprogrammer? Both sound as though they help the muscles relax over time, but I would be interested in the difference.

[@theTMJdoc]

The term "deprogrammer" - what it is, what it means - can mean different things to different people, so I don't feel comfortable making a video on that.

[@san5a89]

if you take the normal bite, how would a peace of plastic replicate that? that thickness will keep the back teeth in contact while the frontal teeth are in distance. I'm asking because I'm experiencing that. is it a good thing for the muscles? or all the teeth should be in contact?

[@theTMJdoc]

A night guard replicates the normal bite in the right and left dimension, and in the forward and backward dimension, but not in the vertical dimension.

[@charlesh3362]

Informative video, how do you determine this relaxed TMJ state? Is this relaxed position same as when TMJ is in centric relation?

[@theTMJdoc]

No typically centric relation and the relaxed state do not coincide in my experience. We determine the relaxed muscular position with TENS and neuromuscular dentistry concepts and the correct condylar position with CBCT.

[@lilliearvizu9447]

Thank you for the information. I got impressions for my teeth since I have a popping sound when I’m eating. I sometimes have pain on my lower teeth when eating as well and at times I wake up with a headache. I used to have an orthotic for TMJ back in 2000 and my headaches went away and didn’t use it for years and now it doesn’t fit. My dentist said I have TMJ and this Saturday I will get fitted but I’m not sure now since I saw your video if I’m getting a night guard or an orthotic. I do clench my teeth when I sleep. I don’t want my jaw and face to get out of alignment! 😟

[@theTMJdoc]

Sorry to hear this. It doesn't hurt to ask your dentist to clarify exactly what you're getting :)

[@HalfHarry]

cant even get this in UK I have been seen by the dental hospital who just recomended a hard night guard and pyhsio along with tmj botox injections all of which i have had now and im currently getting acupunture done also but im stuck with a standard dentist made guard.

[@theTMJdoc]

Dr Jaz Gulati is in the UK and has experience treating tmjd. Our methods differ but he has had success! :)

[@HalfHarry]

@@theTMJdoc ah a bit far for me lol thank you though currently being seen in maxillofacial dep at hospital.

[@theTMJdoc]

Best of luck to you!

[@agmilesmiles]

Can we agree that until masticatory muscles are “relaxed”, the TMJ’s can’t be properly seated? Therefore the splint (orthotic) will need some adjustment amd refinement over time

[@theTMJdoc]

Yes the orthotic definitely needs adjustments!!

[@kayashley6394]

@@theTMJdoc do you know how often you need to adjust orthotic?

[@theTMJdoc]

@@kayashley6394 it varies a lot from patient to patient.

[@bubblebank]

Hi Priya, thanks for the video. Question for you. My dentist has prescribed a split that "for now should not be worn during the night, and taken out chewing, etc.." It is worn on the bottom teeth. What confuses me is that the dentist built the split as a night guard.. as you have mentioned here; with just the bite imprint but no TENS process. I understand that my muscled and ligaments will relax over time eliminating pain, discomfort etc... do you think it's her intention to modify the splint over time to simulate what the TENS process may do at the first screening?

[@theTMJdoc]

I'm sorry but I have no way to guess what her intention may be. It's best to ask her directly :)

[@kalingkong4025]

Hi, Dr I would like to ask is dual arc anterior scribe appliance system considers as one of the TMJ splint to relax muscle & jaw ?

[@theTMJdoc]

I’m sorry but I don’t know what that is.

[@marymalm3346]

Hi there Doctor, I have a question to check correct bite on your patients do you put tens unit in super high until your teeth hits really hard they almost makes me cry? Plus do u make patients have tens unit on for a hour and half before you check for correct bite? It’s so painful. Thank you, For your time I watch all your videos trying to decide if I’m seeing the right dentist… Kindly, Mary

[@theTMJdoc]

hi there! no I don't turn up the TENS that high.

[@ceciliaelias6370]

Hi Pryra! Thanks for your superinformative video, as always! Is a «mandibular repositioning device» (sorry, I don't know how to translate it from Spanish exactly) an orthotic like the ones you mention in your video that are custom-made?

[@theTMJdoc]

Hi Cecilia and thank you! It’s difficult to answer that question because we make our orthotics in a very specific way that respects the jaw joints but also puts the muscles in their relaxed position. Many mandibular repositioning appliances used for sleep apnea will hold the jaw forward to open the airway, but won’t respect the muscles and joints. I hope that answers your question?

[@Sunshine-vz2on]

What do you find the cure to eustschian tube trouble to be ? Thank you

[@theTMJdoc]

Wearing orthotics that put the muscles in their relaxed state helps the stuffy ear sensation to decrease or go away in about 80% of my patients.

[@swapnap5320]

Is custom night guard at dental office and tmj prescribed guard same?

[@theTMJdoc]

no they're not.

[@tonygombas491]

How much would a dentist charge can you give a rough estimate.

[@theTMJdoc]

It depends on the severity of the condition and the dentists level of experience.

[@kerry4250]

Hi there, I watched another very helpful video of yours that talks about the pros and cons of botox. Does the tmj orthotic have any effect on slimming the jaw like botox does, since the tmj orthotic reduces the pressure of nighttime grinding? Thanks!

[@theTMJdoc]

Hi there! I haven't seen the orthotic have a significant impact on slimming the jaw.

[@l.k.r7507]

Is this technology available in india..what kind of doctor should i visit to get tmj splint..orthodontist or maxofacial

[@theTMJdoc]

A skilled and experienced TMJ dentist. Yes some dentists in India know of this.

[@Julmoc4]

Interesting video! My TMJ orthotic is bottom teeth and a hard plastic and really uncomfortable so I find myself reaching for the regular dental night guard instead. Are they always bottom teeth and hard as a rock?

[@theTMJdoc]

yes they are always bottom and hard. Soft appliances encourage more clenching/bruxing acitivity.

[@FM-dm8xj]

Would you reccomend a splint or botox for treatment?

[@theTMJdoc]

I'd recommend a well made TMJ orthotic and treatment with a skilled and experienced TMJ dentist. :)

[@timquain5341]

Thanks, Priya. This is great. Physio in NZ here. Just wondering if a TMJ orthotic can also be made to decrease snoring? I understand that those with TMJ issues and who snore tend not tolerate mandibular advancement splints. Just wondering if you have come across a solution when both are an issue?

[@theTMJdoc]

Hi there! If the snoring is caused by collapse of the soft tissues in the throat, a TMJ orthotic can help. If the snoring is coming due to nasal obstruction, it cannot.

[@samirjha1919]

Hi Priya! All your videos are very informative and it has helped me a lot to understand my problem. I'm from India and have been a TMJ patient after braces treatment. I consulted more than 20 orthodontists and so-called TMJ experts in India but nothing helped. I also had 4 sessions of digital bite adjustment using Tek Scan ,and JV scan done in New Delhi but I'm still struggling with pain. Could you please recommend me someone who is really skilled in TMJ in India as I cannot travel to Portland. Thanks!!

[@theTMJdoc]

I’m so sorry but I don’t know anyone there

[@samirjha1919]

@@theTMJdoc Thanks for the quick reply. Have a nice day !

[@rashisoni5026]

@@samirjha1919 hey are u on insta?

[@kirankumaribhushan]

In Delhi where you getting treatment?

[@kirankumaribhushan]

​@@samirjha1919plz reply

[@ashleym585]

What type of doctor is best to see for tmj and splints? Orthodontist, maxillofacial doc?

[@theTMJdoc]

A skilled and experienced TMJ dentist.

[@ashleym585]

@@theTMJdoc thank you

[@deerfluffy]

Also, is an MRI imperative prior to starting a patient on splint therapy?

[@theTMJdoc]

No it’s not :)

[@deerfluffy]

@@theTMJdoc Can TENS therapy cause nerve damage?

[@theTMJdoc]

@@deerfluffy no it cannot

[@jacquizhu]

Could you kindly tell me the exact name or method of fabrication for your tmj orthotic? I would love to come to see you but I live in Sydney. I would like to find someone who does the same as you locally. Would you know someone similar to you in Sydney Australia?

[@theTMJdoc]

That is not something that's easy or quick to describe. If you'd like to set up a zoom meeting to discuss this at length, you can email Alex at [e-mail]

[@RelishWithReCheil]

I’ve been dealing with all the Symptoms for so long now. I finally have an appt may 24 with a tmj specialist and thanks to your video I’m a little bit more knowledgeable of what could help me. The tightness in my jaw and the severe headaches have sent me to the Er and I visit my neurologist often. I’m really hoping the tmj specialist will help me because I want to give up so bad. ( I clench my teeth a lot and realized I do it while I’m sleep)

[@theTMJdoc]

Your symptoms sound like they could be TMD. I sincerely hope you get relief soon!

[@RelishWithReCheil]

@@theTMJdoc Thank you!

[@theTMJdoc]

@@RelishWithReCheil you’re welcome! 😊

[@Jackie1111]

@@RelishWithReCheil hi how are how doing now? WhaT has helped you

[@RelishWithReCheil]

@@Jackie1111 hello, I’m doing so much better. I get Botox from my neurologist every 12 weeks for my migraines and my TMD is so much better. I receive trigger point injections in my jaw, neck and shoulders as well. The DDS is who I see for that and he is awesome with providing helpful ways to avoid it getting so bad as it was. I haven’t been to the ER in forever and now only use my rescue migraine medicine about once a month if that. I was literally on the edge of losing my mind, but thank God I’ve found treatment that helps me. Another important tip is stress less, being outside in the sun with my child, going for walks and eating healthier has also benefited me tremendously.

[@aj1534]

Such an informative video, thank you! I wish I could come to your office for treatment. I live in the DC/VA area, by chance would you know or be able to recommend any TMJ specialists in this area?

[@theTMJdoc]

Hi Aleisha! I don't know anyone in DC specifically, but in Virginia I do have providers that come highly recommended - one is in Rockingham and one is in Burke. Are either of these a possibility for you and if so, which do you prefer?

[@aj1534]

@@theTMJdoc Hi Dr. Mistry, Burke is definitely near enough to drive to. Who is the provider there? Otherwise I am also not far from Maryland as well, if you know of anyone there. Thank you for your help!

[@theTMJdoc]

@@aj1534 I have someone in LaVale, Maryland. Would you prefer that or Burke?

[@aj1534]

@@theTMJdoc Burke is fine thank you!

[@theTMJdoc]

@@aj1534 Dr Pamela Marzban comes highly recommended!

[@lumiInLA]

So how can they measure the optimal bite? I wonder what steps are involved in getting an orthotic for TMJ disorder?

[@theTMJdoc]

we have jaw tracking technology to measure the optimal position for the jaw.

[@allcedars]

Just got splints, but my new position for my lower jaw doesn't feel "natural" to me. Does it just take time to adjust to? I've had the splint for four days now.

[@theTMJdoc]

Yes it definitely takes time :)

[@MunteanuAdrianXD]

How you feel now?

[@pipisdiyartandcrafts5447]

I wonder if I have an orthotic or a dental mouthguard. I have to wear my mouthpieces one during the day, and one during the night. I never felt pain wearing them except when I first got them, but now I have ear pain that I’m associating with nerve pain. It starts at my ears, runs to my temples, down to my neck, and from my ear down to my chin. It’s more predominant on my right side. Most of my pain is. I do have fibromyalgia, and we aren’t sure if maybe some of my pain is contributing to my issues.

[@theTMJdoc]

You may want to check with the dentist that made them for you to see if they are nightguards or orthotics. Sorry to hear you are having pain.

[@pipisdiyartandcrafts5447]

@@theTMJdoc my tmj specialist made them. I see him Thursday. So I’m definitely going to ask! Your videos are so informative! Thank you for making them! I’m learning so much about my tmj from you, it’s helping out so much!

[@Lalthanzualimizo]

Hi Priya, great video very helpful. And also my jaw have been clicking/popping for about 2 years now and it's very irritating whenever I talk or open my mouth, so my question is can every dentist treat tmj or should I get it check up by an orthodontist ?

[@theTMJdoc]

Most dentists and orthodontists are not trained to treat TMJD unfortunately. We treat clicking and popping with orthotics, myofascial release and osteopathic manual jaw manipulation. It takes 4-6 months of this treatment for clicking and popping to go away and for the disc to stabilize. I haven’t been able to find any dentists that do jaw manipulation. Sorry I can’t be of more help!

[@Lalthanzualimizo]

@@theTMJdoc ok thank you so much 😇

[@theTMJdoc]

@@Lalthanzualimizo you’re welcome!

[@acardinalconsideration824]

Hello, I just got measured for my splint today for TMD and am worried that they weren’t thorough enough in measuring where my joints, ligaments, and muscles want to be positioned ideally. Is that typically something that is more so focused on once they already have the splint and are getting ready to make adjustments to it? Or should most of that have been done today during my appointment? Do you have a video on what is typically involved in discovering a persons ideal jaw position? Thank you!

[@theTMJdoc]

I'm sorry but there's no way I can easily answer these questions via comments. I don't have a video on how I measure optimal jaw position. If you'd like you can email my office to set up a zoom meeting with me so we can discuss this all in more detail.

[@Relesy]

Do you do different kinds of splints depending on the patient? Like stabilization, repositioning, anterior bite, etc? Or just one type?

[@theTMJdoc]

Yes different types per patient

[@samamithasovita2664]

do you wear tmj orthotic only at night or the whole day?

[@theTMJdoc]

The night and day, except when eating or drinking anything but water.

[@Rollwithit699]

I clench my teeth and have migraines, have worn night guards since 1988. I've tried OTC softer ones (prefer) and custom made hard ones which cause more jaw pain and migraines/neck pain. Through the years I have cracked 99% of molars, which have been crowned, and have cracked many crowns that required replacement. Extremely expensive problem! Also my jaws have spasmed and locked after wisdom teeth removal at 19, tonsil removal at 32, or any regular or prolonged dentist appointment. Three weeks ago saw dentist for yearly exam and was told I'm microfracturing my teeth and crowns nightly, and need three new crown replacements ($1700.00 each!). I asked if there was any way to stop the source of the problem-the clenching! Dentist said he didn't know. I talked to my insurance to see if anything is available and was told to try oral surgeon. Saw him and he suggested Botox in masseter muscles. What do you think? Thank you.

[@theTMJdoc]

Hi! I don't really feel comfortable making suggestions without examining you in person. Sorry.

[@Rollwithit699]

@@theTMJdoc Right, but could you tell me what type of doctor should I see?

[@thisisme2681]

I tried a night guard, and now I understand why it didn't work. It actually made things worse.

[@theTMJdoc]

Yes! It can make things worse. Or it can randomly help if it gets in the ballpark of where the orthotic would put your jaw.

[@gj9736]

I have to wear a night guard because of my bruxism, I cracked a molar because of it and have worn down the surface of my teeth. I also was diagnosed with TMJ decades ago and no dentist I have ever seen recommended a TMJ orthodontic device, I don’t even know anyone in our area that would be able to help me since I do get jaw pain and ear pain, particularly on the right side where I was told that my jaw joint was very bad.

[@theTMJdoc]

Are you able to come see me?

[@gj9736]

@@theTMJdoc No I am sorry I can not, I live to far away in Texas but if I could I would. I have a new dentist now whom I like very much, she made me a new mouthguard by scanning my mouth and all my teeth, it was a long process but the end result was worth it! This is the best fitting mouthguard I have had so far, of course the insurance wouldn’t pay for it because they will only pay for a new one every 5 years, even though the other mouthguard was ill fitting (a bottom one) and caused me to have mouth sores which made it impossible for me to wear. Dental insurance is not good, no matter what sort you have, it is pitiful to say the least. I paid for my new guard myself, it wasn’t cheap but worth every penny to me because my new upper mouth guard causes no sores in my mouth and fits perfectly, it is very easy to put on and doesn’t bother me at all, I can actually speak with it without sounding like I have marbles in my mouth and I have not had any ear pain or headaches, yay! 👏👏👏👍😁

[@theTMJdoc]

@@gj9736 ok sorry.. I don’t know anyone there .

[@gj9736]

@@theTMJdoc that’s ok, thank you though for asking me if I could come and see you.

[@alisonsimon5528]

Do you make a separate daytime and nighttime orthotic ? Or is there only one used for day and night ?

[@theTMJdoc]

I make two separate ones :)

[@alisonsimon5528]

Ok I am finally going to get an orthotic, but I think it is the same one for day and night. Hopefully that will help. I’ve only had splints and night guards in the past and they did not help with the tmj.

[@danadaurey24]

Thank you very much Priya! I live in LA and i have had an orthotic for 6 years. I know I need to get new one, for this one is wearing down. The specialist I saw out here in LA, well... He didn't have good bedside manners, I felt really uncomfortable around him. Also I felt like the price was astronomical. it was 6 thousand dollars. Does that seem right to you? Also when I eat with it, it is SO MUCH better. My bite is off when I do not have it in. Do you know if there is a permanent orthotic that doesn't stand out, and doesn't impair my speech? I remember him saying something like he can make my teeth bigger in the back so my bite is always the way it it is in the orthotic? but that was like 20 thousand, and I didn't feel he was genuine. My gut says not to go back to him. I really appreciate your time if you are reading this, and respond. Your outer beauty reflects your inner beauty. I rarely comment on videos, but I appreciate your energy, and felt comfortable doing so. All my love, Dana

[@theTMJdoc]

Thank you for your kind words! Your questions are very involved and I can't answer them thoroughly through typing/text. Please email [e-mail] if you'd like to set up a Zoom Meeting. Thank you!

[@danadaurey24]

@@theTMJdoc I would LOVE THAT! Thank you!

[@Hyapiee]

Will tmj splint correct the bite problem caused by tmj ? Please reply doctor or does it need braces ?

[@theTMJdoc]

No it won’t. Sometimes braces are needed as phase 2. Please watch this video for more information: Phase 1 vs. Phase 2 TMJD Treatment - Priya Mistry, DDS (the TMJ doc) #tmjd #headaches #tmj kzbin.info/www/bejne/kHe5indpqtFpn68

[@alisonsimon5528]

What are your thoughts on muscle relaxers?

[@theTMJdoc]

They can be helpful as a short term pain relief solution.

[@alisonsimon5528]

Ok thank you . Not a permanent fix

[@hnia0]

shouldn't we adjust the teeth before using the tmj splint.?

[@theTMJdoc]

no definitely not!

[@hnia0]

what I meant is : removing any wisdom tooth, and then align the teeth with Invisalign @@theTMJdoc thank you.

[@ashlynarcher923]

After wearing the tmj orthotic and the jaw is in the right place, will you more than likely have to get braces or add on to the teeth to get everything to fit?

[@theTMJdoc]

Please watch my video “phase 1 vs phase 2 tmjd treatment “ and lmk if you have any questions 😊