Blog - Page 3 of 10 - Donald R. Tanenbaum DDS

Most people who suffer from severe headaches don’t think about going to the dentist to get help. But a dentist may be the right professional to turn to if you physician has not been able to determine the root cause of your pain. But first it’s important to determine whether the headaches you are experiencing fit into the primary or secondary category.

Primary headaches are migraines, tension headaches and cluster headaches. Many dentists do see patients with primary headache problems, but it’s the for the secondary type of headache that they can be particularly effective.

So, Can A Dentist Cure Your Headaches?

Secondary headaches can be caused by many things, but in particular trauma to the temporomandibular joint, the joint of the jaw. This is frequently referred to as the TMJ. A traumatized TMJ can be the result of injury, a structural deficiency, a malocclusion (bad bite), newly placed or worn dental work, oral disease, or sleep bruxism (teeth grinding and clenching at night).

Many dentists today are trained in assessing and treating these kinds of pain problems (called orofacial pain) and while a dentist may not be able to cure your headache he or she can often discover the root cause. Dentists training in this special field are becoming increasingly important health team members in the diagnosis and treatment of the type of severe and persistent headaches that are TMJ-related.

If you clench or grind your teeth at night you are not alone. Millions of Americans do it. So, how does sleep bruxism often cause such severe headaches? Here’s how: the constant pressure is being exerted by the act of clenching and grinding your teeth can result in trauma to your TMJ. Next, the nerves become agitated and here comes the pain. But what’s tricky is this is that pain from the TMJ can show up in other places on your body, such as your neck, your face, or even your head. This is called referred pain. Your TM joints are positioned very close to your cranial nerves, and severe headaches are often the result.

Do all the pieces now fit into place? If yes, find a dentist who is trained in treating orofacial pain problems. The best practitioners will not only be able to determine the source of your pain, but will put a treatment plan in place that include massage, relaxation techniques, a nightguard to protect your teeth, or even Botox.

I’ve been treating patients with this very same problem for over 30 years, and in most cases, with a change in lifestyle to reduce bruxism combined with treatment, the outcomes are very positive.

Start by asking your physician for a referral to a dentist with orofacial training or check out AAOP which is an organization dedicated to providing referrals and support for suffering headache patients like you. Good luck!

Clenching your teeth at night? So what’s the big deal?

August 13, 2015 — by Dr. Donald Tanenbaum

For over three decades I’ve evaluated patients with Temporomandibular Dysfunction (sometimes simply called “TMJ”). Specifically, I’ve treated thousands of patients that come to me with all kinds of problems caused by sleep bruxism, defined as grinding or clenching your teeth at night while sleeping. These activities are often linked to neck pain, jaw pain, ear pain, headaches and toothaches that don’t respond to traditional dental treatment.

Millions of Americans clench (or grind) their teeth at night, so it shouldn’t come as too much of a surprise that the consequences can be extremely varied. Here is the story of a good friend of mine.

To protect his teeth while sleeping he has worn a night guard for many years.
Every now and then he would wake up and notice that his lower teeth were pressing against the top night guard very fiercely. He would do some relaxation breathing that I taught him and that usually was all he needed to get back to sleep. He, however, never had jaw stiffness, headaches, or tooth pain due to his clenching.

That all changed last week.

It was a Friday night and he apparently tossed and turned for hours before finally getting into a deep sleep around 2am. The cause of his edginess was likely a combination of a large dinner with wine at an hour later than what’s normal for him and then watching a late movie. On top of that, his ears were straining to hear his daughter arrive home from a party (I’m sure all parents can relate to that!). It added up to a very restless night.

So, finally he fell asleep but two hours later was suddenly awakened by an extreme soreness in his lower left second molar that was braced into his night guard. After taking out the night guard he fell asleep but a couple of hours later woke up to a screaming molar (that’s the only way he could describe it!). To make matters worse, his ear throbbed and jaw ached. Even the gums around this tooth were apparently in crisis.

As it was Saturday he went to play a round of golf but by the second hole was rummaging through his bag for some Aleve. Not only was his mouth freaking out, but also his entire body had begun to tighten up as a result of that aching molar.

The Aleve did work after an hour or so and the pain, stiffness and body tightness began to ease. He was able to finish the full eighteen holes but apparently it was a forgettable round.

So how does something like this happen? Here’s the blow-by-blow:

The force of my friend’s clenching was so great that it traumatized the ligament that binds the molar to the supporting bone.
Then the tooth’s nerve fibers started to react and the area “lit-up”.
Pain spread from the tooth site to his jaw, ear and the gum tissues adjacent to the traumatized molar (all these areas receive the same nerve supply as the tooth).
Finally, the side of his neck and left shoulder started to tighten and lock-up (this is called referred pain).

In actuality, my friend had sprained the tooth ligament by so fiercely clenching his teeth, initiating the pain scenario he described! Treatment was put into place to address this ligament sprain and I’m happy to report that since he came to my office there has been significant improvement in his condition. My friend has also made it his business to go to bed at a decent hour, avoid computer work just prior to going to bed and limit daily caffeine and late night alcohol (known risk factors that can drive teeth clenching and grinding while sleeping).

So…if you are a clencher, even if you use a night guard this could happen to you! If so here’s my advice:

After seeing your dentist to assess the damage, stop and take a good look at your lifestyle. Are you getting enough sleep? Too many glasses of wine at late night dinners? Evening hours doing paperwork or at the computer? Stress at a high level? Dwindling exercise and relaxation time? If so, make some changes and see how you feel. You may find that the aggressive clenching will ease reducing the potential for this scenario to be a common part of your life.

And here’s something you probably don’t know: night guards lose their effectiveness over time and can only do so much to protect your teeth and jaws; so injuries can still occur. Keep an eye on your daily world and do your best.

FOMO Can Cause TMD

July 16, 2015 — by Dr. Donald Tanenbaum

I am blessed with three wonderful daughters, so over the years I’ve experienced their ever-changing “millennial-speak”. And, I have at times heard acronyms that typify what is in their heads and what is driving them. Not long ago FOMO came into my consciousness for the first time (for those who may not know, FOMO is short for Fear of Missing Out. One of their friends was dismayed about not being able to attend a party that she was dying to go to, and FOMO was how she described how she felt. I really didn’t give it much thought and moved on with the conversation.

Several days later I met a new patient in my office that was in the midst of a TMJ crisis. I’ll call her Amanda. Amanda’s symptoms were full blown and characterized by debilitating headaches, jaw pain, inability to open her mouth wide or bring her teeth together properly, and she couldn’t eat anything of substance without additional suffering. This state of misery prompted her mother to come along fearing that her daughter had some terrible illness. What she discovered is that even a great experience, if it has the right elements, can cause TMD.

(Note: TMD means Temporalmandibular Dysfunction…but most people just call it TMJ.)

Fortunately when Amanda’s history was revealed and when I performed the examination, it was clear that her suffering was not a result of some underlying medical disease but due to common factors that pushed her jaw and neck muscles into a state of spasm. Having never experienced this type of problem before, my Amanda couldn’t understand how she had gotten to this point of misery.

I went on to explain that muscles can only get to this degree of spasm when they have been pushed beyond their limits to a point of complete exhaustion. We then began to talk about what had gone one during the previous four months of her life. And here’s the clue: Amanda had recently returned home from her college semester abroad. It was four months of weekend excursions and endless arrays of parties, all characterized by the excitement that comes with exploring a new place. Did she ever consider just staying still for more than a few days? Interestingly, her symptoms began even before she arrived home in the U.S.

At this point her mother blurted out the acronym FOMO! And suddenly connection was made. Amanda’s quest not to miss out had taken its toll. Her longstanding day clenching and nail biting behaviors (which had been previously tolerated) along with sleep deprivation and her state of perpetual exhilaration was all directly related to the spasmodic state of her jaw and neck muscles.

With this awareness and education in place the healing process began immediately. Sleep restoration, sensible eating (and reduced caffeine consumption), cessation of day clenching and nail biting, and a more reasonable social schedule has already helped to restore this young lady’s muscle health and comfort in a few short weeks.  The millennium generation has plenty of challenges ahead. I suspect that I will be seeing many more young patients who let FOMO get the upper hand.

Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat problems associated with facial pain, TMJ and sleep apnea.

Is Botox Effective in Treating Severe Facial Pain?

May 19, 2015 — by Dr. Donald Tanenbaum

In my practice of over 30 years I have had many opportunities to think about why people develop facial pain problems and what I can do to get them out of trouble. The majority of patients who come my way suffer from pain that is muscle-based and in turn is caused by any number of factors. I have found Botox effective in treating severe facial pain, especially when other strategies have failed.

In order to determine who is a good candidate for Botox therapy I must first investigate the cause of the muscle stress in the first place. Usually I discover that my patient is experiencing one (or more) of the following:

Poor sleep quantity and quality.
Repetitive work postures fatiguing the neck and shoulder region.
Behaviors repeated throughout the day which tighten the jaw, neck and shoulder muscles.
Emotional upset and challenging life circumstances.
Shallow and fast chest breathing patterns.
Excessive consumption of stimulants in beverages and food.
Stimulant-based medications.
Poor breathing at night while sleeping.
Autoimmune problems, which lower pain thresholds.
Physical exercise choices that continually stress the neck muscles such as spinning classes.

Botox is proving to be another way to break the cycle of chronic pain. A series of injections are administered into the jaw muscles, upper neck muscles and across the forehead. The goal is to reduce or eliminate the pain, which in turn often imparts a new sense of optimism to my patients who have suffered for years, many believing that there was no solution.

In addition to relieving pain, Botox is helpful for patients who experience nighttime teeth clenching and grinding. After treatment there is a period of time when the muscles simply cannot contract as aggressively. And although the cause of the bruxing isn’t eliminated, many people discover that the achy, tight jaw that they normally wake up with is gone.

Botox is not a miracle drug but it is becoming an increasingly important part of my toolbox to help my patients get better. Do you have questions about Botox therapy? Please use the comment box below.

Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat problems associated with facial pain, TMJ and sleep apnea.

Botox Effective In The Treatment Of Severe Facial Pain

May 19, 2015 — by Dr. Donald Tanenbaum

In my practice of over 30 years I have had many opportunities to think about why people develop facial pain problems and what I can do to get them out of trouble. The majority of patients who come my way suffer from pain that is muscle-based and in turn is caused by any number of factors. I have found Botox to be effective in the treatment of persistent facial pain, especially when other strategies have failed.

In order to determine who is a good candidate for Botox therapy I first investigate the cause of the muscle stress in the first place. Usually I discover that my patient is experiencing one (or more) of the following:

Poor sleep quantity and quality.
Repetitive work postures fatiguing the neck and shoulder region.
Behaviors repeated throughout the day which tighten the jaw,
neck and shoulder muscles.
Emotional upset and challenging life circumstances.
Shallow and fast chest breathing patterns.
Excessive consumption of stimulants in beverages and food.
Stimulant-based medications.
Poor breathing at night while sleeping.
Autoimmune problems, which lower pain thresholds.
Physical exercise choices that continually stress the neck muscles such as spinning classes.

Botox is proving to be another way to break the cycle of chronic pain. A series of injections are administered into the jaw muscles, upper neck muscles and across the forehead. The goal is to reduce or eliminate the pain, which in turn often imparts a new sense of optimism to my patients who have suffered for years, many believing that there was no solution.

In addition to relieving pain, Botox is helpful for patients who experience nighttime teeth clenching and grinding. After treatment there is a period of time when the muscles simply cannot contract as aggressively. And although the cause of the bruxing isn’t eliminated, many people discover that the achy, tight jaw that they normally wake up with is gone.

Botox is not a miracle drug but it is becoming an increasingly important part of my toolbox to help my patients get better. Do you have questions about Botox therapy? Please use the comment box below.

7 At-Home Treatments for TMJ & Painful Jaw Muscles

April 28, 2015 — by Dr. Donald Tanenbaum

Do you suffer from TMJ symptoms, jaw pain, or both? As a TMJ doctor, I have many tools at my disposal for my patients who suffer from tight, painful jaw muscles. To help them feel better I recommend at-home treatments for TMJ that work really well. I want to share some of them with you.

Over the years I’ve recommended (and developed) a number of relaxation techniques and massages for TMJ and jaw muscle pain. If you notice yourself opening and closing your mouth all day long to stretch out your jaw muscles, you probably have a TMJ problem. Try some of these to get some relief.

TMJ Relaxation Techniques and Breathing Exercises

Most people with ongoing jaw pain and tightness tend to breathe with shallow chest movements during the day. As a matter of fact, if you suffer from any kind of muscle pain you probably breathe too quickly. This results in an imbalance of the oxygen and carbon dioxide in your body and sets you up for more even muscle pain and fatigue.

The following techniques will help you slow your breathing (most of us take too many breaths per minute) and help your muscles to relax:

With your lips lightly touching, place your tongue gently on the roof of your mouth behind your front teeth, or place your tongue gently against the back of your lower front teeth. Then, bring air in through your nose and extend your belly outward. Hold this for 3 seconds and then exhale through your mouth while parting your lips slightly. Repeat 6 times. You can do this once every hour.

Try this as well: With your lips lightly touching and your tongue gently placed against your lower front teeth or your upper front teeth (or just floating in no particular position) breathe in through your nose for 4 seconds (fill your belly). Then, exhale through your lips or nose for 4 seconds. Pause for 2 seconds. This entire process should take only 10 seconds. Repeat this 6 times over a 1-minute period. This will help you train yourself to slow down your breathing. Perform this once every hour whenever you need it.

Massage for TMJ and Sore Jaw Muscles

A sore jaw indicates that your muscle health has been compromised and is likely due to the accumulation of an irritating substance which forms in response to muscle overuse, such as lactic acid. The key here is to increase the blood flow to those sore muscles which in turn brings fresh oxygen and nutrients to the affected area. The Temporalis and the Masseter are the two most important muscles for you to focus on.

Using your index and your middle finger massage the sore areas in each of these muscles in a circular motion for 6 seconds on the right side, and 6 second on the left. If you can, do both sides simultaneously. Perform this massage with your mouth hanging slightly open, and your head relaxed. Press firmly, but not so hard that tears come to your eyes. After massaging the muscles, open your mouth to its fullest non-painful position and then close your mouth slowly. Repeat this 6 times.

There are muscles inside your mouth that also can benefit from gentle massage. I find this one is best done in the shower. Open your mouth half way and place the pad of your index finger on the most rear upper tooth on one side. Then slide your index finger off that tooth moving toward the cheek in an upward direction. You should run into a wall of bone. That is where your jaw muscle attaches, and is likely to be very tender. Once you’ve found the tender region, push your index finger inward and hold for at least 30 seconds before releasing. Then switch to the other side and repeat. Massage each side 2 times.

(You can also move your index finger in a circular pattern instead of maintaining constant pressure.)

Exercises for Sore Jaws

This exercise is designed to release tension in the muscles that enable you to open and close your jaw jaw. Place your tongue as far back as possible on the roof of your mouth. Now, try to open your mouth, keeping your tongue in this position (the range of motion will be very limited). While your tongue remains in place, position your thumb under your chin and attempt to open your mouth against the resistance of your thumb. Maintain the resistance for 3 seconds before releasing. Repeat this 6 times. This exercise can be performed up to 6 times per day.

Here’s another technique that many of my patients find helpful. Blow air into your your cheek on one side and hold it for 6 seconds. Then switch to the other side and do the same thing. This can be done 6 times per day.

You can also do some tongue exercises to loosen tight jaw muscles. With your lips sealed, move your tongue in a complete circle 6 times to the right and then 6 times to the left. Then take 6 cleansing belly breaths as described above and repeat the tongue movements 2 more times.

Tight jaw muscles can produce serious pain. If you are suffering, try some of the above massages and exercises for a week or so and see if you feel better.

Please let me know which technqiue eases your pain the most.

Good Luck!

Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat problems associated with facial pain, TMJ, headaches and sleep apnea.

Gender Bias In Chronic Pain Treatment

March 20, 2015 — by Dr. Donald Tanenbaum

A common theme in many of the scientific conferences I’ve recently attended is that chronic pain, when left untreated, can actually cause permanent changes to the brain and nervous system. That knowledge makes it all the more important for physicians to address pain soon after a patient’s struggles begin. In my practice I treat a majority of female patients who are dealing with severe jaw and facial pain. From their stories, I know first-hand that gender bias in chronic pain treatment is real.

There seems to be a common attitude among many health care providers that women who complain about pain are exaggerating their suffering. According to references in the book “A Nation in Pain” by Judy Foreman, studies have shown that doctors are more likely to request tests for male patients who complain of pain. Men’s symptoms are often treated as physical and neurological conditions while similar symptoms in women are considered due to psychological or psychosocial issues. In addition, there is evidence that physicians frequently dismiss women who report chronic pain or write them off as experiencing emotional hysteria, unlike their male counterparts.

This evidence, combined with the well-known biologic factors that predispose women to jaw and facial pain, makes it easy for me to understand why women with longstanding pain problems ultimately seek care in my office. The problems I see are broad in nature and typically caused by disorders of muscle, joint, or nerve tissue. My patients’ stories about misdiagnosis and/or delays in proper pain therapy (as a result of the attitude that the pain is all in her head) are certainly unnerving.

In addition, many of my female headache patients have been told to “tough it out” or take anti-anxiety medications for pain problems. These treatment recommendations again put the emphasis on blaming the patient as opposed to identifying a potential biological cause and directing treatment at specific pain receptors and pathways.

Clearly these kind of gender-biased misconceptions need to be addressed if women are to get the timely pain care they deserve, especially before changes occur in the brain and along nerve pathways. As a result of research in the often-maligned diagnoses of Chronic Fatigue Syndrome and Fibromyalgia, these disorders have been redefined (Chronic Regional Pain and Systemic Exertion Intolerance Disorder) revealing that biases can be changed. As scientific investigations are today beginning to shed light on gender-specific pain problems, hopefully the same kind of change in attitude will prevail.

For the time being women suffering from chronic pain will have to seek help where they can find it. Many chronic pain support groups have sprung up (I often share their posts often on my Facebook page) which can help these patients feel less alone.

My office will continue to assess the physical and cognitive emotional components of all pain complaints that pass through our door, regardless of gender. With a female patient population approaching 82%, I know that not only do these patients have real problems I know that most of them can be helped.

Have you experienced gender bias in your quest for treatment for chronic pain? Please share:

Good News About Teeth Grinding

February 16, 2015 — by Dr. Donald Tanenbaum

“Doctor, why do I grind my teeth so fiercely every night?”

As a professional who works with TMJ and bruxism problems in my practice I hear that question almost daily. The fact is, we don’t yet know all the reasons that so many people grind their teeth at night. If you are a grinder, I have some good news for you! We are getting closer every day to a more science-based understanding of what is at the root of your problem; and that knowledge is helping to choose the best treatment for you.

Is It Your Bite?

Amongst my colleagues there is general agreement that teeth grinding and clenching are not related to the way your teeth fit together (your bite). Therefore, if you were offered treatment that promises to reduce your grinding by giving you a better bite, you would be best served by walking away from this option.

Is It Stress?

Surprisingly, stress appears to be only part of the problem. Studies have suggested that short-term stress has less to do with your nighttime teeth grinding and clenching than does long-term, unresolved stressors and life circumstances. When stress is indeed the culprit, medications can be used for a short period of time to get you through difficult patches relating to home, work, school and medical challenges. Over the long-term, medications (if continued) should be coupled with an oral appliance and routine practicing of pre–sleep jaw exercises and relaxation and breathing techniques. However, long-term medication use is discouraged and often ineffective over time.

The Good News

Researchers are finally gaining a much better understanding of the mechanisms that cause teeth grinding and clenching. In fact, grinding of the teeth is now considered to be a movement disorder (just like restless leg syndrome). Some studies suggest that teeth grinding is much more common when the brain is aroused and sleep is restless. Brain arousals (which lead to unrefreshing and restless sleep) may be due to a multitude of factors including a noisy sleep environment (a snoring bed partner), a crying baby, a chronic pain problem, airway struggles due to conditions such as asthma or sleep apnea, late evening consumption of caffeine or eating, and general anxiety (to name just a few possibilities).

Imagine this scenario, which is not uncommon in my practice: During sleep you struggle to breath because you are either not getting adequate oxygen or because of other factors such as recent weight gain, a large tongue that falls back into your airway, or tonsils that are so large that they compromise airflow. As a result your brain is frequently aroused and that causes you to wake up, take a few breaths of air, and then attempt to fall asleep again.

A severe form of this syndrome is called RERA (Respiratory Effort-Related Arousal). With RERA breathing is so labored (due a small airway) that you never get the quality sleep you need and as a result you are always tired the next day. Interestingly, people with this problem also tend to grind their teeth. If this happens to be why you grind so aggressively, treatment can be designed to address the source of your problem

Treatment For Teeth Grinding

With my patients, I look at all the risk factors that could be driving the brain arousals and are initiating grinding and clenching. Once identified, I work to create a customized treatment plan which can include:

Quieting The Sleep Environment: Can you imagine how peacefully you would sleep if your bed partner stopped snoring?

Changing Dietary Patterns In The Evening: Try to have your biggest meal at lunch and avoid caffeine (including chocolate) after 3pm. If an evening snack is important, frozen bananas can satisfy any sweet tooth!

Managing Chronic Pain: Providing proper treatment for your chronic pain problems, especially if your pain is in your neck and/or back.

Meditation: Meditating in the evening (but not necessarily right before bedtime) is helpful for many people, especially if you are prone to anxiety or if you have a very stressful life.

Jaw Exercises: Performing stretching exercises before you go to sleep can reduce the morning symptoms associated with clenching and grinding.

Losing Weight: When you lose weight you may also find that your airway will allow more efficient airflow while sleeping, and therefore less chance of brain arousal and fragmented sleep.

Tonsils Removal: If labored breathing during sleep is your problem, sometimes removing the tonsils or reducing their size allows easier breathing particularly in children and adolescents.

Sleep Positioning: Sleeping on your side instead of on your back can also increase airflow.

Oral Appliances: Oral appliances are very commonly chosen to address teeth grinding. However, the benefits of using oral appliances is only achieved if the design is the right one for you and addresses the specific reasons for your teeth grinding in the first place.

The Takeaway:

If you are a grinder or a clencher, don’t despair. We have more answers now than ever before and we have more treatments that can address not only the symptoms associated with your problem, but the reasons that they occur in the first place.

Have questions or comments? Go my Facebook page: http://on.fb.me/17w20sg

photo attribution: By Aweisenfels (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons

Is Your Sleep Apnea Appliance Working?

January 15, 2015 — by Dr. Donald Tanenbaum

Snoring and obstructive sleep apnea are not only disruptive to your bed partner; they may also be the cause of many other illnesses. And as we have seen in the news recently, can result in deadly vehicle accidents. If you have opted to wear an oral appliance at night for snoring and/or sleep apnea (as opposed to using a CPAP machine) you may have noticed that it’s not working as well as it did when it was first fitted by your dentist. So, how do you know if your sleep apnea appliance is working?

John: A Case Study

My patient John is a 45-year old who had chosen to wear a sleep appliance to spare his wife from the disrupted sleep she was experiencing as “he snored like a jackhammer.” However, after a period of time his snoring (and consequently his wife’s nighttime annoyance) had reappeared.

John came to my office and we sat down to talk. He confessed that he had gained a whopping 15 pounds over nine months, so it wasn’t surprising that the appliance was no longer effective. I subsequently corrected the fit of his appliance (basically moving it slightly forward), which took care of his nightly jackhammer snoring (and probably saved his marriage!). But, another problem developed.

John began experiencing morning jaw tension and an awkward bite, which lasted for about an hour. Another visit to the office and a bit more adjustment took care of the issue. Now John is sleeping peacefully and not worried about a TMJ problem. So, if you use an oral appliance to manage sleep apnea/snoring, and your weight varies you should be going back to your dentist to reset the appliance

How To Determine If Your Oral Appliance Is Working

For those snoring without sleep apnea, your bed partner feedback will certainly alert you as to when the appliance is not working, but how do you know if you live alone? If you sleep alone and are wearing an appliance to protect the tissues in the back of your throat from the consequences of snoring over time, monitoring is key.

How To Monitor Snoring and Apnea With Technology

There are a number of mobile apps that can monitor your snoring at night. The best ones are SnoreLab and SnoringU.

For those with obstructive sleep apnea (with or without a bed partner) the absolute best way to know if your appliance is working properly is to use a pulse oximeter on two consecutive nights. A pulse oximeter will measure your blood oxygen levels while you are sleeping. If there is less than optimal oxygen your blood, then your appliance needs to be adjusted. The pulse oximeter can be purchased online or provided by your dentist.

Even more information can be obtained through using a HST (home sleep test), which is often covered under insurance plans and obtained through a sleep clinic or your dentist.

Important: technologies such as FitBit and JawBone cannot be used for monitoring oral appliances and Basis Peak and Microsoft Band, though sensing body motion and monitoring heart rate, also come up short.

The message is clear…don’t assume that once fitted, your oral appliance will always maintain its effectiveness. It’s necessary to have it monitored at least once, preferably twice, every year.

FDA Looking At Conditions That Impact Quality Of Life

December 11, 2014 — by Dr. Donald Tanenbaum

There are hopes that TMD will be included.

I’m happy to announce some great news. The FDA (The Food & Drug Administration) is taking a closer look at medical conditions that can have significant impact on your quality of life. Starting in 2016 the FDA will hold public meetings with the goal of determining the impact on daily life of 20 chosen diseases, and to look at the scope of services that are available to treat these conditions.

The TMJ Association is making huge efforts to have TMD (Temporomandibular Disorder) chosen as one of the diseases that will be focused on. That TMJ problems affect your quality of life is not news if you are one of estimated 35 million Americans who suffer from it every day.

Chronic pain problems, like TMD, rarely occur alone. It is estimated that 85% of TMD patients have other chronic pain conditions such as headaches, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, chronic fatigue syndrome, sleep disorders, or vulvodynia. In many cases these conditions are so complicated that patients don’t know where to turn to for care. As a matter of fact, I see many patients every week who have been told that they will never get better and that their problem is in “the head.”

If chosen as one of the conditions to be studied by the FDA, more information will be made readily available to you, the public, as to the nature of TMD and the treatments that are available.

Here are some facts about TMD that more people need to know:

TMD problems are orthopedic in nature.
TMD problems may be the result of (or aggravated by) rheumatologic, autoimmune or neurologic conditions.
Women are the largest group with TMJ symptoms as a result of specific biologic predispositions, some of which are hormone-driven.
Common TMJ problems may be the result of an accident, overusing the jaws, bad posture, teeth grinding (bruxism), or muscle tension caused by by emotions and life’s challenges.
Treatment for TMJ disorders should not focus merely on the teeth; the ultimate goal should be tissue healing and change of habits.
Getting better typically will lead to less pain, less medication, better function and increased optimism in people who before had anticipated a lifetime of suffering.

The same as with other orthopedic problems, after treatment patients may still have some pain, but it is likely that it will be at a much more tolerable level.

For all of you TMD/TMJ sufferers out there, the fact that the FDA has recognized that it’s time for this type of condition to be validated is welcome news. The result will be more access to information and thus, more access to treatment.

Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat problems associated with facial pain, TMJ, and headaches.