Doctor for TMJ disorder?

I have long had a TMJ disorder, and I really need to see someone about it. A decade ago I saw an oral and maxillofacial surgeon who made a great retainer/spacer/splint that realigned it perfectly. Unfortunately, it no longer fits. I understand there are several types of physicians one can see for this. I don't have dental coverage, so I'm trying to avoid seeing a dentist, and as far as I can tell, there are no oral and maxillofacial surgeons on my insurance plan (Blue Shield). If anyone out there with experience with this can give me some guidance, I'd appreciate it. Thanks in advance. jaw clicker

Seeking MD or dentist to treat TMJ

Does anyone have a recent recommendation for a dentist or M.D. who knows what to do about TMJ? After some bad dental work in San Francisco, my friend and I now both have a problem with our bite not occluding correctly, and in my case it has actually caused problems in my jaw joints. Did your treatment involve orthodontics, replacing dental work, etc? Thanks. Dental Despair

Seeking treatment for TMJ and headaches

I'd like some updated information on Dr. Dwight Jennings at the Northern Califiornia Cranio-Facial Diagnostic Center. I've had daily headaches for 2 years that haven't responded to any of the numerous treatments I've tried. I have TMJ (my jaw pops on one side when I open it and I clench and grind my teeth at night), which I assume must be related. I was seen a year ago at the UCSF TMJ clinic and was told it was unrelated to my headaches. However, other postings have complained about UCSF so I want another opinion. Has anyone been seen at the Northern Califiornia Cranio-Facial Diagnostic Center? Was it worth the expense? Monique

Please look at Dr. Jennings' website, www.dentalphysician.com, very carefully. He has a self-published article on his website, which isn't easy to read--it's almost entirely one paragraph--but it's very revealing. In the article, he states openly that his aim is to give his patients an open bite. Having an open bite means that your top and bottom back teeth don't meet--which means that you can no longer chew food. He also claims on his website that his treatment is appropriate for illnesses ranging from asthma to vaginal infections.

For information on TMJ issues and treatment options, see www.tmj.org. This site contains a link to a National Institute of Health conference report on TMJ treatment options, which I found extraordinarily helpful.

For your headaches, I'd encourage you to talk with a primary care physician about Imitrex (I hope I've spelled that right), if you haven't already. To relieve muscle tension at night, you might want to also discuss Flexerill with your doctor; it's a very inexpensive muscle relaxant, available as a generic, whose only side effect is drowsiness. Other options to consider might be antidepressants, such as Wellbutrin and Cymbalta. Cymbalta in particular is supposed to be helpful with stress-related pain; I haven't tried it, so I can't give a recommendation for it. Perhaps someone else on this list can?.

Alternatively, or in addition, you might want to get a stabilization splint for night- time use (stabilization splints don't change your bite). I had one made by a prosthodontist where I now live, Dr. Larry Over in Eugene, Oregon. You could call him (541-687-1499) and ask him for a referral to someone in your area. I found that a well-made stabilization splint, with adjustments as needed, was very useful. It prevents night-time clenching.

I hope this is helpful. You're welcome to contact me for more info. briank

MD FOR TMJ

I'm looking for an MD to treat chronic TMJ. Recommendations greatly appreciated. Thanks! Christine

Here is what I found helpful: three weeks of Valium, and wearing a well-made (i.e. was comfortable and didn't change my bite) stabilization splint (in my case, made by a prosthodontist) for several months. The splint caused $1,500, wasn't covered by insurance, and was worth every penny. I'd refer you to my prosthodontist but he's in Eugene, Oregon. I would specifically caution against proceeding with treatment with any medical or dental professional who says that your problem is the result of a misaligned jaw or a ''bad bite.'' This approach is, in a word, fraud, but it's unfortunately very common. You'll be encouraged to spend huge bucks ($8,000 to $20,000) to buy a repositioning splint to realign your jaw and''fix'' your bite, followed by years of braces: the end result is you'll need expensive crowns to repair the damage. I'd also caution against going to a physical therapist; both because it's very expensive, it's ultimately not helpful, and, in my experience, it's dangerous: an aggressive jaw manipulation displaced the cartilege disk in my jaw joint, causing permanent damage. Best of luck to you (and by the way, there's always the option of doing nothing; for many people, the problems self-resolve within a half year). Feel free to contact me if you'd like more information. briank

I am glad you posted this inquiry as I too will be interested in the other responses. Dr. Friedman is tops, though. Worth the drive there. Mother searching for new options

Her name is Lucia Castillo, and she's the most gentle (and incredibly intuitive & nurturing) practitioner of any kind I've ever had. Her office is near the Berkeley Whole Foods and you can reach her at 510-204-9664. Good luck! Susan

Dentist sensitive to TMJ

I am looking for a dentist in the greater Berkeley area that is good for patients with TMJ. I have avoided going to the dentist for 2 years because of the pain I feel after having my teeth cleaned or other dental work. I have been diagnosed and treated for TMJ and remain pain free most of the time. A trip to the dentist, however, can aggrevate my jaw and cause pain for weeks after. Anyone out there know of a TMJ-sensitive dentist? No more pain in the jaw

Dentist TMJ & Pain Sensitive Patient

I need to find a dentist who understands TMJ (gives lots of jaw rest breaks during procedures) and can manage very pain sensitive patient (not anxiety). Berkeley/Albany etc. area, non-mercury fillings and well-run office a must. I have checked all the related archival posts. anon

Her name is Dr. Aviva Scherman. The drawback is that she's in SF on Howard Street. But during non-rush hours it's a very quick drive or BART ride. Their number is (415) 371-1300. Good luck! Stacey

Looking for orthodontist who specializes in jaw problems

I am looking for an orthodontist who has experience with jaw problems and jaw surgery. I live in Hercules, so someone north of Berkely is preferred, but I am willing to drive as far as Oakland, San Francisco, or Walnut Creek. I have read the previous recommendations, but these are not specific to jaw problems. Here's the background: As a young child I suffered an injury to my right jaw joint. The injury didn't cause any problems until much later. I went through 4 years of braces, headgear, retainer, etc without regard to any jaw problems. Towards the last year of my orthodonia treatment, I began having pain in my left jaw joint. My orthodontist dismissed the pain. The pain continued to get worse, and I continued to ask my orthodontist about it. It wasnt' until my jaw started locking four years later that my orthodontist took my pain seriously (I was young, so I didn't realize that I should get a second opinion). He then sent me to a specialist. It turned out that due to my earlier injury the bone on the right side of my jaw had stunted growth where my left side grew normally. My orthodonia work was forcing my bite to stay centered, putting extreme pressure on the left jaw joint. I was promptly given a mouth piece that allowed my jaw to move freely to where it needed to be to and at the same time, I lost my bite entirely (my top teeth and bottom teeth do not connect, so I cannot eat without my mouth peice). The specialist indicated that I would need to have jaw surgery to cut out part of the left jaw bone, and go through several years of braces, etc. again. He warned that it is extrememly important that I get someone who knows what they are doing and is familiar with jaw problems, jaw trauma, and jaw surgery, since my jaw has been through serious stress. At the time, he said that there was no hurry to move forward, so I put this off - - being pain free has been my main concern. Now, 15 years later, I know that I need to deal with this. All of my treatment took place in Colorado, and both my orthodontist and my specialist are now retired anyway. If my mouth piece breaks, I will be in serious trouble, so I need to take action. I am terrified of starting orthodontia again with someone who is not an expert with this type of problem, and potentially ending up with the pain that I previously was experiencing. So, any recommendations for orthodontits that specialize in jaw problems, and that are extremely thorough in their work, and LISTEN to their patients would be greatly appreciated. Thanks! Marie

Looking for East Bay dentist specializing in TMJ

I'm looking for an East Bay dentist specializing in TMJ. My current dentist made an acryllic mouth guard for me to wear at night, but the bite's not correct. I've heard that a new development is to build up the canines and use them as ''sliders''. Does anyone have experience with this, or a great East Bay tmj dentist to recommend? Thanks for any responses. night grinder

Close to two years ago, I sent a posting to the Recommendations Digest about TMJ specialists (now archived.) At the time, I recommended University of the Pacific, as well as a pain management specialist at the Kentfield Rehabiliation Center, Dr. Marvin Zwerin. For the record, UOP's TMJ treatment plan turned out to be worthless: very expensive (close to $3,000.00), caused permanent damage to my bite, and did nothing for my pain. I no longer recommend them, needless to say, nor do I recommend Zwerin, who referred me to UOP. MarinaH

Seeking general advice about TMJ

I've been having some problems with my TMJ joint and have gotten a referral to Dr. Brian Krey. Does anyone have any experience with him? Also, any general advice about TMJ would be appreciated - what sorts of treatments are out there for someone with relatively mild pain and soreness? Any ways to prevent progression of joint damage?

TMJ is kind of a blanket term; there isn't a one-size-fits-all treatment. I felt U O P was terrific at actually figuring out what was specifically wrong with me. One other thing that I found helpful: The Kentfield Rehabilitation Hospital Pain Treatment Center, in (you guessed it) Kentfield. I saw Dr. Marvin Zwerin (he's in a lot of medical plans), and he's really (really, really) good. (He also has TMJ problems himself occasionally and is very sympathetic.) Best of luck. WHatever you do, don't go to a physical therapist or chiropractor...it's very easy to get hurt...and definitely stay away from UCSF's Center for Orofacial Pain. I found them extremely cold. They failed to diagnose a jaw misalignment, and instead attributed the problem entirely to stress. They wasted a lot of my money and time. Stress is quite possibly a component of TMJ, but it's not necessarily the whole story.

Have you done cranio-sacrial therapy for TMJ?

My dentist has recommended sacrial-cranial (or is it cranial-sacrial?) therapy for my TMJ pain. Has anyone done this? Is there a practitioner that they like? Is it New Age voodoo or proven science? Can they hurt you? All I've been able to find out on my own is that it's expensive. Marina