As this video shows healthy functions, you should be good!

Find a dentist who understands the TMJ, they should be able to check what is going on and let you know if it's an issue you need to be concerned about.

It is beyond our field. It's good thinking to suggest some sort of cushioning in the crown but once somebody understands that crowns on implants shouldn't be set at the same level as the natural teeth, the solution of creating the crown fractionally shorter is much easier than having a crown with in-built cushioning. I suspect that is a disincentive to anyone creating such crowns.

Whoever provided you with a splint that works to relieve your symptoms would be the best person to recommend a permanent solution. If that person is not available, look for another TMJ specialist in your area.

@@BiteFX usually what are the options to fix it permanently? Surgery and/or orthodontics? In my case what caused my tmd Is a 2 class malocclusion

@@toffer-2541 There's no single answer as it depends on exactly what the TMD problem is and how far off your teeth are from positions that will support a healthy TMJ. The fact that a splint can help relieve your symptoms gives hope that the changes required won't be too extreme - but that can only be confirmed by a TMJ-savvy dentist after diagnosing your bite and TMJ. Solutions range from making minor adjustments to a few teeth (adding or taking away small amounts of material), to orthodontics, to restoring multiple teeth, to surgery - depending on the severity of your problem. Lastly it's more likely that your TMD problem caused your class 2 malocclusion but that's for the dentist to determine and resolve.

@@BiteFX mine its a skeletal 2 class malocclusion so it's more likely that It Is the cause and not the consequence

Hi Yana. I'm sure this is a scary experience and not one you want to happen very often. I asked a TMJ specialist what he thought based on your comment. He said "Disc is displaced, needs to see a competent dentist in TMJ pathology to assess what may/should be done." In the meantime if you can recall what you did that caused your jaw to lock, like opening your mouth wide, try to avoid doing that. Wish you well.

The answer to your question depends on finding someone who can diagnose what's going on with your TMJs. Look for a dentist who understands the TMJ and will do a CBCT scan or MRI of your joints. Without one of those scans a person can only guess at what's going on. Your symptoms strongly indicate that you have at least one displaced disc but the scans will show the state of your bones.

Answered your question posted on the other video.

It's a type of splint designed by Dr. John Kois to help the jaw settle to its fully seated position. The "deprogramming" refers to helping the pterygoid muscles relax so the jaw can find that position. See www.koiscenter.com/kois-center-a-new-standard/kois-center-research/kois-deprogrammer/ for the full explanation.

Understand. The occlusal splint should be a short-term measure. It allows your condyles (jaw bones) to settle into their fully seated position in the joints (can take a while as your muscles and TMJ disc adjust to the new position) and allows the dentist to confirm that they have the right jaw position and required tooth adjustments. Once that is done, the dentist can propose permanent changes to your teeth that negate the need for wearing a splint. One of the leading dentists who use BiteFX, Dr. Chris Toomey, has developed a technique in the last year or two in which he builds up the teeth instead of creating a splint. It's still a temporary measure but I'm sure would be more to your liking - I'm sure that's one of the reasons Dr. Toomey is having so much success with this technique. He's in Towson, MD, a suburb of Baltimore - a long shot that you're anywhere close to him.

First, know that I'm not a dentist, we've just worked with many top dentists to produce these animations and videos. Over the years we've gained good insights into how the TMJ works and how it can go wrong. The dentists and specialists who have the scans and can examine you are in the best position to diagnose your condition. That said, the dentists and TMJ specialists that we work with use CBCT scans or MRIs to discern exactly what is going on in the TMJ. A 2-D X-ray image does not provide sufficient information for a confident diagnosis. Pain in your TMJ indicates that something isn't right. Exercises may relieve the symptoms - and we had a physiotherapist on our monthly webinar last week describing how she helps TMD patients in collaboration with TMJ-savvy dentists. She was clear that patients need help from both physio and dentist to bring them to full health. A stabilization splint has a chance of resolving your issue so definitely worth considering. Ideally the TMJ specialist would take a CBCT or MRI to confirm the problem, but it may be that they are confident enough from examining you that they know your problem is minor and the splint is the way to go.

@@BiteFX thank you for your reply

The splint that Dr. Reid was describing is a permissive occlusal splint. There are several different types with slight variations in design, usually determined by your dentist.

@@BiteFX thankyou 🙋🇭🇲🇭🇲🇭🇲

As far as you can, make sure that whoever is treating you has a good understanding of the TMJ - do you feel confident they "get" the concepts described in this video. Tonight we are hosting a webinar (for dentists) which features a physiotherapist, Carol Cote, who will describe how she works with dentists to help ease the symptoms being suffered by people like you. Unfortunately there aren't that many physiotherapists around who know the right things to do, but Carol tells me a key element is the CCTT qualification: Certified Cervical Temporomandibular Therapist. They can't cure your TMJ issues, but they can ease the pain and increase functional range.

@@BiteFX thankyou for your reply..the thing is I don't have any pain what so ever and good range and movement , this problem has left me confused and I have no trust in the system anymore.. all I do know is that when I Saw the video how it looks is exactly how my bite feels ..in my last comment to you I just noticed that I wrote yourning is easy..meant not easy thankyou

​@@littlelotta7975do u have condyle deterioration cause of an accident like in the video or not?

@@myemailsempiternallysucks no I don't no pain it just happened 🤷 specialists don't know, Joints are all good

@@littlelotta7975 so its just like asymmetrical jaw? if yes we have same problem

I wanted to check with a TMJ specialist before replying to you so here's what he said: "Two reasons typically explain a forward bite. Posterior interferences that the body decides to avoid, or joint inflammation. An MRI should be done to diagnose the joints, and a clinical exam is a must." A simple nightguard might help protect the teeth at night but unless it is designed to help resolve whatever is going on with your TMJs, and you have other dental work done to complement whatever the splint does, the nightguard is not going to fix your bite.

Unlikely. I haven't heard any TMJ expert describe unclogging ears as an additional benefit of using a splint to improve TMD issues. You'd want an ENT doctor with a TMJ (dentist) specialist to confirm this was a viable treatment option.

TMJ orthotics works for clogged ears?

@@prashanishah325 Same as previous reply. I was assuming you meant a TMJ orthotic when you said "splint".

Also, will fixing tmj will fix the assymetry of jaw?

@@calalkazimov6179 I've certainly heard some dentists talk about correcting scoliosis by using splints, but it's not a common specialty. It seems logical that if you have a problem in one TMJ that is producing an asymmetry in the jaw, that will influence how you hold your head, perhaps tilting to one side, and that in turn will feed down to your back so your spine curves. If the TMJ issue can be resolved, one would hope that the head posture would correct and that the scoliosis would also correct - unless there is some other cause of the scoliosis. What's more certain is that if there is asymmetry in your jaw, it likely indicates a TMJ problem and that fixing that TMJ problem can correct the asymmetry - provided the TMJ problem is fixable and hasn't advanced to a state where repair is difficult. Worth finding a TMJ specialist who can tell you what is going on with that joint.

Fill the form in on this page: hubspot.bitefx.com/help-me-find-occlusally-aware-dentists and we'll send you a list of those we know of who are close to you.

Glad the video was helpful. We created a few new videos recently, some of which go into greater detail on the TMJ with new animations. For example: A Tour of the TMJ (Part 1) kzfaq.info/get/bejne/mqejhKShppfSqps.html and A Tour of the TMJ (Part 2) kzfaq.info/get/bejne/ma6WeZyqx7OYZXU.html. We broadcast a monthly webinar for BiteFX member dentists. This month we have physical therapist who specializes in orofacial pain and TMD, working alongside TMD-savvy dentists to help patients recover from the types of problem you describe. If you'd like me to tell you more about that, send an email to [email protected] asking that it be forwarded to Doug.

all the doctors who say they don't know, just don't want you to get healed so they can earn money on you. They all know. It's hard to say what the issue is from ur point, but make sure you don't have tongue tie, not mouthbreathing. If you have deviated septum then you have to fix ur septum first otherwise everything is useless. The problem is that when having one issue in ur body it will have a domino effect on other parts. The key is to find what is causing trouble eg uneven hips, muscle dysbalance. I advise you to start yoga everyday so you have no tight muscles in ur body. Also make sure you have correct tongue posture and correct swallow technique. It's a long journey and your body learned to compensate by doing unatural habits like clenching teeth or grinding. There are so many factors that it's hard to tell and average people who don't have the knowledge are not even aware of it.

I'm 52 and I've been bothered by tmjd since I was 15. My lower jaw feels like it's clicking in and out of place. Do you know if there's a surgical solution for it?

Saya mengalami apa yang saudara rasakan . Sakit leher sakit kepala ,dan kualitas hidup memburuk . Bisa jelaskan pengobatan apa yang saudara jalani. Terima kasih

They’ll tell you that so you pay them to take them out (in many instances) needlessly.

Thanks for sharing Nita!

Obviously it takes a little training and practice (on models) to perfect that skill, but there are fairly simple rules that are taught which allow you to progress from only hitting on a single tooth to establishing point contacts on multiple teeth. CE institutions like Dawson, Pankey, Kois, Spear, OBI, BSOS, all teach these skills.

Hi Bassam - We don't have one that explicitly shows tinnitus but we have many on TMJ related issues that would be easy for a dentist to relate to tinnitus. That said, I'll check with our dentist advisory group to see they would support us creating an animation on tinnitus.

You are correct. The splint needs to be the right one for the patient's condition. Splints won't always influence the position of the disk, but they can do, particularly if they are designed to reduce the pressure at the condyle and give a displaced disk a chance to recapture.

@@BiteFX Thank you for your reply!

Good suggestion. I'll add it to our list to consider for a future animation. Thanks.

Thanks!

Sounds like your left TMJ disc is displaced when your mouth is closed and is recapturing when you open. Suggest you get to a dentist/TMJ specialist who can diagnose exactly what is going on and hopefully give you a splint that will help the disc to recover its normal position. The sooner you can do this the better so the disc doesn't deform in the displaced position.

The "simple" solution is to take the bite record with the condyle in its fully seated position then there won't be a a difference between the space available for the crown between taking the impression and fitting the crown. However, it's not quite that simple as you have to: a) Learn how to settle the condyle into its fully seated position - and know when that position is stable and won't change in the next few weeks. b) Know if there are adjustments required to other teeth to make the bite work with that fully seated position. c) Know when those adjustments are complete and you are ready to make and fit the crown. CE institutions like Dawson, Spear, Pankey, OBI, BSOS, Kois provide the training that will help you understand and master these skills.

@@BiteFX thanks alot

Hello. I have this problem, but my dentis doesnt see this problem. When I wake up i bite on my back teeth- molars only, after one hour and more i bite on my front teeth - incisors.do I have to grind those back teeth or fill in the front ones? or wear braces? I have exactly the same situation as in your video under point 2.

Thanks for the comment Scott. Since this video was created 10 years ago we've refined the animations and, I hope, resolved your concern.

A pseudo disc can be formed by scarring of the retrodiscal tissue making a tough enough barrier between the condyle and the fossa to prevent those boney structures rubbing on one another. If it forms, it may prevent further degeneration but there's no guarantee. It doesn't always form - for example, if the retrodiscal tissue has perforated it's unlikely new tissue will grow to stop bone rubbing on bone.

Occlusal splints won't automatically cure TMJ clicking. If the goal is to address the cause of clicking, the design needs to be a little different.

These are all questions that your dentist needs to answer based on a good diagnosis of your current situation. For minor TMJ issues full recovery may be possible; for more severe issues it's more a case of stopping continued deterioration rather than recovering to full health. A splint is serving a different purpose than a mouth guard so the two are not interchangeable. Whether or not it is wise to box when you have a TMJ issue would again be a question for your dentist. With a TMJ problem, one of the areas of your body that is a prime target for a boxing opponent is damaged - do you want to spend much time and money to have things repaired or stabilized in that area only to be destroyed by a well-aimed punch? But you may feel that is just part of the risk of boxing.

@@BiteFX by minor do you mean just muscular non clicking and lock jaw issues? Thanks, i might just shift to wrestling (also i really meant muay thai instead of boxing). My dentist said i should stop but was just getting a second opinion about if my tmj is cured can i start again.

@@FM-dm8xj Some clicking and lock jaw issues are fixable. Sometimes you can have clicking, but it goes away, however, that can be a sign that things have got worse. Basically there's no hard-and-fast rule that says a particular set of symptoms you observe means your problem is fixable or not. Needs a TMJ-experienced dentist, with the appropriate scans, to diagnose and make that determination.

Might be worth seeing if you can find a TMJ specialist (or a dentist who understands TMJ) to see what they think. Perhaps they can do something to help you.

First, I'm not a doctor, but we are connected with many dentists who inform us and comment on issues. You can send your contact information to [email protected] and ask that your request be forwarded to Doug.

Checked with some of our dentists and the advice is to first go through the ENT screening (as the discharge from your ear suggests an ear issue is part of your problem) and then go to a TMJ specialist as so many of your symptoms are related to the TMJ.

Are you still experiencing muffled ears?

even i faced the same problem even i got tmj because of chewing gum , how is your symptoms by the way is everything okay?

Hi Urban. The best advice we can give is that you should find a dentist who is also a TMJ or TMD specialist. They should be able to scan or arrange for a scan of your TMJs and give you an accurate diagnosis of the state of your joint(s) and how they got there. The fact that you are noticing these changes suggests you have a problem that needs to be addressed. Watch the other videos on the TMJ that we published on this channel recently for more information, but you really need to see a TMD specialist.

@@BiteFX Thank you!

Splint therapy may be part of correcting an overjet issue but will not be all that is required. It may also be that no splint therapy is required. Only a TMJ/occlusally aware dentist, likely in collaboration with an orthodontist, can determine for sure.

I'd hope that a TMJ specialist would understand exactly what this video explains and know how to help you. There's a chance that your TMJs are mostly OK and that your problem is more with how your teeth are coming together when your condyles are fully seated. Changing the shape of the tooth that broke might have seemed sensible because it was sticking up and therefore taking most of the force and therefore broke, but that change allowed your condyles to take a different position when your teeth come together so that things don't feel the same as they used to. A dentist with a good understanding of occlusion (how the teeth come together, and how that relates to condyle position in the TMJs) should be able to diagnose what's going on and possibly give you some relief with a well-designed occlusal splint. I wouldn't let anyone reshape any more teeth until they've demonstrated that they can give you comfort (for several months) with a splint. You might be able to find an occlusally aware dentist who can see you much sooner than the TMJ specialist.

@@BiteFX Thank you for the reply. I had experienced extreme pain after the initial rework as it felt like my bottom teeth were digging severely into my front two, and it's just been a miserable experience since. I just regret ever having had the crown done, as I am fairly certain that dental office was the one that cracked it to begin with. Regardless, I will look into what you've written here, both the orthodontist and the initial dentist said to see the specialist, but perhaps a third opinion with a new dentist might be worth a shot. Thanks for taking the time to reply.

I'd say it's worth finding a dentist/TMJ specialist who can diagnose what's going on. Sometimes, if caught early enough, the dentist can design a splint that helps the disc settle back into place. Will stop the clicking and prevent things getting worse in your jaw.

That can vary widely depending on the type of splint required and the amount of support the dentist includes in the price of the splint. Several different problems can be eased by the use of splints, each one requiring a slightly different design and most of them require adjustments over a period of a few months when the lower lateral pterygoid muscle becomes more used to relaxing and allows the condyle to settle further back. We did a survey a few years ago on what dentists charged for splints and it varied from $500 to $4,000 with averages in the $1,400 to $1,700 range. However, it's not an item to be purchased based on price. It's more important that you are confident the dentist understands your problem and has a plan to give you a long term solution that works for you. If a $500 appliance doesn't give you full or long-term relief, you may be paying thousands for crowns or more major restoration work. If a $1,700 appliance delivers pain relief, confirms what a long-term solution should be, prevents further tooth breakages and gives you a year or two to plan for permanent work, you might see it as a great investment.

@@BiteFX thanks for all that information much needed!!🙏🏽🙏🏽

@@BiteFX another question sorry, will a splint work if I’m suffering from arthritis?

@@AL-mb4gs I checked with one of the TMJ specialists that advises BiteFX and his answer was "it may" and went on to explain: The splint’s goal is to create an environment of less pressure on the TMJ. It’s somewhat like crutches for a sprained ankle, it takes some pressure off the joint. The splint doesn’t do the healing part, the person’s body has that responsibility. The splint creates better conditions for healing, the body heals according to its capacity to repair or adapt. So some patients heal great, others less. A well made splint does its job. Hope that helps.

@@BiteFX that’s great information thank you So do would you recommend a splint in this situation? Or what treatment will be necessary for this situation??

The animations used in this video show fairly normal use of the lateral pterygoids. The lower muscle tenses to pull the jaw forwards, and the upper muscle tenses while the jaw is closing, to keep the disc in place between the condyle and fossa. Do you know that you have a constricted envelope of function? If you do, perhaps the pterygoids are fighting against the rearward push on the jaw by the constricted envelope, but it's not a consequence I've heard expounded. Overworking of the lateral pterygoids is more often attributed to holding the jaw forward to achieve comfortable tooth contacts. Maintaining that position means the lateral pterygoids are fighting against the closing muscles which pull the jaw up and into the fossa. That's a tough battle, likely to make the lateral pterygoids tired. The video "Bruxing" on this channel (kzfaq.info/get/bejne/hNKlfKupm9nJnGQ.html) explains the concepts (you may or may not be bruxing, but it shows the pull-forward to avoid an uncomfortable contact). Both the constricted envelope of function and the pull-forward to avoid an early contact between back teeth can lead to the lower front teeth rubbing on the upper front teeth. Tooth-wise the effects may seem or feel similar, but I'd say your awareness of pain in the lateral pterygoids makes it more likely that you're pulling forwards. A dentist who understands occlusion and the functioning of the TMJ should be able to diagnose exactly what's happening. An occlusal splint may give relief to the pterygoid pain - but make sure that airway or any sleep apnea issues are considered as that can be another reason for pulling the jaw forward - to open the airway, and you don't want to do anything that will close off your airway!

@@BiteFX I actually have a class 2 division 2 malocclusion, i.e. a deep bite. I am currently wearing a functional appliance (an activator) which places my lower jaw several millimeters forward to correct the deep bite. Now that I've been wearing two kinds of splints/appliances that moved my lower jaw forward, I do know that I have developed a constricted envelope of function as that is exactly how I move my jaw when I'm trying to put it into position to chew food (01:05 - 01:20). My upper incisors are also chipped and shortened by the deep bite I had all my life. So, in a way, yes the lateral pterygoids may be fighting against my closing muscles which are trying to place the mandible backwards so that I can chew my food. And yes, I am a big clencher, but not a grinder and I used to get big headaches from it. I also snore, and have seen from a CBCT image that my airway is very narrow from the deep bite I had. I am now looking to expand the airway by positioning the mandible forward, but first I will be doing upper incisor intrusion so that I can place the mandible as forward as possible. I am strongly against retractive orthodontics and anything that pulls the jaws backwards. In an ideal world I would do MSE (Maxillary Skeletal Expansion), to also widen my maxilla, thus widening my nasal cavity, making room for my tongue to rest on the roof of the maxilla and have jaws the size of a prehistoric man, the way nature intended.🙂 Thank you for your response.

@@andrejmilojeski7160 Sounds like you're aware of and working on all the issues. Is it clear in your mind how you will establish a stable bite when your current and future functional position is to hold the condyle forward, out of its socket? Might pose this question to a mastermind group we are hosting next month as preliminary exchanges between the attending dentists suggest that "airway vs seated condyle - which is more critical?" will be one of the topics we discuss. (Everyone agrees that airway is more critical, but how do you resolve airway issues while establishing a stable bite?) Thanks for sharing!

@@BiteFX That is an excellent question! Airway vs seated condyle? My current orthodontist had me do an X-ray of both condyles with and without the functional appliance. Logically, while wearing it the condyles are positioned forward by several millimeters. I cannot say how much, I tried measuring but I think the millimeters on the X-ray don't translate to the millimeters in real life. I could say 2-3mm, I guess. Maybe she was going for that "Gelb 4/7" condyle/fossa position, I suppose. When the orthodontist saw the X-ray, she said it was looking good. So, to answer your question, she plans to establish a stable bite by holding the mandible (and the condyle) a bit forward. She will first intrude the upper incisors a bit forward too (class 2 division 2) as they are positioned backwards and will then "lock down" the bite by bringing all the posterior teeth together with the mandible also positioned a bit forward. So yes, the condyles will be a few millimeters forward and a bit out of their socket but she saw nothing unusual about it and I don't feel any pain in my joints whatsoever. If I were a teenager and had been wearing the appliance then I know the condyles themselves would have grown into the new position (grown backwards and upwards). But I am a 34-year old man and that growing process may be finished for me. P.S. If it helps I could send you a few photos of the appliances and the X-rays I had to better visualize what I'm describing. Thank you for the debate so far. 😉

@@andrejmilojeski7160 When you say "X-ray" was it actually a CBCT scan? The latter is better for assessing the state of the TM joint. Seeing photos and the "X-rays" would be great, but I need to give you a caveat: I would share these with a group of dentists (which includes one or two orthodontists, TMJ specialists, and airway specialists) who likely see things differently from your orthodontist - I don't think any of them would agree with the perspective that a condyle functioning forward of its fully seated position in the socket is a normal, stable position. They might accept it is the best position short of major surgery, but they'd want to monitor the bite fairly regularly (every couple of months to begin with, perhaps extending to 6 to 12 months over time if things don't change). So your case and info could be a very interesting example for the group to discuss, but what if they come back with a recommendation that's different from your current treatment plan? I'm sure they wouldn't want to interfere with your orthodontist, but I expect they'd want you to be aware of possible issues going forward. The situation could become difficult for you: your local specialist says one thing, and a remote group that can't treat you says another. Of course, they might come back confirming what you're doing is the right way forward but recommend things to watch out for in the future. And they might say you don't have the right scans for them to assess the situation. If you're happy to expose yourself to this analysis and possibly feedback that might put you in a quandary, then please email me at [email protected]. Best regards, Doug