Our TMJ and bite Treatment and Fee                             

In the best case scenario, TMJ symptoms (pain, limited opening or closing or clicks and sounds in the jaw joints.) can be treated by balancing the bite. In this case, the balanced bite will cause equilibrium between the teeth, the jaw muscles and the jaw joint, calming everything down.

To balance the bite, the first step is to determine where the lower movable jaw wants to be when closed. Ideally, once that is determined, the teeth should then be moved (orthodontics) or resurfaced (crowns and onlays) to an ideal occlusion or bite to hold the position. Both these options are not practical for most people. 

The typical solution for most dentists is to make a night guard that will override the patient's unbalanced bite. Since a guard cannot be permanently worn during the day, guards are worn at night when most of the damage from an unbalanced bite occurs (teeth grinding or bruxism). These guards are delivered in two appointments. At the first appointment, impressions are taken. At the second appointment the guard is given to the patient. The problem with this is that no effort was made to determine the best position of the lower jaw when the person grinds on the guard. We have a better solution. 

When we first deliver a guard, it is worn 24/7 and equilibrated (adjusted) as the patient's jaw joints and muscles harmonize over a period of 8-12 weeks (this takes time). During this time, the patient will present for weekly adjustments to the splint as the lower jaw settles into a more relaxed and comfortable position.  

In the best case scenario, as the weeks pass, the TMJ symptoms will decrease until eliminated. At the end of this time, there are two options for the patient. Since the guard cannot be worn 24/7 indefinitely, the patient can use it as a night guard while sleeping. If the symptoms continue to be relieved, then the therapy can end here.

If wearing the the guard only at night does not continue to resolve the symptoms, then an occlusal analysis can be performed to determine how to balance the bite in the position determined by the guard. This treatment may require equilibration (click) orthodontic movement of the teeth, resurfacing the teeth with restorations (onlays and crowns) or a combination of these therapies.  

The cost for the guard and all adjustment appointments is $1200. 

In the rare case when the temporary splint therapy does not adequately decrease the TMJ symptoms, the patient will be referred to an oral surgeon who treats TMJ more invasively (various injections, surgery, etc.). Their analysis will include at least an MRI (click), CT scan (click) and a clinical exam. Most patient do not have to go this route.