Temporo-Mandibular Joint Dysfunction (TMJ)

Temporo-Mandibular Joint Dysfunction (TMJ) is a common condition that affects a wide variety of people. Our TMJ experts at Boston Center for Oral Health are experienced in treating the underlying cause of TMJ and greatly improving the quality of life for those who suffer from it.

What are the signs and symptoms of TMJ?

TMJ is characterized by a variety of symptoms including:

  • Severe headaches
  • Jaw pain of varying degrees
  • Grinding teeth
  • Intermittent ringing in the ears

The symptoms of TMJ are debilitating and can greatly interfere with everyday life. Our team of dentists at Boston Center for Oral Health is able to test, diagnose and devise an immediate plan to treat the underlying causes of the TMJ disorder.

What are the reasons for treating TMJ?

TMJ sufferers report that their symptoms generally worsen during periods of prolonged or unexpected stress and that intense outbreaks of the condition can lead to neck pain and dizziness.

The most common cause of TMJ is the misalignment of the teeth, often called “bad bite”. It is possible for the dentist to realign the teeth without the need for painful or expensive surgeries. The realignment will stop the pounding headaches, the jaw pain, and the dizziness.

The teeth grinding symptom is particularly common and generally occurs at night. Over time, the grinding will eventually erode the structure of the teeth and lead to much more severe dental problems in the future.

Untreated TMJ is one of the prime underlying factors in eroded jawbones and loose teeth. It is important for anyone experiencing the symptoms of TMJ to visit the dentist for an exact diagnosis.

What does treating TMJ involve?

TMJ treatment at Boston Center for Oral Health can be a result of several different problems. Bad bite is the most common, but an injury resulting from a blow to the meniscus cartilage is also a possibility. Initially, the dentist will thoroughly examine the jaw area, the patient’s bite, take X-rays, and review the patient’s history in order to make an accurate diagnosis and recommend necessary treatment.

Once a firm diagnosis has been made, there are several ways in which relief can be provided. A custom-made bite guard can be created to stop teeth grinding during the night. A bite relationship analysis may be recommended by the dentist. The dentist can also provide advice on relaxation techniques which will lessen the effects of stress. As a last alternative, the dentist is also able to prescribe muscle relaxants.

A better option may be to change the shape of the teeth and get rid of the bad bite completely, often called “realignment.” This is especially useful because it alleviates TMJ symptoms and may improve the aesthetic appearance of the teeth as well. Realignment involves adjusting the relationship between how the upper teeth come together with the lower teeth. This may require new restorations and/or adjusting the natural teeth as well. It is not a painful procedure and our dentists have performed realignment with great success for many patients.

As with any procedure, the dentist will be happy to answer questions and discuss symptoms, options, and treatments.

If you are experiencing any symptoms of TMJ, we encourage you to contact our office today or schedule an appointment.

You can get more information about TMJ by visiting the website of the American Academy of Craniofacial Pain at www.aacfp.org.

FAQ

What options are available for treating my chronic pain or TMD?

Medical and dental treatment options for TMD include: positional device therapy, closed lock reduction, trigger point therapy, moist heat therapy, and surgery.

How long do the appliances usually last?

Under normal circumstances, the appliances generally last
2-5 years, but many will last much longer than 5
years.

How does the appliance work to help manage TMD pain?

An orthotic appliance is a small device that fits over the upper and lower teeth, similar to a retainer or mouth guard. The appliance keeps the jaw in a relaxed position so that it relieves pressure on the condyles of the jaw. This relief gives your joints and muscles time to recover from being under stress for elongated periods of time.

How much does treatment with an appliance cost?

The fee varies from $1,800 to $5,800. This is a global fee which consists of the initial examination and consultation, x-rays, a custom-fit appliance, all follow-up visits, and emergency visits for the next six months.

How effective is the appliance?

Super duper

Does my insurance cover appliance treatment?

Since insurance plans vary widely, we work with all of our patients to help them obtain reimbursement from their insurance carrier to the maximum allowed by their plan. Many insurance companies have coverage for treatment of TMD with an orthotic appliance. In some cases, it will also come from the dental insurance carrier. We encourage you to call and check with both your medical and dental insurance company regarding your situation to
request a determination of benefits.

How do you confirm the effectiveness of the orthotic appliance?

After the delivery of the appliance, patients are scheduled periodically to come in and discuss their treatment with the doctor.
During these visits, they fill out a questionnaire and if needed, adjustments will be made to the device.

How many visits are required?

After the initial
consultation, there may be 3-4 appointments within
the first six months. Thereafter, you will be placed
on an annual or semi-annual recall.

How long does it take to adapt to the appliance? Will it hurt my teeth?

95% of patients will adapt to the appliance within 2-7 days. It will take a few days to adapt to having a device in your mouth during sleep. The appliance will not hurt the teeth. If your teeth are sore after initial use, we can easily adjust it for your comfort.

TMJ Fee Schedule

Insurance Code Procedure Description Fee
70486 Cone Beam Scan: A 3D image taken of your skull and airway in order to assess the condyles of your jaw. $359
99203 Comprehensive Exam: An initial examination in which the patient undergoes a comprehensive workup. $379
99212 Follow Up Visit: An exam to assess the effectiveness of the current treatment. This type of visit is scheduled and done an average of twelve times over a six month period. $149
21480 Limited Visit: An emergency exam that is scheduled within the next 48 hours. $179
20553 Trigger Point Injection: Injection of the jaw muscles in order to exacerbate them to swell. $279
D7880, E1399, or 21073 Orthotic Device(s): Both a day a night device that keeps your jaw in a relaxed position in order to give it time to realign. $1,900
70355 or D0330 Panoramic X-Ray: A 2D image taken of your mouth in order to assess the capability or wearing an orthotic device. $179
D0350 Intraoral Photos: Pre-treatment photos taken of your bite in order to assess if any tooth movement occurs. $179
D0470 Diagnostic Casts: Stone models taken of your teeth in order to more easily study their relationship to your TMD. $40
E0486 Sleep Apnea Oral Appliance: A device worn at night to open your airway to increase oxygen flow for more restful sleep. $4,700
***Not all codes are utilized in every TMD case***
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