TMJ Information

Many people today are aware of Jaw & Bite pain problems, caused by the Temporomandibular Joints. Your TMJ are actually two sets of muscles, one on each side of the skull behind the ears, that connect the lower jaw to the skull.
When your teeth, muscles and jaws work together correctly, the teeth do not wear out and your facial muscles and jaw joint are comfortable. Patient comfort is our main concern. Dr. A.J. Boyajian is dedicated to repairing teeth with a focus on maintaining Jaw and Bite health.
For more information on Jaw and Bite health and other services provided in our office, please call and schedule an appointment with Dr. Boyajian in Westchester, CA.

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TMJ Dental Treatments Stop Your Headaches

It never ceases to amaze me how my TMJ (Temporal Mandibular Joint) experience comes in handy on a daily basis. About half of my practice is devoted to TMJ treatment so I am always thinking about solving TMJ problems or managing bruxing (grinding of teeth) habits. Patients frequently come in with broken and cracked teeth, and maybe some irregular, strange pain that comes and goes on its own whims. Well, knowing how the TMJ joint works with all the muscles, discs, etc., I can use this knowledge to help determine if those phantom pain symptoms are for an undiagnosed TMJ.

Sometimes a tooth will break because of TMJ, yet anyone might think it was caused by something completely different. The knowledge is best practically utilized in how I repair teeth. Through experience of solving TMJ problems, I know how teeth are supposed to hit when you bite down. This is extremely valuable, because if I were to place a crown or filling in the mouth and it did not hit the opposing tooth correctly, I could have inadvertently caused a TMJ problem for the patient. Yes, you heard right. In my opinion, small mistakes in general dentistry gradually snowball into large TMJ problems.

There is a principle called the DUML rule that I follow religiously. DUML stands for the Distal of Uppers and the Mesial of Lowers. This translates into avoiding bad contact points between teeth that can contribute to TMJ. When I solve TMJ problems, I make sure that I do not have those contacts on the teeth.

These incorrect points are like sitting next to a car booming with ear-grating rap music at an especially long red light. Is there even such a thing as good rap music? I am revealing my age now…

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

We Treat TMJ – Call Us Today

Frequently, people are coming in to see me, wondering if they have a TMJ (Temporal Mandibular Joint) problem. Also known as TMD (Temporal Mandibular Dysfunction), TMJ symptoms will include, but are not limited to the following: facial pain, headaches, sore teeth, neck aches, shoulder pain, pain all around the neck, recession of the gums, earaches, ringing in the ears, popping or clicking jaw joints, crunching or grinding noises of jaw joints, soreness or scalloping of the tongue, ridges along the cheek, frequent root canals, broken and chipped teeth, short teeth, difficulty in smiling, more prominent facial wrinkles, loss of lip contour, etc.

This list is mind-boggling! One may have one or multiple symptoms, and not everyone suffers from the same ones. Symptoms commonly appear, seemingly without explanation and often under the wrong diagnoses, but people’s lives have been changed through simple TMJ treatment.

So how do we discover if you have TMJ or TMD? Well, we start with a thorough medical background check. How long have you had the symptoms? Do you have a history of trauma to the face, head, or neck? Have you tried any other forms of therapy or treatment? Your answers to these questions will greatly help me determine your problem and how to solve it.

Treatment of TMJ begins with a series of tests to diagnose the condition as accurately and thoroughly as possible. After that, patients are frequently given exercises to perform at home, a splint to aid in correcting the jaw’s alignment, or are requested to arrange meetings with a local physical therapist on a weekly or biweekly basis. Extreme cases may require surgery.

So if you think you are suffering from TMJ, request an examination. Ask your dentist about the things you can be doing to prevent TMJ. It is always better to speak up than to let the problem sit and grow worse!

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

A Day With A Master

The last two days for me have been a phenomenal learning time. For years I have been a professional student and I had an opportunity to add to my practical and theoretical database. That’s right, my brain. I have been involved with the diagnosis and treatment complex TMJ (Temporal Mandibular Joint dysfunction) for the last 20 years. This is also known as TMD.

Jess Bloomquist came to visit for two days. Jeff is the owner of Bioesthetics Laboratory, which is the premier dental lab in the world contributing to the oral repair for patients with TMD and TMJ problems, such as unexplained facial pain or headaches. He comes from the technician’s view, and I from the clinical view. We worked closely with my patients for two days to help find better solutions. It was a rare privilege.

http://bioesthetics.com/home.html

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

Locked Jaw – What To Do

This week brought two new patients that have locked jaws. Their “TMJ joints” either have been displaced or they are having muscle spams. There was a significant differences in age as well as both sexes.

So what do we do? First, I always start with a full exam. This includes history of the injury or event along with full dental exam. I check muscles and all the related supporting structures to get an idea of the extent of the problem.

A word about x-rays: I recommend a complete set of x-rays as well as additional x-rays of the TMJ. For the x-rays of the TMJ, there is a single cone x-ray called an I-Cat. The I-Cat gives a great hard tissue view of the bone. If I need additional information after I see the I-Cat, I may request an MRI. This kind of X-ray will fill in the blanks of soft tissue information that the I-Cat will not have.

With the combination of the exam, history and supporting documentation can give me a great idea as to the health of the TMJ and a prognosis. Having an accurate diagnosis is what dictates treatment and projected outcome. Based upon this information, I design and make a TMJ splint. A well designed TMJ splint is essnetial for TMJ treatment as well as for aiding in the diagnosis.

Locked jaws are nothing to waste time about. One of the most important factors determining recovery is the time lapse between the event and a visit to your dentist. Time is critical. The sooner care is started the better the chance of complete recovery. I am pleased to say that I expect these two patients from last week to make good recoveries.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

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Why Does My Veneer Keep Falling Off?

This is a true story told to me by a new patient named Stacey.

Stacey is originally from the East Coast and was given my name by a dentist who attended the Pankey Institute, an entity that teaches a sophisticated way to repair mouths.

Anyway, back to my story. Stacey asked me how long a veneer should last. The answer is usually a long time. Some of the first ones I placed almost 25 years ago are still in the mouth and functioning well. Stacey, on the other hand, has had three replacements of her veneer in the last three years. This is obviously far too frequent, especially since she had had to pay each time. To make matters worse, these three replacements did not include the multiple times she had to have them re-cemented them. When I met Stacey today, she was missing her right front tooth. Obviously this was not a pretty sight and she was not happy. I asked her if she wanted to find out WHY and, to her credit, she decided to let us discover the problem and plan the cure.

So this is what we did…

I started with a complete exam. This told me Stacey’s mouth has three problems:

1. She has been grinding her teeth!
2. The way her bite hit was causing all the force of the bite to come down right on the veneers which caused them to break the cement junction!
3. Her teeth are significantly worn down. This changes the the forces and dynamics of her mouth accentuating the harmful forces.

After completing the exam, I placed a temporary bonding on the front teeth. Stacey was ecstatic and I thought, “not bad if I did not say so myself.”

I also made some molds of her teeth to make her a TMJ splint called a MAGO. This appliance is used to help diagnose the true jaw position called CR (Centric Occlusion) and then we can find true, neutral position. Finally, after discovering the CR and the neutral positions, we are ready for the full diagnosis and we can develop the PLAN.

In the meantime, I think the temporary bonding will last through this time, giving Stacey a temporary beautiful smile while we work to give her her permanent, stable one. I will keep you posted.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com

What is a TMJ Exam?

A TMJ exam is the reviewing of the systems that move and support the temporal-mandibular joint. In our office, this has several componants:

1. We examine all the muscles and palpate the joints for discomfort. Healthy TMJs are not sensative to touch.
2. We listen to the movement joint with a Doppler. We are listening for bones rubbing and discs slipping. What we hear can also give us an idea of the health of the bone surfaces and the cartilaginous disc.
3. We also measure the range of motion that the jaw can move. Normal ranges are from 38-45 mm for women and 42-50mm for men.
4. Pain evaluation.

Healthy joints do not pop, click or hurt. If any of these conditions are present, or if other concerns are found during the exam, the patient may be referred for additional diagnostic x-rays, such as the I-CAT.

Dr. Boyajian, West Los Angeles

www.dentalwellnessarts.com