TMJ/TMD/Occlusion/Sleep Disordered Breathing (SDB)
TMD, TMJ, Occlusion, SDB are usually inter-related. Patient cases can be extremely complicated and confusing, therefore getting to the bottom of the etiology is essential. It has now been shown that TMJ/TMD and occlusion problems can be strongly related to the airway, Sleep Disordered Breathing (SDB), sleep hygiene, silent reflux (LPR), and diet and exercise. For example what we observe many times in patients who have poor sleep is that they suffer also from pain (TMD, fibromyalgia, depression). Many times the poor sleep may be related to the airway. Some physicians even successfully treat patients who have fibromyalgia, TMJ problems, and depression with a CPAP machine, which is usually prescribed for patients with sleep apnea. An explanation is that sleep fragmentation and/or poor quality sleep leads to inflammation and lower pain thresholds. Stabilizing the airway helps patients fall into and maintain deep sleep to ideal levels. What we learned over the years in treating TMJ symptoms with oral orthotics and oral appliances (OAT) is that in some cases by also stabilizing the airway and improve sleep quality, the pain and/or TMD symptoms can also improve. We are seeing many females, and even more alarming, a large number of younger patients (as young as early teens) with wellness problems. Insomnia, depression, and pain seem to be on the rise while wellness is in decline. Unfortunately, it appears that oftentimes, medication is being used as the primary treatment for long term therapy.
Drs. Yang and Dr Nguyen studied at the Pankey Institute in Key Biscayne Fl, and the Spear Institute in Scottsdale, AZ for TMJ/TMD/ and Occlusion. They also completed a Sleep Disordered Breathing/TMD mini residency at UCLA in the department of Orofacial pain.
This is a patient with Severe Sleep apnea that had 4 bicupid extraction. Headgear, elastics may retract and prevent the proper forward growth of the upper and lower jaws.