I, too, am having trouble sorting out the various TMJ specialists in my area: San Diego. I search on neuromuscular dentistry and I get pretty much all cosmetic "extreme makeover" dentists who seem to have a sideline in TMJ. How do you know someone is going to be good?

You should pm tmdyan. She found me a reliable dentist =)

rosy22 ill get to you on this. Madness you can pm me too--ill get you one as well--i know a couple in your area

thenumber12--thanks for your reference--much appreciated

An expensive "Extreme Makeover" or full mouth reconstruction is likely what you will be sold from a neuromuscular dentist who does cosmetic dentistry. Run, do not walk away. Stay away from these offices. Find a reputable dentist by contacting a faculty member at your local dental school who deals with TMJ. You may also want to seek out the help of a dentist who is also a board certified physician or oral surgeon.

There is no such thing as a TMJ Specialist. It is not a recognized specialty by the American Dental Association (ADA). Nor is there such a thing as a NM Specialty. I am a highly trained LVI NM Dentist, in practice for 30 years and I take great offense by "lovemyface" above who states that you should "find a reputable dentist by contacting a faculty member at your your local dental school who deals with TMJ" . Hogwash! Not all of our TMJ patients are "sold an expensive Extreme Makeover or Full mouth Reconstruction". I think it is harmful when people such as "lovemyface" repeat lies as their opinion! Repeating a lie over and over again does not make it the truth. As a Dentist myself, I recommend anyone with TMJ issues be evaluated by a well trained NM Dentist after having been evaluated for other possible causes of pain such as a tumor, etc.. Can we help everyone? No. But if TMJ sufferers are looking for help and there are ignorant answers posted on forums such as this, from those who "don't know what they don't know", there is needless suffering. NM Dentists are evrywhere in the world..US, Canada, UK, Europe, Japan, Australia...Some of the best and brightest Dentists in the world!

Heh, NM dentist are everywhere. Ok, charlatans are also everywhere.

I saw NM dentist and he wanted to do permament placement of a orthotic device, I suppose more like veneer things, and they told me it would cost me 3,000.
It is outragous, spending this ammount of money, do any of these so called Las Vegas Institute "Certified" dentist return any of the money if the patient is worse. Also, upon seeing one, he did not care to mention anything about MRI of TMJ to see what's happening there. I guess it might help people, but again, it's a money making machine with no garantees or peer reviewed and published reports validating so called neuromuscluar dentistry. Muscular component is well known in TMJ disease process, and of course it involves the nerves - all muscles have nerves.

I wonder how much the NM certification cost and what exactly it consist of? In part I am sure - LVI sending the bunch of brochures to the dentist office and providing the specialized equipment (which by the way, I am supportive of, as it can provide analytic data, and no oral surgeon does these kind of tests), but what else, how much training does the dentist get? How many hours? Why is this the only institute training people?

Just as I said....go see an LVI Neuromuscular dentist and see how much unnecessary dentistry they will try to sell you. I was told I needed a full mouth reconstruction which meant crowning every tooth in my mouth for the "perfect LVI smile".....supposedly that would also fix my TMJ.....HOGWASH! I agree with edgaras post above. No mention of MRI's to actually see the condition of the TMJ prior to treatment. No reputable doctor would propose a treatment plan unless all diagnostic testing results were seen first. I have seen first hand the LVI courses and the emphasis placed on marketing cosmetic dentistry under the pretense of TMJ therapy. It's all a scam....and well worth staying away from.

How can you justify such radical approaches when splints work for over 90% of patients with far fewer risks and at far lower costs?

can anybody reccomend a surgeon in the pittsburgh pa area to have an artificial joint put in? i have had 6 surgeries so far over the last 25 years and basically just don't have a joint left. i had a proplastic teflor inmplant put in on my first surgery which did a lot of damage and now i'm told i need a replacement. constant pain and joint malfunction. i know of one surgeon i think is good but a few years ago he moved to a different hospital and i really dislike that hospital. and lets face it... the hospital as well as the anasthesiologists are a major part and if you have no faith in them it's hard to trust the surgeon completely no matter how good he is. how about someone at UPMC? it's a giant teaching hospital with a dental school. anyone there outstanding?

thanks

Please read this:

If your TMJ is due to bruxing, this is a neurological problem and not a dental one. There are dental consequences, but this a neuro problem. Gabitril, combined with either Lamictal, Lexapro, or Welbutrin should end bruxing for many.

Expecially avoid neuromuscular dentists. They are trying to manipulate the trigeminal afferents when it's the trigeinal nucleus that's the problem. This approach can be hit and miss at best, and either way is extremely expensive and too often makes people much, much worse. These people don't know what they're doing and are witch doctors. Perhaps some of them can help some people, but should only be tried if you've tried absolutely everything else.

I don't care if the neuromuscular dentists on this board are offended. They offend me and should offend nearly everyone. They sell hope at higher prices than anyone else who tries to address these problems and cause the most permanent damage when they're wrong.

As with any profession a patient should always research the Doctor they are interested in seeing. Just because someone has had advanced training does not make them a specialist or the best in their field. Take a plastic surgeon, there are many with years of training, yet there are those that are just average at best on a good day. Neuromuscular dentistry has and can change lives. I have seen it and continue to see lives improved. No it is not a cure all for everyone experiencing TMJ related symptoms, But the science behind the approach is real. As for the meds - many of the SSRI'S can have nocturnal grinding as a side effect. So many physicians are too lazy to actually try and find a problem with a patient and the magical cure for many is take a pill. Why would a patient want to consume medicine like, take lexapro, where the side effects range from dizziness, constipation, decreased appetite, premature ejaculation in men, decreased sex drive, diarrhea, flu-like symptoms, insomnia, sweating, fatigue, impotence, runny nose and sinusitis when there may be an option. SSSI's are an amazing thing when needed, but can also be an easy out for a Doc.
If someone is seeing a neuromuscular Dentist that only offers the option of full mouth reconstruction with porcelain then perhaps you should get a second or third opinion. There are always options, just as when someone needs glasses for visual improvement, they sometimes have the option to have a surgery that can eliminate the need to wear glasses, that is just an option, they can also opt. to just continue wearing glasses. A Orthotic can reposition the jaw into an ideal position and relieve symptoms for patients and give them back a normal life. The orthotic is both diagnostic and therapeutic, Moving beyond the orthotic is a option, which can include orthodontics, surgery, partial or full mouth reconstruction with porcelain as well as just continuing to wear a custom made orthotic. Just like glasses, if it improves your function, then it must be correcting something that is wrong. Many times partial or full mouth reconstruction is the best option due the the extreme wear, missing anatomy on the teeth due to the grinding. Bottom line do your research, talk to real patients from the office you have chosen, and remember you always have options, there is never only 1 way to do something and you can always do nothing if you so desire.

greeneyes00,

As I mentioned, neuromuscular dentists might be able to help some people, but their approach is demonstrably sub-optimal for most. Also, the approach is ofter much riskier than alternatives.

One thing to understand about Gabitril combined with either Lamictal, Lexapro, or Welbutrin is that most people respond very positively to them. However, as with all medications, not everyone will be able to tolerate one, or any combination of them.

Speaking for myself, I take low doses Gabitril and Lamictal and have no discernible side effects of any kind.

Now, some have expressed concerns that Welbutrin and Lexapro sometimes cause bruxing. This is true, but only in a minority of cases and it should be recalled that these would be taken in combination with Gabitril, rather than alone. Also, if these drugs make bruxing worse, administration can simply be discontinued and the bruxing ceases. The fact that they can cause bruxing tells you they affect the areas of the brain relevant to bruxing, which when combined with Gabitril may directly address the neurological problem.