Medical Questions > Conditions and Diseases > TMJ Forum

What Should I look for When Choosing a Dentist to Treat my TMJ ?

So I'm almost certain my headache and pain problem for the last few months is because of TMJ.
When I first go for a consultation what questions should I ask the dentist I'm seeing to know whether he is legit or not ?

I have one consultation next week but I'm wondering if I should see a few before deciding what to do? I've read that treating this disorder costs a fair bit so I would like to make sure if I'm paying everything I have saved that I'm going by someone who will fix me.

I was also considering going for a second opinion by this guy.

Consultation here is 150-250$ and I've tried quite a bit to see if there are any reviews or opinions but no such luck. If you good folks can share your thoughts as to if you all think he is a good fit to help me out I will be grateful.
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replied July 9th, 2011
Experienced User
You're in the same boat as me in terms of the head pain you're experiencing. Is the pain non-specific? In other words, does it feel like it rotates around the face and head in different spots? I get mine in the forehead, jawjoints, cheeks neck, and sometimes veen at the back of my head in small little aches.

Don't go and see just any dentist. The people you need to see is a "TMJ specialist", a "neuromuscular dentist" and even a physiotherapist trained in TMJ disorder. The nly person i haven't seen yet is the first one and that appointment isn't scheduled until later on.

Going to see anybody else (medical doctor, ENT, oral surgeon, orthodontist etc) will all be just a waste of your time. You'd be surprised how many people (even dentists!) just frown or laugh at me when I mention my TMJ symptoms. It is VERY frustrating!

Are your symptoms due to you having a bad bite? (teeth are misaligned) If so, a neuromuscular dentist can fix you practically overnight. It's 100 dollars for an initial consultation, then they hook you up to a machine that relaxes your jaw entirely. You may be put on that machine for upwards of 3 hours, depending on the severity of your condition. It's called a TENS unit. It's boring, but it eliminates 90% of the pain and discomfort you're feeling. It's 50 dollars per hour you're on it. Then, once your jaws are relaxed, the NM dentist makes an orthotic for your teeth that's invisible and mimics the bite you SHOULD be having with your teeth. You wear this for about 3 months, but it is said that all of your TMJ symptoms would be either eliminated or extremely alleviated within the first week of wearing it.. two weeks at the absolute most!

But again, this will only work if the cause of your TMJ is due to a bad bite. (which it almost always is)
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replied July 9th, 2011
I see .

Thanks very much for your reply .

I'm seeing a doctor in the Toronto area on Monday for a consultation. I've heard good things about him helping his patients but I believe he uses two splints as opposed to one ?
Should I definitely go in for a second opinion by someone or if he seems good enough just go through with the therapy.

At the start of my problems I had a bad headache one day followed by nausea and then I threw up which was very rare for me. I've only threw up maybe 5 times in my life.
That was in January. I've seen many doctors and at first all I got told is that it was probably stress and to take Excedrin or Naproxen. It didn't get better though so I got referred to a neurologist and had CT scans and MRI done both which showed I was fine . My neurologist wasn't sure what was wrong with me and nobody ever suggested it could be a jaw problem nor did anyone check. I'm just glad I managed to stumble upon this disorder because it really matches up perfectly and while my jaws can open fine...can easily fit 3 knuckles...and no pain in jaw joint save for a couple times...I can feel a little bit of sliding and clicking.

The symptoms do match up as well...I have the pressure behind my eyes but I found it strange to describe since it wasn't a headache yet it was in my head..
Yes my pain does feel non specific ...I've been going to a chiropractor for months and it didn't seem to help much which was strange. Sometimes it's in my neck , other times in shoulder and once in a while a light pain at the jaw.

My problems are definitely because of a bad bite. When I was 9-10 I had about 8 teeth extracted to prepare me for braces but never went through it due to parent not being able to afford it. At 20 I had invisalign done so I saw a dentist quite regularly yet never was I told about my bite or jaw. I've definitely noticed it though that my teeth done really come together properly but like the slight sliding in my jaw never thought it was a big deal as I didn't know about tmj and from the looks of things neither did any of my dentists or doctors/therapists/specialists I've seen .

I will see how the consultation on Monday goes and reply back . I hope I can be fixed...was starting to get really pessimistic about having to live with mystery headaches for the rest of my life.
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replied July 9th, 2011
Experienced User
How old are you now? Judging by your screen name, I'd say 22..23?
If you had teeth extracted at age 9 in preparation for corrective measures but never went through with them, this can definitely cause problems later on, especially if your teeth are left crooked. Not only do you still have crwoding, but now you have missing teeth. This puts great strain on the jaw muscles. The same kind of thing happened to my mom just last year when she had her wisdom teeth extracted. After the procedure, she experienced sever spurts of debilitating vertigo which confined her to a couch for several weeks at at a time. She is 50 now, but she told me she was diagnoed with TMJ when she was 21 (my age now) but the symptoms remained hidden. It was believed that her jaw-to-bite relationship was thrown off due to the tooth suddenly being removed and this aggravated the existing TMJ condition. Same thing with you i'm guessing.

Which doctor are you seing in Toronto, because I live in a nearby city. Maybe I've heard the name before. Is he a TMJ dentist? Going to medical doctors will warrant either a laugh, a look of confusion, or pressure to take medication for psychological reasons. This has happend to me too. I started out with my medical doctor, went through an ENT, eye doctor, oral surgeon, orthodontist, neuromuscular dentist and a TMJ physiotherapist before ending up back tothe medical doctor for answers. And you know what he said? "You're probably thinking about it too much" So i've been prescribed anti-depressants and sent to another ENT (when I know it's not an ear problem!) I'm back in the vicious cycle of running from doctor to doctor and i'm sorry that had to happen to you as well.
Another thing that upset me was having another doctor come in the room and asking me "how long i've been sick" with a smile on his face because my symptoms on the clipboard were "clogged ears and facial/headpain/pressure". I didn't appreciate that at all since I KNOW it's a jaw problem, and nothing to do with "feeling sick" or having a virus.

It sounds to me like the person you would REALLY benefit from is a neuromuscular dentist. Research their practice online. They relax your jaw with a machine, and then give you an orthotic to wear. It totally halts all pain and strain put forth on your jaw and even eliminates all the otehr subtle symptoms like pressure behind the eyes. Look it up! Smile

I also wanted to touch base with you about this pressure you are feeling behind your eyes. Does it make you dizzy? Not dizzy in the light-headedness sense (blood pressure), or even the spinning sense (inner ear), but just generally dizzy-ish (off balance). I find that it irritates me the most when there's a lot to look at, such as trees, grocery store shelves, or words on a page. And then i feel a slight burning around my eyes/eyebrow region/center of forehead. Do your eyes feel weak whe you wake up in the morning? do they fee stiff? is i hard to open your eyes? All problems with me!
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replied July 12th, 2011
Yep 23. When I was doing invisalgn treatment my dentist did say my teeth were crowded and she had to file quite a bit to straighten them.

I went for a consultation at Dr Hugh Frazier ( not allowed to post links) near Broadview subway stn. He was nearbye to where I live and while researching I read someone who said good things about him. He said he's been doing TMJ treatments for over 20 years. His price was decent for a consultation - 60$
He gave me a sheet with what the pricing would be like if I went along with his treatment :
exams & x rays and impressions - $374
Lower Daytime splint - $295 + lab costs
Upper nightime splint - $295 + lab costs
commercial lab charge -$330
Monitoring etc ..4 visits - $520
then more visits etc - 65$ each

I asked him about TENS therapy to relax my jaw and he said he usually refers people to an Osteopath or Chiro.
He said he tries to do the least possible first which would be a nighttime splint and then if that doesn't work he does a daytime splint.
Also I asked about how he would determine my proper jaw position and he said from the impressions and from his experience.
So I'm sort of wonderering...because when reading up I see other places with jaw tracking and alot of other technology when they treat this along with alot more tests etc to treat TMJ .
The price seems resonable compared to other places but he is quite old 75 and I'm not sure how up to date he is with technology. Quite difficult to decide as the only person I can talk to about this is my mom...but she's depressed since my brother died by suicide last I am just spending hours researching and trying to figure out what the best route to take is.

Yep the way those medical doctors act really annoys me as well. I moved here from Calgary and the healthcare I recieved there was so top notch. I was really shocked when I went for an eye exam and the guy literally spend 2 minutes looking at my eyes before telling me I needed glasses. I complained that he barely told me anything or took his time ....and his answer was I'm very experienced.

He did say I was middle of the line in terms of what he sees. I can easily fit 3 fingers into my jaw etc...but at the same time I do need to be fixed and hopefully soon...I wanted to go back to University of Toronto in september but time is running out on me and in the state I am I will definitely not be able to survive as a fulltime student.

Also as much as I agree with starting treatment at a low level I wonder if it's not better to just do a fulltime daytime appliance to wear as that would help with sooner results.

Hmmm. I think my symptoms are a bit less severe with my eyes. That said I definitely have to hold on tight in the subway for example...when I see other people keeping their balance by just standing...I could never do that.

So I've been looking at what other neuromuscular dentists there are I would like to get a second opinion. At this point I rather be fixed properly and sooner than it taking a long time.

I went for another consultation by a different dentist but he seemed to just be a general dentist who does a little TMJ work as well. He said he would make a nighttime moutguard for me @ 550$.
However he didn't seem to think my condition was that serious and didn't mention any xrays or anything like that...just impressions and then an accrylic mouthguard.

I called one other place and while the guy has the technology he said he's only treated 5 people for it so far...and 2500+$ ...

Gonna call a couple more dentists tommorow and then make a decision.

Please do tell me what you think as I don't really have anyone else to ask.
Also where are you at in terms of treating your TMJ?
That's so interesting that you say your mom had it....since my mom says her Jaw is fine but my dad had problems with his.
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