Dr. Shapira's Chicago Headache Blog

All patients with TMJ disorders especially if they get morning headaches or are tired during the day should be evaluated for sleep apnea. Sleep apnea (see www.ihatecpap.com) is a collapse of the airway during sleep.

Patients with clicking or popping TM joints will frequently have resolution of the TM Joint (temporomandibular joint) clicking if they wear a sleep apnea oral appliance.

The appliance stabilizes the condyle of the TMJ forward and if the disc is reduced allows time for the soft tissues to heal and stabilze the disc.

This stabilization will require the use of a daytime neuromuscular (splint) orthotic to maintain joint stability during the day.

Labels: CGRP neuromuscular dentistry, chronic daily headaches, facial pain TMJ, improving quality TMD, morning headache, temporomandibular joint, TMJ clicking, TMJ pain, TMJ popping

Patients with morning headaches usually have either TMJ disorders or Sleep Apnea. Sleep Apnea can be treated with CPAP or an Oral Appliance. Patients who have TM Joint clicking and are undergoing treatment for headaches or TMD can benefit in several ways from having a night-time apnea appliance and a daytime neuromuscular orthotic.

A problem that is sometimes encountered with oral appliances for sleep apnea are undesired bite changes. These changes can actually be helpful when treating TMJ clicking and popping and headaches. The bite changes that occur are actuallly the healing of the TM Joint. The jaw usually postures forward unloadding the retrodiscal lamina of the TM Joint that is compressed in patients with clicking. The retrodiscal lamina rehydrates and does not let the condyle go into retrusive pathology which serves to stabilize the disk.

The Daytime appliance allows this position to stabilize and heal. In patients who are not undergoing treatment exercises are done to prevent this healing from occuring. The joints will frequently heal if placed in a healthy position. A recent paper showed no damage to the joints with sleep appliances.

The American Academy of Sleep Medicine recommends that dentists fitting patients with oral appliances for sleep apnea be well versed in treating TMJ disorders. There are many good reasons for this recomendation. Dentists who do not uderstand how bite changes affect the joints and the muscles as well as head posture can create difficult problems they do not have the expertise to treat. Please check my I HATE CPAP website (http://www.ihatecpap.com) for more information about the dangers of sleep apnea and on how oral appliances are used in treating sleep apnea.

Labels: AASM, American Academy of Sleep Medicine, bite Changes, cluster headaches, headaches, neck pain, SLEEP APNEA, TMD, TMJ, TMJ clicking, TMJ pain, TMJ popping, TMJD