Conservative treatments for improving TMJ symptomsThe Temporomandibular Joint (TMJ) is a sliding hinge between the jawbone and temporal bone. The TMJ disorder entails the pain in the joint and the connecting muscles responsible for jaw movement. It is often is caused by the combination of factors including arthritis, jaw injury, and genetics. People suffering from TMJ disorder also suffer from eroded teeth crowns due to excessive reflex teeth grinding.

Mouthguard: A popular conservative treatment for TMJ symptoms

People suffering from TMJ disorder are often recommended to wear mouthguards to deal with the stiffness of jaw muscles and excruciating pains. There are two major reasons why TMJ patients are prescribed the use of a mouthguard.

Mouthguards prevent overnight bruxism

Many TMJ patients involuntarily grind and clinch teeth during sleep. As mentioned earlier, bruxism can instigate the wear and tear of teeth crown. By wearing mouthguards before going to bed, people suffering from TMJ disorders can prevent that involuntarily clinching, which can result in a deteriorated physical state of teeth. Many people get over-the-counter mouthguards for the purpose. They might help some, but mass-produced mouthguards are not manufactured for custom fitting.

So, there are strong chances that patients don’t get any benefit from OTC mouthguards to prevent involuntary clenching and grinding. One can get a custom-fitted mouthguard from a dentist office manufactured according to the dimensions of his oral cavity and corresponding jaw bone.

NTI mouthguard for alleviating TMJ symptoms

Dentists also offer specialized mouthguards solely made to ease the symptoms of TM disorder. These special mouthguards are called NTI (Nociceptive Trigeminal Nerve Tension Suppression System). They are designed to put the troubling jaw in a normal resting position that prevents stiffness of the connecting tissues and also limits the involuntary jaw movement. Many patients have succeeded in managing their TMJ symptoms with the use of custom-made NTI devices.

Mouthguards are not always the answer

While the use of different types and forms of mouthguards can act as a successful conservative treatment. Nevertheless, it is not an absolute solution for TMJ symptoms. Many people can’t find any relief even after using custom-made mouthguards and NTI devices for a long time. For that matter, dental experts also make use of some other conservative treatment methods for providing necessary relief to troubled TMJ patients.

For instances, they employ particular massaging techniques and stretching exercises to improve the movement of the TMJ joint. Similarly, nonsteroidal anti-inflammatory drugs are also prescribed for treating the stiffness of connecting muscles.

Some people also go for alternative therapy techniques such as acupuncture and trigger point injections to get rid of the troubling symptoms inflicted by TMJ disorder.

Surgery: The last resort

When all the above mentioned non-invasive conservative measurements fail to produce desired results, dentists have to resort to a surgical solution. There are two least non-invasive surgical techniques usually offered to treat the issue of troubling TMJ joint.

Persisting with the symptoms of TMJ disorder can only aggravate the existing condition. Therefore, the wise move is to get in immediate contact with any good dental care facility such as The Gentle Dentist that also provides exemplary services for treating TMJ related issues.  We can be reached at 586-247-3500.





Categories: TMJ Pain

Causes and Treatments for TMJ Disorder

Do you often experience chronic pain or discomfort in your jaws? If yes, chances are you might be suffering from TMJ. Temporomandibular disorders can cause discomfort and pain in the jaw point, which is known as temporomandibular joint (TMJ). TMJ can cause pain in the surrounding tissues as well. The nature of symptoms ranges from slight discomfort to severe pain.

Causes and Treatments for TMJ DisorderAs it turns out, every dentist has a different method of treating TMJ. Having the basic knowledge of TMJ’s causes and the treatment options can prove to be beneficial for you if you’re seeking relief from TMJ disorder.

The Symptoms You Need to Look Out For

The joint at the intersection of the lower part of the skull and the lower jaw is called the temporomandibular joint. The function of this joint is to allow horizontal and vertical movement of your jaw. When you feel pain in this joint and the muscles around it, it’s said you’re suffering from TMJ disorder. One of the major symptoms of this disorder is the clicking sound of the jaw. It is caused when the disk inside the joint shifts. At times, this clicking sound is loud enough to be heard by people standing near you. This is a very common symptom and there’s really no need to seek treatment for it. However, treatment is recommended when the clicking sound is accompanied by discomfort and pain, or if it feels that your jaw gets stuck when you open or close your mouth.

Another common symptom of TMJ is muscle pain. If you feel the muscles of your temples and cheeks are causing you discomfort, especially in the morning when you wake up, you need to consult a dentist. The stiffness that you feel in the morning is usually caused by the chronic habit of teeth clenching during sleep. In order to keep your teeth from coming into contact forcefully during sleep, it is recommended to get an occlusal night-guard designed for your teeth.

The third symptom of TMJ is experiencing sharp pain in the joint itself. Like all the joint pains, this one too is classified under arthritis. Unfortunately, there is no cure for this kind of pain and you have to control it by taking painkillers, undergoing physical therapy, and a soft diet.

Deciding on the Right Treatment

Although the pain in your jaw joint may indicate that you are suffering from TMJ, there is a possibility that the pain is caused by other parts of your body, considering that jaw joints share the same network of nerves with teeth, sinuses, and neck and back muscles. That’s why before assuming that you have TMJ disorder, visit a dentist for a proper diagnosis.

There are generally two methods for treating TMJ. The first one is less invasive and includes orthopedic procedures, like physical therapy, exercise, light stretching, and massage to strengthen the joint muscles. The second method is a little more aggressive. It includes treating bad bites and malocclusions to treat the pain you feel in your jaw joint or surrounding muscles. This method involves invasive procedures, like teeth reshaping and crowning.

For a reliable diagnosis and treatment, contact The Gentle Dentist today if you’re experiencing pain or discomfort in your jaw joint.  Please visit our website at or call us at 586-247-3500. We look forward to hearing from you!



Categories: TMJ Pain

Shelby Township Dentist Discusses Jaw Pain

Shelby Township Dentist Discusses Jaw Pain, Clicking and Restricted Opening of the Mouth

We had a request recently from a patient to address the problems of jaw dysfunctions and more specifically on the reduction of one’s ability to open wide.

The jaw joint is called the TMJ (temporomandibular joint).   This is a complex problem that has many aspects which must be considered. The human jaw joint is the most complex joint in the body and functions differently than any other joint in the body.  Signs that patients can have are: Headaches, jaw clicking in front of the ear, pain in the jaw joint or head and/ or a limited opening of the mouth.

Anatomy: The jaw functions in a rotational motion similar to the way a door opens and closes on a hinge.  The jaw is shaped like a modified ball and socket and works like any other joint in the body during the initial half of maximum opening.  The lower jaw and disk are supported by muscles at the front and ligaments at the back.  The sling that supports the jaw provides high mobility of the joint which gives the lower jaw (mandible) a large area of motion.

When opening to maximum the jaw  comes forward and ideally the disk that is supported my muscles will come along with it for smooth opening.  This is assuming that the muscles are functioning properly and the jaw joint is healthy.

The operative word is “healthy”.  If the jaw joint make noise, there is limited opening  or there is pain in the jaw joint then this usually means that there is a joint dysfunction.  Joint dysfunctions are usually from either muscle tension or an internal anatomical problems.

Muscles:  muscle tension usually comes from clenching and grinding of the teeth either in the day or at night.  During the night this becomes a significant problem because there is no way that you can monitor the amount of pressure being placed.  During sleep the amount of pressure on the teeth can be about 3-4 times more than during the day.  This pressure creates tension in the muscles in the temporal area of the head and affects the functioning of the disk.  This “sticky”  movement of the disk will create a click in the jaw as the mouth is opened.  The severity of the click can be reduced with treatment.  If the click is from muscle tension I usually recommend using a a small bite guard that allows only the front teeth to touch.  When wearing this at night the muscles relax allowing the disk to work properly and even reducing headaches.

Internal derangement of the Joint:  If there has been irreversible damage in the joint complex then the disk can have what is termed anterior displacement.  When the cartilage disk is displaced anteriorly symptoms will be experienced such as a grating noise when opening and closing and a reduction in the maximum amount of opening possible.  In these cases there can be breakdown of the bone as they wear against each other.
It is very important to examine the patient to determine what the is the source of  jaw pain.  Accurate diagnosis requires the use of a cone beam CT scan to determine the status of the joint.  If the space between the” ball and socket” is reduced then it probably indicates that the disk is permanantly out of position.  Items such as full coverage bite guards are necessary to reduce the pain in the joint as bone rubs on bone.

Treatment for Jaw Pain

Treatment options are indicated and recommended based on the symptoms that the patient has  and diagnosis we have made.

Jaw Pain Treatment Option One: Bite Splint Therapy 
The first part of the treatment protocol could require the use of a bite splint.  A full coverage splint is used that will cover the entire surface of either the upper or lower arch of teeth.  This will help take some of the pressure off of the joint and reduce the destructive forces that take place during night grinding.  We may recommend a guard that only covers the front teeth if the patient has headaches or a minor click.  When covering only the front teeth with this removable appliance there is a reduction in the biting forces and a reduction of muscle activity.  You can demonstrate this on your own:  1) Place a pencil in between your front teeth and clench.  2) Gently position  your hands on the side of your face and notice the significant reduction in the muscle activity compared when you bite on your back teeth only.  This principle is used to reduce headaches in a number of our patients by reducing the muscle activity to those areas where headaches are typically  located.

Jaw Pain Treatment Option Two: Bite Adjustment (equilibration) 
Clicking of the jaw can be treated once we know there is complete relaxation of the muscles that control the disk position.  Once the musles are relaxed we can assess the bite and make sure the teeth are contacting properly.  Ideally when the jaw is in the correct position you should bite on all of your teeth at the same time.  If not,  then a minor adjustment of the biting surfaces will be recommended to reduce the  destructive forces that take place on the teeth.  This will also help with the muscles that control the disk position.

Jaw Pain Treatment Option Three: Anterior Repositioning Splint
If there is destruction of the internal aspect of the joint then more advanced treatment becomes necessary.  Only about 5% of the patients have this as a diagnosis and pain is the typical symptom they have.  The other 95% can be successfully treated as described above. For those who have Internal breakdown of the joint a different type of bite splint called an anterior repositioning splint  will be fabricated. This type of removable splint covers all of the teeth and  forces the lower jaw forward when the teeth come together.  This takes the pressure off of the bone to bone contact in the jaw with the hopes of reducing the pain.  The goal at this point is to get the patient out of pain which may require rebuilding the entire surface of the teeth to keep the jaw positioned forward.

Jaw Pain Treatment Option Four:Surgery
Surgery  is the last resort for these patients who have this breakdown of the joint.  Usually a referral to an oral surgeon is necessary if this is a concern.

Shelby Township Dentist Discusses Jaw Pain, Clicking and Restricted Opening of the Mouth

If you or a loved one has either headaches, jaw clicking or pain in the jaw please give us a call as we will try to provide some level of support. If you would like additional information, visit our TMJ and Jaw Pain page.
If you have any questions or ideas about any future topics there are a number of ways to contact us. Please give our office a call at (586)247-3500, email me at or even write us at 15055 22 Mile #2  Shelby Twp. MI 48315

Shelby Township Dentist Discusses Jaw Pain, Clicking and Restricted Opening of the Mouth



Categories: TMJ Pain

TMJ is Explained by Shelby Township Dentist

This is Dr. Antolak from in Shelby Township, Michigan. 586-247-3500 is our phone number. And I want to just talk a little bit about what TMJ is. As everybody refers to as TMJ.

Well, TMJ is actually a jaw joint. It’s the joint as I’ll show you on the skull right here. It is the joint between the upper jaw here and the lower jaw here. Okay? And so, what happens is, people, if you get a clicking in your jaw, that has to do with the cartilage disc that lies between the lower jaw and the upper jaw that clicks. But also TMJ what people think too, is an issue where they not only have pain up in this area and a clicking but also headaches. So it’s a whole syndrome it’s called TMD which is called temporomandibular dysfunction which is more broadly defined. Right now what I want to do is basically go over some of the issues that you can have with your jaw and why it clicks when opening and closing why you have some pain in the jaw joint.

The temporomandibular joint is the most complex joint in the human body and the reason why that is, is, it has a couple of different functions. One function is it’s used to just rotate like this, just when you minimally rotate your jaw like this, it just acts like a hinge, like a normal hinge, like a normal joint down the body. But then here’s the special part about it, is when, we’ve been designed so that if we, you know? Obviously, we can’t get a whole lot in the mouth. If we can just do that much. But, if we need to open up real wide, what happens is, our lower jaw will start shifting forward, and I’m going to try showing you in this model here. As we open wide, our lower jaw will start shifting forward, as you can see right here. And right on here, how our jaws are designed, is there’s a disc that sits between them, that traverses and goes right. If everything is functioning normally, that disc itself will go right along with this lower jaw here with the joint. It’s called the condyle. And it will function smoothly as it goes up and down. And literally the jaw joint moves forward and backwards right with the disc itself.

Now what happens when it clicks is part of that disc literally, not the whole thing but some part of that disc will actually come off the joint. And it will shift forward. Then you close back and it shifts back on.

This disc is actually contained and supported by ligaments which are attached to muscles. So if you get a lot of stress in your muscles, or if you clench your teeth, then those muscles become activated and hyperactivated. And that hyperactivation makes these very sensitive. So they shorten up real fast and that can create this jaw clicking and so for example if this is your…

I’m going to show this is the lower jaw here. And this is the upper jaw which I just showed you so when you first start off your jaw rotates like this. Okay no problem, then after you open up wide, your jaw comes down like this, like I just demonstrated. If you start moving forward and that disc between it, part of it snaps forward. Then that’s the clicking you get. Then you start moving back a little bit as you close. Then it snaps back on. And so that goes back on and off and on and off. So that can become a problem. So what we need to do many times is to relax the muscles in there.

We do that by using bite spreads, or something called the NTI. Things that can prevent the stresses from going on within the joint itself, and within the muscles that support that jaw joint, that support that disk. As we relax those muscles and they perform more normally, as long as there is not too many problems that have taken place.

With that being said, there are some people who have some more issues, or problems with their jaw joint internally. That’s at the internal joint. So what I do is I have here just a patient that we had seen before in the past. What I want to do is show you a CAT scan that’s made of the joint a little bit more close up. What it will do is, it will show you the space that’s in there is where the disc will actually be. So right now within this CAT scan we’ve got 3 different planes. Right now this is the view which is looking, if you took a section like this, we just took a section, cut through here you can see the jaw joint here and the jaw joint here, and if you look right here, this is that part here which is called the condyle which is the top of it here, that’s what this is and that’s what this is right here. Now, as we as we move up and down.

Up and down, as we move this angle like this up and down, we can see how this is changing. So, as we do that, you can see how its changing it’s shape. Okay, so now as we go up further, now it’s getting into the jaw space right in there. Now, let me show you something right in here. This view here is showing a section like this. Now this section is showing this, which is more of what I was just describing.

This is the part of the jaw joint from side to side, from the right side to the left side here. And now, as we move it forward and backwards we can see the position of this. What this does, this actually allows us to see if there’s arthritis in this space here, or if there are any bony attachments and things like that, that can create pain in the jaw joint itself. And so, as we go through it we can see in this patient, at least in this joint, it looks pretty healthy.

There’s a nice space as we can see here. Let me make this a little bit larger as we look right here. There’s a space between here so this is the space where the jaw joint is actually sitting, that’s why you can’t see it and it continues as we go through here as you see that, you can see there’s a space between the whole thing alright.

Now, on this view here, which interesting now.

We’re looking at it from this view here. So, on the scan. This part right here is actually this. Okay? And this part right here is this part right here at the top part of the, it’s called the maxilla. So you have the superior part and the inferior part and this is where the jaw, this person here, normally this jaw sits up in this region here but to take this, to take this scan he had to move his jaw forward a little bit and you can kind of see right now where this is positioned. This jaw was fitting here, now it’s slide, it’s starting to come forward a little bit.

If this is unhealthy, this disk is going to slide forward. And this space is going to get closer and closer and even grind into, even be bone to bone here. So this is the anatomy of the jaw joint. And a CAT scan like this is really nice because it gives us some abilities to see the health of the joint itself. So if there are problems that can’t be resolved easily, we do a scan like this so we can figure out there might be an anatomical reason for that. Surgery is usually the last thing that anybody wants to do for these. Because it just makes it more difficult and it can become more debilitative with doing surgery for the jaw joint. So we try to do much more conservative treatments. Like I said, splint therapy with bite guards adjusting the bite, things like that. Muscle relaxant sometimes and that type of thing.

 TMJ is Explained by Shelby Township Dentist

I have quite a bit of experience with this type of dentistry. So if you do have some jaw problems or headaches, clicking in the jaw, please feel free to call our office in Shelby Township, Michigan at 586-247-3500. Thank you.

TMJ is Explained by Shelby Township Dentist



Categories: TMJ Pain

At The Gentle Dentist located in Shelby Twp., Michigan we see a lot of our new dental clients who  have a history of  tension headaches and migraine headaches which hit them when they wake up from sleep.  Many people like Dawn in this interview have given up hope and just think they will have to just live with headaches for their entire lives.  Their physicians will put them on medications and tell them that this “pill” will take care of your problem.  The problem is that relieving the pain does not get to the source of the pain. Many times headache pain is brought on by a combination of a poor bite, stress and how the patient handles the stress.

I see many patients in our dental practice who have had previous dental treatment including crowns, fillings and orthodontics who have symptoms and regular headaches.  When the teeth don’t fit together and mesh properly it can create disharmony in the jaw joint and the musclesStress and clenching will often bring on tension headaches especially if their bite is off.

Treatment with the NTI prevents the back teeth from touching and therefore the patient can’t clench down hard.  Try this on yourself- Place your finger tips on your temples.  This will be an indicator of how hard you can bite down.  Now put a pencil between your front teeth and bite down and compare this with the amount of force you can generate when biting down on the back teeth.  When only the front teeth touch this prevents the patient’s ability to bite down hardHeadaches usually will diminsh over time when the ability to bite down hard is reduced.

If one of the major influences of the headaches are a bad bite then the maximum affect isn’t obtained until the bite can be adjusted.  This equilibration is necessary to eliminate the triggers that bring on the pain.  When the NTI device is removed after using it during the night the teeth should bite uniformly.  If this isn’t taken care of then only limited resolution of the headache can be accomplished.  The teeth adjustment (equilibration) is a separate process that does’t require numbing and is very effective for long term headache resolution.   For more information visit our website at  The Gentle Dentist or go to located in Shelby Twp. Michigan  is the place to go if you are at your end of the rope with your existing Michigan dentist who ignores your request that something is not right with the way your mouth feels.  This becomes evident when things feel different, if you have a tooth pain or have ear/jaw joint pain after dental procedures have been done.  This patient drove a distance because he has been suffering with consequences from an improperly adjusted crowns and fixed bridges.  He had ringing in the ears, tooth aches, inability to eat properly and jaw pain all caused because his previous dentists didn’t listen to his concerns or didn’t have the proper training to treat his bad bite.  This testimonial was done right after the equilibration and is live and genuine.  If these issues describe you then call our Shelby dental office at (586)247-3500.

This patient has been suffering from headaches and has sought treatment from five dentists in the course of two years.  She was told that it was just because she grinds her teeth and they couldn’t do anything for her. Tension  Headaches and migraines are very common when the bite is altered many times with dental procedures and crowns that aren’t adjusted properly.  Missing teeth, crowns, bridges, and even fillings that aren’t properly adjusted after they have been placed will stress the muscles, teeth and TMJ.

The body attempts to alter the shape and size of these restorations but in an attempt to do so the muscles become stressed and this affects the jaw joint and teeth.

Things to look for are:

  • Sensitive teeth especially when waking up.
  • loose teeth
  • headaches which originate from the temporal area on the side of the head.
  • neck pain
  • Migraine pain
  • Clicking in the jaw which leads to jaw pain.

If these listed symptoms describe you and if it may have started after braces, after a filling, crown or bridge has been placed then give us a call at (586)247-3500.  More than likely we can help you.  You can also email us at

Robert Antolak DDS, Shelby Twp. Dentist is able to take of a bite problem by adjusting fixed bridges, caps, crowns and previously placed dental work. Many jaw problems, headaches, TMJ and other issues take place when the bite is not adjusted after their insertion. The muscles usually get tight and things just don’t feel right. This simple solution can help with going back to a dentist who just says that “everything is fine”. We listen to your problems and take care of them. 

Second opinions are sometimes important when you know that there is a probem that isn’t getting satisfactory results.  Give us a call at (586)247-3500 or email us at

Our dental office located in Shelby Township is a family friendly place to be treated for the following reasons:

  • We are gentle and treat each person as an individual.  The common factor that every person wants in a dentist is for them to be caring and gentle.  No matter your age dental pain is real and the mouth is very sensitive.  In fact, the majority of patients we treat who suffer from high fear of the dentist hav developed their fear from a childhood den

Having  just returned from a Seminar relating the way a person bites and level of comfort they will have in their head and shoulders.  Stress Headaches are very common and many times this relates to the level of stress the person has, the occlusion (bite), and the level in which a person handles their stress.  Headaches are very complex in both their origin and the way they effect the individual.   The use of spraying muscles and using pressure points can reduce headaches if they are muscular in nature.  Jaw pain can also be referred in nature. For example, pain in the side of the face can be generated  from a problem or knot in the muscle in the shoulder area.   If you suffer from headaches or your teeth don’t fit together like they used to give us a call at (586)247-3500 or visit us at  Our gentle dental office is located in Shelby township, macomb Michigan. 

The use of medications to relax the muscles are helpful for a short period of time up to 6 weeks. This, in addition to a bite guard to protect the teeth are very effective to resolve muscle pain.  For those patients who wake themselves up at night may benefit from medications that used in high doses are anti depressants.  Elavil is an example of a short term medication that is used to help patients get to a deeper level of sleep in a low dosage.  This is also used in low dosages for up to 6 weeks to help break the cycle of pain from TMD (Tempro-mandibular dysfunction). is the gentle dentist in shelby township, macomb county michigan who specializes in treating high fear patients where you are treated like family.  This auto accident patient of his had tmj pain from the emergency and has been suffering for the last few years.  Through gentle care of her jaw and knowledge of the bite he as been able to take care of her needs and get her out of pain

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