ABOUT PAIN & SLEEP

TMJ & SLEEP THERAPY CENTRE OF MONTANA

Craniofacial Pain – Head and Facial Pain, Primary Headaches, TMJ Pain

Sleep Breathing Disorders – Snoring & Sleep Apnea

TMJ & Sleep Therapy Centre of Montana is committed to providing the highest level of care for adults and children without surgery. We understand the structural needs required for pain relief and proper breathing to obtain quality, life sustaining sleep. Led by Dr. Schuyler VanDyke, we provide comprehensive evaluations using the latest technologies to properly diagnose the root cause of our patient’s complaints. This helps us direct treatment for pain relief, fatigue, snoring and sleep breathing deficiencies unique to each person.

Treatment plans are based on individual patient needs and may include: plans to re-train, re-align and correct the problems associated with pain in the head, face, jaw and neck. TMJ & Sleep Therapy Centre of Montana also provides treatment plans for customized FDA approved oral airway appliances for adult patients with Sleep Apnea, snoring and / or CPAP intolerance. Additionally, we provide orthopedic orthodontics for pediatric structural development and the treatment of pediatric Obstructive Sleep Apnea. Our goal is to provide pain relief and proper structure to allow our adult and pediatric patients to Breath, Sleep, Heal and LIVE a quality life.


Services for Adults

Include but are not limited to:

Comprehensive Evaluation for
Primary and Secondary Diagnoses
Hard and soft tissue evaluation
Range of motion evaluation
Skeletal structure evaluation
Oral airway evaluation
Muscle, tendon, ligament palpations
Directed Imaging / Radiographs
Neurological testing
Volumetric analysis of airway
Patient Specific Treatment Plans for:
Rehabilitation for craniofacial pain (TMJ, head, face and neck pain) utilizing:
Orthopedic appliance therapy
Nutritional counseling
Physical medicine / laser therapy

Services for Children

Include but are not limited to:

Comprehensive Evaluation for
Primary and Secondary Diagnoses
Hard and soft tissue evaluation
Range of motion evaluation
Skeletal structure evaluation
Oral airway evaluation
Muscle, tendon, ligament palpations
Directed Imaging / Radiographs
Neurological testing
Volumetric analysis of airway
Patient Specific Treatment Plans for:
Skeletal development for proper function, pain relief and proper breathing (treating pediatric OSA) utilizing:
Orthopedic Orthodontics
Nutritional Counseling
Physical medicine


Sleep Related Breathing Disorders

Obstructive Sleep Apnea (OSA) is caused by an airway blockage (obstruction) during sleep. During the day, muscles in the airway region keep the throat and airway passage open but when a patient has obstructive sleep apnea, the throat collapses during sleep, blocking the airway and preventing air from getting to the lungs. The site of obstruction in most patients is the soft palate, extending to the region at the base of the tongue.

There are no rigid structures, such as cartilage or bone, in this area to hold the airway open. So as a person with OSA falls asleep, these muscles relax to a point where the airway collapses and becomes obstructed. Although OSA is typically considered an ‘adult’ condition, there is no age boundary and apnea can affect otherwise healthy children. OSA may in fact be the root cause of childhood behavior and attention problems. Enlarged tonsils and small structural features of the maxilla/nose, mouth and throat may contribute to childhood OSA. Proper evaluation and testing is needed for an accurate diagnosis.

OSA is a medical condition that is diagnosed by a medical doctor, but can be treated by a dentist with special understanding and training on this life threatening breathing disorder. At present, the primary method for diagnosing OSA is to have the patient undergo a sleep study, known as Polysomnography (PSG) or Home Sleep Test (HST). We are happy to assist our patients in coordination of any necessary sleep testing.

 

Sleep Services

TMJ & Sleep Therapy Centre of Montana provides dental sleep medicine. Dental sleep medicine is the management of medically diagnosed sleep-related breathing disorders (sleep apnea, snoring) using oral appliance therapy for adults and orthopedic orthodontics for airway development or correction for children. Dr. VanDyke of TMJ & Sleep Therapy Centre of Montana is specifically trained and experienced in dental sleep medicine.


Adults


Sleep Services for Adults

Once a patient has been diagnosed with a sleep condition, recommendations for treatment can include behavior and lifestyle changes, Oral Appliance Therapy (OAT) wear Continuous Positive Airway Pressure device (CPAP), and surgery. OAT is often the option for treatment. These appliances can be very effective for patients who suffer from snoring and mild to moderate sleep apnea. Oral appliances may also be recommended for the severe sleep apnea patients who are unable to tolerate using CPAP.

There are over 100 different appliances approved by FDA for treating sleep apnea. Although these appliances have an appearance similar to mouth guards, they are unique and require specific design, fabrication and customized fittings to achieve successful treatment results through proper positioning of the lower jaw and tongue. Dr. VanDyke of TMJ & Sleep Therapy Centre is specifically trained and experienced in oral appliance therapy. They utilize advanced technology and specialized equipment to measure the airway, predict improvement, and determine custom appliance designs. Dr. VanDyke monitors patient care for success and efficacy in treatment results. To maintain success, the appliances require regular follow-up and monitoring. Any patient considering oral appliance therapy (OAT) for sleep apnea or a sleep related breathing disorder should seek care from a dentist specifically trained and experienced in dental sleep medicine and custom appliance design fabrication.


Sleep Apnea Symptoms for Adults

Common signs of obstructive sleep apnea (OSA) in adults include unexplained daytime sleepiness, restless sleep, and loud snoring (with periods of silence followed by gasps).

Additional symptoms of sleep apnea include:

Morning headaches
Insomnia
Trouble concentrating
Mood changes such as irritability, anxiety and depression
Forgetfulness
Increased heart rate and/or blood pressure
Decreased sex drive
Unexplained weight gain
Changes in urination
Frequent heartburn and heavy night sweats

Adults have been found to be at higher risk if they are male, obese, of an increasing age, have anatomic abnormalities of the upper airway, have a family history of sleep apnea, use alcohol or sedatives frequently, are a smoker or experience hypertension.


Sleep Apnea? Take the Test (Adults)


Children


Sleep Services for Children

Orthodontics/Orthopedics for Treatment of OSA

Adult therapies for the management of OSA are not suitable for children. Therapies such as Continuous Positive Airway Pressure (CPAP) and Oral Appliance Therapy (OAT) have been known to arrest skeletal development of the growing child. The good news is, with proper diagnosis and communication between medical and dental providers, Pediatric OSA can be cured!

 

Orthodontics for Airway Development

At TMJ & Sleep Therapy Centre, an increase in airway volume is always our goal in the treatment of Pediatric OSA. The airway is evaluated and any obstructions are addressed. Obstructions can occur anywhere in the airway and are not limited to the mouth and nose. Common procedures in airway development involve upper and lower jaw expansion and relationship changes, myofunctional tongue and lip exercises and lifestyle changes. Orthopedic airway development has a very high success rate in pediatric patients.

Pediatric obstructive sleep apnea is a prevalent but under-diagnosed disease. The importance of screening for OSA in every child has recently been re-emphasized by the American Academy of Pediatrics Guidelines.


Sleep Apnea Symptoms for Children

Sleep disorders in children are conditions that prevent them from getting the oxygen needed while they sleep, creating a form of suffocation. Obstructive sleep apnea in children is being increasingly recognized as a cause of attention and behavior problems as well as learning and developmental problems.

 

Symptoms include:

Snoring
Mouth breathing
Restlessness during sleep
Sleeping in odd positions
Periods of not breathing
Teeth grinding
Night terrors
Mood changes
Poor concentration
Bed wetting
Headaches
Frequent infections

Children with undiagnosed OSA are frequently misdiagnosed as having ADHD and placed on unnecessary medications.


Sleep Apnea? Take the Test (Children)


Craniofacial Pain (TMD/TMJ)

Head and Face Pain / Facial Neuralgia TMJ Pain / Orthopedic Dysfunction/ Primary Headaches /Migraines 

Musculoskeletal Pain

At TMJ & Sleep Therapy Centre of Montana we understand the complexities of craniofacial pain that are unique to each patient. Some patients experience TMJ (Temporomandibular Joint) pain and dysfunctions (TMD), some experience primary headaches (known as migraines, tension and cluster) while others may have facial neuralgias, musculoskeletal pain or a combination of all.

TMJ pain is one of the conditions most frequently identified by patients. This is a very real condition caused by disturbances in the action of the jaw. Research has shown that many factors may lead to this disorder – it can occur by itself or be a part of a more complex problem. We believe that there is usually more than one factor responsible. Causes may include macro traumas: automobile accident, sports injury, accidental falls etc. or micro traumas: clenching and grinding of the teeth (bruxism), which causes the muscles that stabilize the joint to become fatigued from overwork resulting in head, face, jaw and muscle pain. Often the jaw problems, head and facial pain, headaches, migraines and musculoskeletal pain are symptoms of a greater problem affecting the body, much like a fever is secondary to the common flu. In the absence of an acute injury to the head or facial area, we believe the primary cause of these problems is frequently related to insufficient oxygen while sleeping i.e. an unidentified sleep breathing disorder, sleep apnea or obstructive sleep apnea (OSA). Everyone assumes they are breathing and getting enough oxygen during sleep; few recognize that nighttime teeth grinding and clenching (bruxing) is an unconscious effort to prevent suffocation. This repeated action all night long, over extended periods of time, wears down the skeletal structure and the joints resulting in TMJ pain, headaches, musculoskeletal pain, TMJ dysfunctions and facial neuralgias. 

Craniofacial Pain Services

Proper diagnosis and emphasis on origin rather than symptoms alone is key to successful, long term treatment results. After proper diagnosis, a specific non-surgical, treatment plan for rehabilitation is developed for the unique needs of each individual patient.


Adults


Craniofacial Pain for Adults (TMD/TMJ)

Facial pain, headaches and jaw problems are frequently only a symptom secondary to a greater problem affecting the body, much like a fever is secondary to the common flu.

 

Craniofacial Pain Services for Adults – may include 1 or more of the following:

Comprehensive diagnostics
Non-surgical treatment plan for rehabilitation
Decompression appliance therapy (short term wear of custom orthopedic oral orthotics – not splints)
Nutritional counseling
Medication and supplement regimens
Physical medicine treatment (Laser therapy, trigger points, prolo therapy, phonophoresis)
Multi-discipline Referral Coordination
Proper diagnosis and emphasis on origin rather than symptoms alone is key to successful, long term treatment results. After proper diagnosis, a specific non-surgical, treatment plan for rehabilitation is developed for the unique needs of each individual patient.

 

SYMPTOMS

Headaches – recurring or chronic
Earache or ear symptoms of stuffiness or ringing
Neck Pain or Stiffness
Facial Pain
Jaw joint sounds – clicking, popping or grating
Limited ability to open or close mouth
Jaw locking (opened or closed)
Sensitive, loose or worn down teeth
Pain or soreness in the TM joints
Dizziness or Pain or difficulty chewing or swallowing
Pain behind the eyes
Extreme sensitivity to light




Children


Craniofacial Pain for Children (TMD/TMJ)

The good news with children is that they are still in developmental stage and the earlier the problem is diagnosed and treated the better the results!

 

Craniofacial Pain services for Children – may include 1 or more of the following:

Comprehensive diagnostics
Non-surgical treatment plan for rehabilitation
Orthopedic orthodontic development
Nutritional counseling
Supplement regimens
Physical medicine treatment (Laser therapy, phonophoresis)
Multi-discipline Referral Coordination

Craniofacial pain, although most commonly thought of as a disorder affecting only adults, can present in children at an early age. It may be milder or it may simply seem milder because unlike adult onset conditions, these young children have always had symptoms of jaw pain and headaches or difficulty in normal functions of opening, chewing, swallowing, speaking and communications. As sad as it sounds, they know no difference and assume pain and/or difficulties with function are normal and what everyone experiences. Unfortunately, if undiagnosed and left untreated, the symptoms and condition increase with age.

 

SYMPTOMS

Headaches – recurring or chronic
Earache or ear symptoms of stuffiness or ringing
Neck Pain or Stiffness
Facial Pain
Jaw joint sounds – clicking, popping or grating
Limited ability to open or close mouth
Jaw locking (opened or closed)
Sensitive, loose or worn down teeth
Pain or soreness in the TM joints
Dizziness or Pain or difficulty chewing or swallowing
Extreme sensitivity to light
ADHD
Bed wetting




Orthodontics/Orthopedics for Treatment of OSA

At TMJ & Sleep Therapy Centre of Montana, our approach to crooked teeth and bad bites is one of prevention, early diagnosis and treatment of the cause. In most cases, crooked teeth are the symptom of a more serious condition, one of dysfunctional breathing and/or improper tongue posture. Pediatric Obstructive Sleep Apnea (OSA) is a prevalent but under-diagnosed disease. The importance of screening for OSA in every child has recently been re-emphasized by the American Academy of Pediatrics Guidelines. 

 

Is Your Child at Risk for OSA?

TAKE THE BEARS SCREENING TEST


OSA is a medical condition that is diagnosed by a medical doctor, but can be treated by a dentist with advanced understanding and training of this life threatening breathing disorder. Working with a Sleep Physician, ENT and others is necessary in treating OSA. Adult therapies for the management of OSA are not suitable for children.

Therapies such as Continuous Positive Airway Pressure (CPAP) and Oral Appliance Therapy (OAT) have been known to arrest skeletal development of the growing child. The good news is, with proper diagnosis and communication between medical and dental providers, Pediatric OSA can be cured!

Symptoms of Childhood OSA:

Snoring
Mouth breathing
Restlessness during sleep
Sleeping in odd positions
Periods of not breathing
Night terrors
Mood changes
Poor concentration
Bed Wetting
Headaches
Frequent infections


TMJ & Sleep Therapy Centre of San Diego