What do MY TMJ Orthotics Look Like? - Priya Mistry, DDS (the TMJ doc)  

Ma’am thankyou thankyou very much for the videos you make. They are probably the only ones on RU-vid about a lot of details of tmjd. Here in India, there are only 2 or 3 docs for tmj in the capital city, and this being so unheard of, it’s difficult to know if we are being treated right. Your videos are a guide, they help me, assure me and let me rest peacefully. Keep making them. Wish you all the good things. You are the rainbow in the rain for me 🌈🙏🏻

1st- because of your recommendation, I went to a TMJ specialist and was fitted for top and bottom orthotics. I believe they have helped. I still can’t sleep with the top one (I can’t breathe) but I’ll wear it watching TV and such. I use the bottom one while driving or working at the office. I need to seek out some manual manipulation help. 2nd- yowzers! Great way to start my morning. 😂 Anyways… thanks for everything you do Doc!

TMJ suffers, in my experience, Prolotherapy has helped me to correct my facial imbalances, relaxed my facial muscles and pain reliefs. After 9 treatments, no pain and I can eat even nuts and chips. Hope this help. Hi from Canada

I’m having a flare up after about 20 years of good Tmj health. I really like your approach, and wish I could see you. I’m in Melbourne Fl and wonder if there is a directory of sorts that would allow me to find a practitioner that espouses your methods?

MRI TEMPORO MANDIBULAR JOINTS Protocol: MR examination of the temporo mandibular joints was performed in open and closed mouth positions. Oblique sagittal PD/T2 FS, coronal T1/STI sequences and axial T2 sequence. OBSERVATIONS: The study reveals normal anatomical configuration / signal morphology of the bilateral temporo mandibular joints. No subluxation / dislocation is seen. Condylar fossae appear normal. Condyles & the necks of mandible under view appear normal No demonstrable focus of altered marrow signal is seen involving the bones under view. No marrow edema / cortical erosion / destruction is seen. Right TM joint: Intra articular disc appears normal in thickness with presence of mild intrasubstance hyperintensity. The retro-discal tissues appear normal, No disc thickening/crumpling or abnormal displacement seen. Closed mouth: Both mandibular condyles and fibrocartilaginous disc are noted in the fossa. The position of junction of posterior disc and retrodiscal tissue remain in normal position in relation to mandibular condyle. Intermediate zone remains between mandibular condyle and articular eminence. Open mouth: There is abnormal suboptimal anterior translation of the mandibular condyles on mouth opening. The articular disc remains stuck in position in open mouth position. Left TM joint: Intra articular disc appears normal in appearance with presence of intrasubstance hyperintensity. The retro-discal tissues appear normal. No disc thickening/crumpling or abnormal displacement seen. Closed mouth: Both mandibular condyles and fibrocartilaginous disc are noted in the fossa. The position of junction of posterior disc and retrodiscal tissue remain in normal position in relation o mandibular condyle. Intermediate zone remains between mandibular condyle and articular eminence. Open mouth: There is abnormal suboptimal anterior translation of the mandibular condyles on mouth opening. The articular disc remains stuck in position in open mouth position. Joint spaces are normal. No effusion is seen. No demonstrable soft tissue mass / collection is seen. Soft tissues and the muscles under view appear normal & bilaterally symmetrical. Hello sister. I'm from India Gujarat. I'm suffering tmj pain near right side ear around last 5 months. Priya sister I'm also Mistry.. Please help me what am I do now Pain is not extremely. But continues.. I'm very upset and tired now. Please help me.. 🙏

I feel like I’ve been cheated by my dentist. I’ll be talking to them on my next appointment. Thank you for posting.

nice video i am so use to using a stack pull forward on lower generated off a k7 thanks for your videos great for learning .

Is there a website where we can find skilled providers trained in proper fitiing of these devices? I would love to visit you, but the distance is prohibitive

Sounds like the $500 upper night guard was a rip off then. It sure doesn't seem to do anything.

Great information Dr. Mistry. I went to a TMJ specialist, and before making an orthotic, he asked me to have an apnea test which showed some apneas during the night. So he said I cannot wear an orthotic because the apneas will get worse. So now I don’t have the option of an orthotic and continue to have pain on my 3 last upper teeth (all with root canals) for the past 10 months. I wonder if you had such cases in your practice. Thank you very much for your time.

This is very interesting. Cause I have no idea what I am currently wearing. I was made a guard by a gnatologist. Those are the tmj specialists in my country. I live in Europe. It's for my lower teeth. And I should wear it during the day and night. And it pushes my lower jaw a tiny bit forward. But it does get worse when Ive worn it. But it also does feel good while I have it in. So I'm pretty puzzled if I should keep using it or if it's just getting used to it. It was custom made for me and I was told my tmj will get worse before getting better. In the beginning. I saw a different gnatologist yesterday who adjusted the guard completely and I don't know if I should've let her done that. It was not hers but she wanted to help me when I told her I'm in a lot of pain. No one has ever told me about the differences in these guards. And I really wanna know. So I can be more comfortable knowing I have the right one. I feel like seeing another gnatologist who can explain it to me more. Cause I've become reluctant to wear it because I don't know what I'm dealing with. She's adjusted it and shaved it and I had to bite on these pieces of red see trough paper but I wasn't explained what was exactely done to my guard. I feel good communication is key. Cause it can help or make me worse. And I'm already in a lot of pain.

Would the Mora for example be warn 24/7, meaning it’s just not a temporary correction guard?

Hi Dr Priya, I went to a " tmj specialist " and unfortunately got swindle out of close to 12,000$ 😢 when you are in pain you will pay almost anything to help you feel better. I went to this Dr and she " diagnosed " me with sleep apnea. Instead of treating my tmj she was focused on sleep apnea that I don't even think I have. She made me a sleep appliance not a tmj orthotic. That appliance has done nothing but caused me more cheek pain and the kicker I am now 10,000 in debt. If the right appliance would have been given then the money would not have mattered, but unfortunately, her appliance did nothing but put in me in debt and cause me more unnecessary pain. This has made me go down a bit of a depression spiral as I don't know where or what to do next. Unfortunately I do not have the means to go to another tmj specialist because it's not covered by my insurance. I guess this is me just venting. Anyway, thank you for your tips you give us to help those of us with this horrible condition. It is much appreciated ❤

Do you have any advice or guidelines for how to identify a TMD doctor who knows what they are doing? It's difficult as a layman to know the difference. I went to an oral medicine specialist who wasn't interested in doing any imaging, be it CBCT, MRI, or anything else. I thought it was weird for someone handling a delicate and precise treatment not to want all the possible information available, but I figured he knew what he was doing. His orthotic shifted my jaw right because my jaw opened with a leftward slant. Soon my right side TMJ disc audibly shattered and drove the joint into my ear. I now live with hearing loss and intense reactive blasts of tinnitus in response to the faintest sounds. So, any tips on what signs to look for that a practitioner might be equipped (or unequipped) to properly treat TMD could save lives.

Hi doctor thank u so much for replying my questions previously 😇I went for checkup and the specialist is suspecting i might have myofascial syndrome based on symptoms doc..Pain on cheek bone,one side headache,shoulder pain and neck pain,pain behind ear too..And also upper teeth sometimes sensitive hard to open wide..This is why i thought it might be TMJ disorder anyway thank u so much doc now taking medicine hopefully it helps and everyone who read my comment can learn also.

What happens if the ARA changes the bite? What would be the next steps if you have a posterior open bite from the appliance?

I had a MORA type orthotic made by a TMJ dentist and unfortunately it made my issues worse. He failed to observe the primary cause of my symptoms is from clenching and grinding my teeth during sleep. The MORA gave me something to bite down on harder and also grind on which promoted the bruxism even more. I'm now trying an anterior deprogrammer. If it doesn't help I'll be moving on to some kind of self invented biofeedback device. This issue really sucks, not much help out there for bruxism. Your videos are great though, very informative and thorough.

I’ve been told orthotics cause an open bite- do you have to wear them permenantly, when you stop wearing would it come back? do you know anything about palate expansion? Thanks :) Also how much do they cost usually?

Thank you very much for this wonderful video

I have tmj and osteoarthritis in my jaw. My tmj specialist quoted me $3500 for custom fit orthotic. I just want to make sure that that price is right for this appliance. want to make sure before i spend $$ for a pricey tmj orthotics that I think I need. Thanks

Hi Doctor! Thank you for the excellent information . I have been dealing with migraines that popped up about 4 years ago. Im 61 and never had headaches before. I have been put on a migraine med but dont think that is what I really need. I feel its probably stress related. I live in San Antonio area and am having a hard time finding a TMJ doctor. I feel an orthodic would benefit me because I have been wearing a night guard for 25 years and dont think it helps. DO you know of any in my area I could go see to get one made? I have tried 2 and one only does corrective surgery and the other wont see anyone until August when school is out. Thank you for all your exercises and advice I am trying!

Hi Dr. Mistry! Love all your videos. On average, how many millimetres does an orthotic pull your jaw forward?

Do you take into consideration the posture when doing an orthotic ? Did your patient notice some improvements or modifications in their posture ? (especially in the head/neck area) If the orthotic works, do you have to wear it for the rest of your life ? How many months, or year can the orthotic last before having to change it ? Thanks a lot Dr. Mistry.

Please, we want you to explain how TMD problems affect the throat and cause throat problems

Hi Dr. Mistry, I had an unsuccessful arthrocentesis 1 year ago for my jaw locked closed. I’m still searching for help and came across you. Would it be safe to say that an unsuccessful arthrocentesis procedure make the probability of the orthotic (if you made me one) unsuccessful too? Running out of options but it’s very expensive! Thank you for your time! -Tori

Hi doctor when i open my moth it go to write.what can i do. What the problem please help me its for 3 years

Just found you - LOVE your content! Do you have a preferred antidepressant/antianxiety medication for patients with TMD and bruxism? My doctor said SNRIs are better but they are difficult to get off of so I'm a bit worried about trying various ones. Any advice is appreciated!

What patients do you recommend a day time orthotic for and for how long do patients typically need a day time appliance? I saw a doctor who recommended the MORA and to wear it day and night for 1-2 years depending on patient response to treatment.

Hello Doctor, would these prthotics hel with tinnitus if you believe its from TMJ ?

Hi my ENT doctor I have tmj so I go to Tmj specialist and I have splint now I will wear in the evening..Because I do clench my teeth every evening and I have ear pain,tinnitus and vertigo, neck pain amd throat pain..I hope it will help my situation its hard to deal because I have work🤔

My dentist wants me to get a deprogrammer to find out the next steps on how to treat my TMJ. Does this sound correct?

Nice informative video i didn't know there were so many different type of mouth guards in a friendly tone no need to highlight me👩‍⚕

Hi Dr Mistry! I have started seeing a dentist that specializes in my area for TMJD who wants to make me both a day time orthotic to wear for 16 weeks and a night time orthotic (both top and bottom) to wear forever. Is there questions to ask to ensure it is the right treatment for me? Dentist did a CBCT scan and some physical tests

Thank you so much for your information. I was changing my sheets and pulled a neck muscle. Now I click! I’ve been going to PT for jaw massages. I’m waiting to get my night guard from UCLA Dental School. They are on break. Question: how do you feel about using Oral B night guard in the meantime. It gets shaped to your teeth by heating in microwave . I’m worried I will clench down in wrong position and cause more problems.

Dr. Mistry, I have an orthotic that is a daytime wear but it was created without the K7. I had my teeth scanned and the orthotic was created. My dentist would use the blue bite sheet to check where I am hitting on it. They do calls this a neuromuscular orthotic. My question is, is this truly a NM orthotic then? I just got this not long ago and when I wake up I am still locking in it… I am supposed to get a night time orthotic that is both an upper and lower wear. Do you know what this could be? Thank you for such great videos!

Hello Dr Mistry. A question for you. I've been wearing a daytime orthotic appliance for seven weeks. When I’m wearing the daytime appliance (on bottom teeth) I am often dizzy, lightheaded and foggy-headed, a bit nauseous and often have ringing in my ears. As soon I take the daytime appliance out, those symptoms will gradually go away. I would like to know if this is a normal side effect of wearing the daytime appliance? Thank you. (Hard reach the doctor who created the appliance for me - or get an answer quickly from him, so I'm reaching out to you. Thank you!!)

Thank u fr information

I am wearing an ARA device as I am typing this. I've had disk displacement without reduction, which unfortunately, after my symptoms got a lot better by wearing the ARA at night every night and then later every 3rd, suddenly turned into a displacememt without reduction. I can manually reposition my disk and am wearing the ARA for like 3 days for 24hours after that, but I'm not sure if that's enough time. Can it be said at what duration of wearing the ARA the open bite might become a problem? I am aware of this risk but I found studies where people were wearing the ARA for 3 month or even longer for 24h. Would it be unlikely to become a concern if I wear the ARA max. 7 days in a row for 24h?

What’s the difference between an orthotic and a split? I was recommended a “surgical splint” that gets adjusted monthly

I just got a MORA type orthotic on my lower teeth. When resting with my jaw closed, am I supposed to conciously close my jaw so that my upper teeth contact the orthotic? My typical resting state is lips closed, tongue at roof of mouth behind upper front teeth, and upper and lower teeth(/orthotic) not contacting.

Mam where are you from? I am struggling to find TMd specialist in India😢

Do you know if anything like this is available in the uk? I’m struggling to find a TMJD specialist in the uk that does anything similar.

I have a video recommendation that I'm not sure if you've done before. Can you make a video about TMJ and how that leads to facial asymmetry. I have gotten fitted with an orthotic from my TMJ dentist and I've noticed that the joints have stabilized but my masseters differ in size from years of dysfunction that probably needs more time to recover. I've seen some people online who share their TMJ journey sometimes develop severe facial asymmetry that mainly noticeable in their masseter muscles, thankfully mine isn't that severe. If someone has clicking and popping on one side of their face does it make sense that the muscles of mastication on the affected side will grow or shrink more relative to the properly functioning side. Also, are there exercises that help bring back the muscles to equal size and strength quicker once the joints have stabilized or is it just something that just needs time to balance out the muscles with the new proper bite. Thanks!

What if I have developed TMD w/o reduction after orthognathic surgery for a class 3 underbite? Do the orthotics result in a relapse of the underbite?

@theTMJdoc Hello Doctor Mistry, What do you think of the NTI TSS device ?

Hi Doctor, I (22yr) was recently diagnosed with TMD. Doctors suggested a bite guard(to get my teeth grow downwards, making space in joint) or a deprogrammer to address it. Which one do you recommend? MRI shows mild bilateral TM joint dysfunction and minimal disc subluxation on the right, with some edematous changes. Thank you so much!!

Are there any providers in Europe that use the mora system? I hope, so now I have to wear a nightguard doesn't do anything for my muscles. No one uses this system in my country (belgium) they always give night guards. I have no choise i got tmj after bad orthodontis. I have so much pain because of it I also had a root canal treatment because my tooth gave up. I'm also scared that my nightguard (only top teeth marks) will damage my muscles. I do MYO therapy and I try to do my daily exercises but it's not enough i can't control what I do in my sleep.

i just got a nightguard made 🥹🥹🥹 it was expensive but now I don't know if I want to wear it because it's been 3 days and my pain is even worse

How to properly diagnose tmjd? Is there any imaging accurate enough to determine if the patient really has tmjd?

Dr Priya. What if I have an implant crown , but my bite was off before the crown was placed and got even worse after the crown was placed and I do have TMJ problems, would I still be able to treat my bite and dislocation of the jaw with your orthotics having an implant crown ?

This is extremely helpful! How long on average is the orthotic treatment?

Hey. Do you prescribe a cream for TMJ relaxation for your patients? Have you ever used CBD oil too?

Does a TMJ guard survive extreme clenching? In other words, does it go out of shape under that much force? Thank you!

Hello! I’ve been following your videos for several months now and find your guidance and information to be a life saver. I’ve had joint trouble caused by clenching at night. I’m using a mora but still clenching. My upper front teeth have become hyper sensitive and can’t have any pressure on them at all. My endodontist checked out my front teeth and they are healthy but hypersensitive. My TMJ dentist removed the contact points on my mora device for my upper front. My upper front teeth have settled down…and I’m hoping this will work for me. I’ve also tried an anterior device but run into the same problem….my front teeth are so sensitive to pressure that I can’t have contact on them. Have you come across this problem and what do you use in your practice for patients experience hypersensitivity to pressure.

If a posterior open bite is formed as explained during the ARA segment. What happens after? How would a posterior open bite treated?

Hi! Are myobraces a good treatment for TMJ pain, malocclusion, uneven bite?

Hi, my daytime orthotic was thickest on the canines. It looks like the one in your video is as well. Why is that? Could that cause an open bite? Thanks!

Nice.

HI Priya, i have tried everything stretches,posture and orthotics but nothing has changed--given this would your recommend botox and if so what i should be aware of?

Which one of all of these is/are most suitable for osteoarthritis for someone in their 20s?

how do you keep the tongue from falling back and blocking the airway? My orthotic has a place wherem y tongue can relax t the roof of my mouth so it doesn't fall back

Do orthotics can be wear through out the day and night except while eating or just day time or night time

Anyone in Mexico that you can recommend?

Hi, Are MRI scans safe for your patients who have metal dental crowns?

Can i order mora from cosmetic dentist?

I have my TMJ.... ma'am I am 55y. O....from Philippines

How do one self diagnosed as with sleep apnea

Can I eat with those ones? I have headache when I chew a lot 😢

What do you think of the gleb orthoic?

Shounding a shlurrpy 😂