Sleep Apnea, UARS, & TMJD - Priya Mistry, DDS (the TMJ doc)
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- Опубликовано: 10 июн 2021
- Hello Friends! The connection between sleep disordered breathing - sleep apnea, upper airway resistance syndrome (UARS) and temporomandibular joint disorders (TMJD) is clear to me at my practice every single day! Sleep disordered breathing stresses the body; this stress increases clenching/bruxing frequency, force and duration which leads to excess strain on the muscles of the head, neck and jaw as well as the temporomandibular joints (TMJs). This then leads to TMJ Disorders - clicking or popping in the jaw joints, episodes of the jaw locking, headaches, jaw pain, ear pain, neck pain, & more!
Please watch this video for more information!
As always, I hope this video proves informative to those of you who are or have patients who are suffering from TMJD!
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#tmjd #tmj #dentalappointment #headaches #jawpopping #jawclenching #jawcracking #lockedjaw #UARS #tmjtreatment #sleepapnea
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This channel is all about TMJ disorders - what they are, how they manifest, what to do about them and how they relate to other issues that may be going unnoticed in the body such as tongue tie, sleep apnea, ADHD, and more! I will also be posting about being a dentist and a working mommy to two wonderful children. Thank you and I hope you enjoy my videos! 
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Thank you, this video has put all the pieces of the puzzle together for me!
You’re so welcome!!
This makes so much sense !!! for the longest ive had poor sleep and also grinding/clenching issues. It's all connected. So well explained. i'm so glad that there is greater awareness around all these issues.
Thank you for your kind words! Glad you’re finding the videos helpful!
Easy to follow & very informative! Thank you!
You’re welcome!
Awesome job on explaining how to take care of sleep apnea, UARS & TMJD Dr. Priya.
Thank you so much 🙂
Such an important topic! Thank you so much for explaining in such an easy way to understand
Thanks so much! Please be sure to Subscribe and Share if you find my channel helpful 🙏🏼
Very informative. Thsnks doc!
You’re welcome!
Tysm for the great video, can you make a video on TMJD interpretation on CBCT, MRI, and Ultrasound? Trying to like maximum videos of you today, now I'm your new big big fan.
Yes I already have one:
ruclips.net/video/j2yixq5AgTM/видео.html
I tried getting a sleep study last night but couldn’t sleep at all! They had to reschedule me to take a sedative next time. I’ve had chronic fatigue and fibromyalgia and anxiety and TMD and noticed my soft pallet fell down lower in my throat years ago. I suspect UARS after watching your video! I hope I can sleep next time I attempt the sleep study! Thanks for this information. This describes me exactly!
Sorry to hear this and I sincerely hope you can sleep next time too so you get some answers! :) Knowledge is power!
I have these diagnoses as well. Were you able to do the sleep study and get any helpful results Ashley Nerpio? Thanks
@Ashley Nerpio
thanks so much, finally makes sense, so can i clarify that you treat the pain first of the joints and muscles with orthotics, once under control we move to a Mandibular advancement splint to hold the lower jaw forward and address the UARS or apnea?
Yes and yes!!
What about having Sleep Apnea on your back but UARS (this is rapid breathing that exhaust you rather than a lack of oxygen?) on your side? I don't get any benefit from using CPAP or a Mandibular device, sleeping on my back or side, even while trying both at the same time, i have had a septum corrected and turbinate reduction but im still very ill on daily basis, ive been told i have a class 3 lower jaw and a very deep upper narrow palate, this is the only option i can think off, its MMA surgery as im a mouth breather, could it be pushing on my nasal airways?
Huh - pity I'm not in Portland! A very informative video, thank you. I've just been diagnosed with UARS here in England, however my doctor doesn't seem interested in looking for any problems in the airways - prescribed yet another nasal spray.
I’m sorry to hear this! Dr Jaz Gulati may be able to help you! He’s in England 😊
@@theTMJdoc Many thanks!
@@robertp.wainman4094 you’re welcome!
There are a couple of good docs in Britain. They have RUclips channels.
@@DTM45 Thanks. Would one be Vik Veer? He makes excellent videos - and I have an appointment with him soon.
Thanks for explaining all this! I thought my sinuses were an issue with bruxism and sleep (leading to other TMD issues) and you have supported my theory! Have a much better idea of what I need to pursue to get treatment. But question, should the sinus issues (UARS) be addressed before dental to make dental more effective?
As long as the UARS is addressed, it doesn't matter too much when it's addressed. :)
Hi Dr Priya, thanks for the great video. Question: What would be a normal number for the volume of the laryngeopharyngeal airway? Mine measured at 35 sq mm. I know it is restricted. Would customized orthotics help to expand this? Can surgery help to expand this? Thanks so much.
I was told by an maxillofacial radiologist that if it's below 90 sq mm, then sleep apnea is a likely possiblity as this is considered very constricted. Oral Appliance Therapy will hold the jaw forward, thereby increased the airway when the appliance is worn. As for surgery, it would be best for you to consult with an oral surgeon as that is not my specialty.
I've been binging your videos, and reading all your posts in the facebook TMJ groups, Dr Mistry! I'm in Virginia and trying to figure out where to start since I can't come see you :( Do you know of Dr Pam Marzban? I believe I have either apnea or UARS. I've been grinding for years not knowing why. I've broken so many teeth. My TMJ symptoms are at an all time high :( Thank you for all you share, you're a gem. Wish I could be treated by you! I'm sure I couldn't in just a few days time :(
Hi there! Dr. Marzban comes very highly recommended and I'm hopeful she can help you! If you'd like, you can email patientcare@tmjdentaldoc.com to set up a Zoom meeting with me as well :)
Hi are there any doctors in Southern California that you recommend for tmj issues, uars and sleep apnea. I have had tmj issues for years and have recently been diagnosed with sleep apnea.
I'm sorry, I don't know anyone there. Many people travel to see me from California but I know not everyone can do that.
i have small airway and a flat angle of jaw line which my dentist says i can't do orthodontics. :( but this video is very helpful thank you doctor 😊
You’re welcome!
Hi, in the future could you make a video on Wisdom teeth and how they might or might not effect the TMJ joint. I'm about to turn 28 and still have my in. I've not found any articles about it and if wisdom teeth can contribute to any TMJ pain someone could be feeling.
Yes, can do!
During a displaced disc without reduction does it make sense to wear a night (apnea) appliance (in addition to the day one)?
I make most of my patients a day and night orthotic.
Hi Dr Mistry! I'm undergoing the jaw orthotic treatment as well as osteopathic manipulation yay! It has made a tremendous difference in my overall body pain, as well as neck and jaw pain. My dentist here in Toronto Canada wants me to do a sleep study, since I never feel rested and have a narrow airway. However I also don't sleep and wake up a lot in the night, so I'm not sure if there's any point? I'm in phase 1 treatment, phase 2 I will have the expanders which will open my jaw and airway, should I just wait until then? I'm also wondering if there is anything that can help in the meantime. Thank you so much for your amazing videos, this treatment is giving me a new life.
Hi Christina! I'm so glad you're getting relief. Do you mind sharing who you're seeing for the orthotics and for the manipulation? It definitely wouldn't hurt to have a sleep study. Knowledge is power and I never turn down the opportunity for more information :)
@@theTMJdoc Dr Estrabillo is the dentist and going to a physio near me. He has his own physios that he has trained, however they are too far away for me to go to every week in Hamilton.
I have been diagnosed with sleep apnea years ago and have been on a CPAP. I have been having what feels like deep and extreme ear itching that is not relieved from itching or prescribed medication (oil drops). I have popping in my jaw from time to time and overall my jaw feels over worked. I am believing this to be TMJ and cause of the ear issue to be TMJ as well, it helps when I massage the muscles around the jaw. What should be my next step? Dentist that specializes on TMJ or ear,nose, throat?
I'd recommend seeing a skilled and experienced TMJ dentist.
I have been recently over the past few months having rapidly increasing TMJ pain. I know I have sleep apnea and grind my teeth, so I am getting fitted for a sleep apnea mouthpiece. My concern is, can this make tmj worse by forcing the jaw forward? Will that not be in its natural relaxed position? What if the dentist makes it too far forward?
I'd recommend treating the TMJ pain FIRST and then making an oral appliance for sleep apnea. Can you use a CPAP to treat the sleep apnea in the meantime?
You mentioned UARS can be hard to diagnose with a sleep study. How does a person get diagnosed with this if a sleep study can miss it?
That's a great question and one I don't really have a good answer for. You could try consulting with another sleep doctor to see if they catch it? I'm sorry, I don't have a better answer.
I have a "chicken or the egg" question. I was diagnosed with TMD (displaced disc without reduction with limited opening) many years ago. Recently diagnosed with obstructive sleep apnea. Can TMD cause apnea or is it always apnea before TMD? Can you point me toward medical studies? References to TMD specialists in Phoenix, AZ?
It’s almost always sleep apnea first and then TMD. I don’t know specific medical studies. And I’m sorry I don’t know anyone in Arizona..
I read playing a didgeridoo can help the airway and is a therapy for sleep apnea. Should someone with TMD try this or will playing that instrument flare up the tmjs?
I really don't know much about that instrument so I don't feel comfortable making a recommendation for or against using it.
My dentist said my airway is really bad and I’m getting a sleep test to confirm OSA as i show several symptoms. Is it possible a cpap along with other treatments will result in relief?
I really can’t answer that without knowing your symptoms and/or examining you in person. Sorry.
I'm a disabled veteran and have really bad tmj problems. How do I get an appointment with you?
You can call my office or set up a zoom meeting with me. :)
When it comes to sleeping with TMJ....which is best position sleep on to help TMJ
There’s no best position unfortunately. I would recommend not pressing your hand against your jaw if you sleep on your side.
Can a snoring device appliance splint, help TMJ issues.
An orthotic is used to treat TMJ issues. Once the joints are stable and there is no pain, you can transition into an appliance that treats sleep apnea and snoring.
Hi Priya, I have TMD and apnea, but apnea is (successfully) treated with CPAP (less than one an hour). Can I rule out apnea as cause of TMD? Thanks for your clear and excellent video's!!!
I'm so glad you're tolerating and using the CPAP and that it is taking care of your apnea. What are your current TMD symptoms?
@@theTMJdoc Most of all toothache (without visible cause) in tooth 15, but also pain behind cheekbone and neckpain. I think my biggest cause is stress... Problem in Holland where I live is that TMD is kind of a "non existing disease" as I see the knowledge you have!
@@erikvdhorst yes there are muscles that can refer pain into teeth. Sleep apnea can lead us to clench/grind, which can make the muscles dysfunctional. The muscles can remain in a dysfunctional state even after the sleep apnea is successfully treated. The dysfunctional muscles can then lead to pain in teeth, ears, neck, jaw, behind the eye, etc
@@theTMJdoc Thank you for your reaction! Apnea already under control with CPAP for 13 years, problems with TMD for 1,5 years now, so I don't think Apnea can be the cause. Tried (still have) splint, botox, physical therapy, chiropractor, massage... Now try to relax and follow your advice! Thank you once again!
@@erikvdhorst ahhh I see. Did you have any jaw or neck injuries in the past few years? Any whiplash?
How do I treat UARS while I wait for expansion? Thank you
I cannot tell you how to treat this over the internet and without examining you.
I have been suffering with an irritating sensation running down my forehead and around the eyes and temple. Also now that has moved into jaw ache and what I believe to be tmjd. I also have a wisdom tooth. This has been since last March and my headaches and jaw pain have never stopped no matter what I do/take. I have had ct scans and a mouth guard and many many items purchased online to help me but nothing is. Any suggestions what the next steps for me could be? I also feel like the right side of my head is in a vice, there is alot of tension there. Please help! ;-)
Have you seen a tmj dentist? A mouth guard is not the same thing as a tmj orthotic. Please watch my video “dental nightguard vs tmj orthotic” and lmk if you have any questions!
@@theTMJdoc Hi no I have not seen a tmj dentist just a regular. I will watch the video thankyou. I also have neck ache, it cracks alot and I feel like a have a pinched/trapped nerve in my shoulder/neck. Not sure if that's related but it all seems to be on my right hand side. Thanks again
@@lyndsayadamson6367 yes the neck and jaw are intimately related.
Any doctors in the LA area to help ?
I’m sorry, I don’t know anyone there.
Hi,
My dentist something similar the other week, he said my tonsils are very big, he thinks thats whats blocking airways and im bringing jaw forward while sleeping
Yes tonsils can be an issue. I would recommend getting evaluated by an airway-minded ENT.
What if the TMJ disc is damaged?
There's only so much that can be done if the disc is damaged. Sometimes surgery is a good option depending on the severity of the damage.
Hello Dr.Priya. I developed tmj condition during this pandemic. Still struggling with it after 11 months. I use splint on bottom teeth. Can you share your emails address. I want to show you my CT scan images and I want to share what exactly my problem is. Here the Dentists seemed to be confused.
I’m sorry but I don’t look at imaging unless you are my patient. If you want to discuss your symptoms you can set up a zoom meeting by emailing my assistant Alex at: patientcare@tmjdentaldoc.com
23 Views In A Hour?!
Yup! So exciting! I can’t wait to see your handsome face today ❤️
It took me 3 weeks to get at least 90 views on one yt video