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Temporomandibular disorders (TMD) are disorders of the jaw muscles, temporomandibular joints, and the nerves associated with chronic facial pain. Any problem that prevents the complex system of muscles, bones, and joints from working together in harmony may result in temporomandibular disorder. When these structures (muscles, ligaments, disk, jaw bone,  temporal bone) are not aligned, nor synchronized in movement, several problems may occur. Patients with TMD pain often take many medications, lose time from work, lose time with their family, and lose time out of their daily life. TMD includes many symptoms that mimic other conditions and may mislead physicians to a different diagnostic path than TMD. Patients, unaware that the symptoms originate from TMD, typically have seen various specialists before they end up at a dental office. It is only after all other conditions are ruled out that TMD is left as the final diagnosis. As a result, the patients can go on for years in pain and are managed with medications.  

Whether you need a Sports guard, Night guard, TMD appliance, or sleep apnea appliance, OneGuard will fit your needs!  Temporomandibular joint dysfunction can cause chronic facial and jaw pain. The TMD appliance can ease and relax the jaw and neck muscles. Sleep apnea causes disruptions of sleep, snoring, and fatigue. This kit can create an appliance to reduce snoring and get you feeling energized again!  Most sports require a mouthguard to protect your teeth. Use OneGuard to make a customized guard for all your sports!  Are you grinding your teeth or clenching your jaw? Use OneGuard to make a customized guard to ease your bite. 

Botox relaxes muscles, it temporarily prevents nerve cell signals from reaching your muscles and reduces abnormal muscle contractions. With this in mind, you can understand how it can be useful for relaxing the muscles around your jaw, too. In patients suffering from TMJ disorder symptoms, Botox helps relax tense jaw muscles and alleviate pain. Once you get those muscles around your TMJ to unclench, you’re going to notice some other changes too. 

Once Dr. Kassab establishes that treatment should be beneficial to the patient, the patient will proceed to the appliance fabrication.  

This process consists of several steps:

1. Obtaining a physiological relaxed bite registration that is deprogrammed from the neuromuscular daily engrams of a pathological bite.  This bite provides the relationship between the top and bottom jaws during the appliance fabrication by the laboratory.  This position can not be arbitrary and is obtained after 45 minutes of TENs of the facial muscles.

2. Molds to send to the laboratory so that an appliance can be made.

This device is used to position the condyles in the fossa in a less pathological, more true anatomical position, reduce stress to the jaw joint, increase joint space, allow remodeling of the condyle, heal retrodiscal tissue, re-capture the dislocated articular discs, provide proper alignment of the mandible to the skull, reduce myospasm and pain, and maintain the muscles of mastication at their proper physiologic resting length. Please note that all treatment is neuromuscular and orthopedic in nature and necessitated by a medical condition resulting in head and neck pain and should be considered as a medical necessity. A Neuromuscular TMD removable mandibular orthotic is discussed with our patients, full time wear for up to 4 months then weaning off into nightly wear. We inform the patient that the goal is to resolve symptoms originating from TMD and then evaluate which symptoms persist after TMD therapy is completed so that the physicians can treat those independently. The patient will come in at least monthly for appliance adjustments, muscle testing, and monitoring by Dr. Kassab of symptoms resolution.