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TMJ, Bruxism and Obstructive Sleep Apnea

Many patients suffer daily headaches, neck pain,  jaw pain, and even ear pain, that can be related to

dysfunction or disease of the Temperomandibular joint or TMJ. Bruxism can exacerbate TMJ

pain and dysfunction, also causing head and neck pain, and can even result in broken teeth.

The following is an excellent overview and explanation to patients of the distinction

between bruxism and TMJ disorder.


Many patients suffer daily headaches, neck pain,  jaw pain, and even ear pain, that can be related to dysfunction or disease of the Temperomandibular joint or TMJ. The joint consists of the condyle which is a part of the mandible or lower jaw, and a disc that sits between the condyle and scull. Clicking or popping when opening or closing is a result of the disc coming off the condyle and can sometimes be associated with pain.

Dr.’s Mike and Tina Cox have taken additional training to be able to treat TMJ pain and dysfunction. If you are living with daily head and neck pain, make an appointment to see how we can help you today!

Bruxism (Teeth Grinding) / OSA

Most people who grind their teeth do so at night while they sleep. A lot of times, the patient will wake up in the morning with discomfort of the masseter or “cheek” muscles, and headaches related to their bruxing at night. When we sleep we put roughly 3 times the amount of force on our teeth than we do during the day. Over time, this can lead to broken or fractured teeth and dental restorations. Bruxism, a lot of times is directly related to having Obstructive Sleep Apnea or OSA.  When we grind our teeth, we move our lower jaw forward, which in turn, opens the airway. The brain signals for you to grind your teeth when you stop breathing, in order to get oxygen to your brain. Bruxism can exacerbate TMJ pain and dysfunction, cause head and neck pain, and even result in broken teeth.

Obstructive Sleep Apnea happens when the tongue and soft palate falls to the back of the throat, completely blocking the airway while you’re asleep. This cuts off the oxygen intake, and the patient stops breathing for a period of time. Your brain then has to try to wake you up either through diaphragm muscle spasms or bruxism. This results in an interrupted sleep pattern, and poor night’s sleep. People with OSA are constantly tired, fall asleep easily during the day when they have down time, are irritable, and have trouble concentrating.  

“Sleep deprivation impair cognitive and motor

performance as much as alcohol intoxication”

Alice A Kuo MD, University of California, Los Angeles School of Medicine

OSA affects up to 40 million Americans with less than 10% of OSA sufferers diagnosed. OSA can triple the stroke risk in men, and has a direct correlation to hypertension, which can put patients are risk for heart attacks. If untreated, OSA can take on average 12 years off your life and increases the risk of death by 46%, making it more dangerous than smoking.


Risk Factors for OSA: Weight gain, BMI greater than 30, neck circumference equal to or greater than 15 inches in women and 17 inches in men, smoking, mouth breathing,  diabetes, and hypertension.

Treating OSA and Bruxism: Depending on the severity of OSA and Bruxism, treatment options include an oral appliance, CPAP, or surgery. If Dr Mike and Dr Tina suspect you have OSA and/or bruxism they will recommend you take home a sleep monitor distributed by our office which will test for both bruxism and OSA. You will then return the sleep monitor to the office the following morning, and the doctors will read the results of the sleep test. If diagnosed, the results of the sleep test will be read by a Board Certified Sleep physician, that will give a diagnosis of mild, moderate, or severe OSA and bruxism. Our office will work with the patient’s physician if mild or moderate OSA and bruxism are diagnosed, in order to make the proper oral appliance for the patient. Most medical insurances will cover the cost of these oral appliances.

For mild to moderate OSA, and especially for people who cannot tolerate a CPAP, a custom oral appliance is the standard of care. For severe OSA, the patient may best be treated by a CPAP or surgery.

Ask us today about treatment options for teeth grinding, TMJ, and obstructive sleep apnea. It will change your life and the life of someone you love!

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