TMJ Services, Nightguards, & Therapeutic Botox®

+ Custom Night Guards

What is a night guard?

A night guard, also known as a dental splint or occlusal guard, is a custom-made appliance that covers and protects the entire upper or lower arch of your teeth from the damaging effects of bruxism (grinding and clenching).  Bruxism is the medical term for forceful clenching and/or grinding of your teeth. It is considered a major cause of tooth problems. Some patients will say that they notice signs of wear, but it is not just a cosmetic problem (although worn down teeth can age you as bad if not worse than wrinkled skin).  If you have been diagnosed with bruxism, a night guard will be recommended to treat and to prevent further wear, fractures, and damage to your teeth due to clenching, grinding or bite issues.  Our comfortable, custom-made night guards are designed to fit your specific grinding pattern and are made to fit your teeth exactly.

How does a night guard work?

A night guard works in a few ways. First, it works as a shock absorber by distributing the forces during grinding and clenching at night. A night guard prevents fractures by protecting the teeth and preventing traumatic interferences. Additionally, it prevents wear on the biting/chewing surfaces, so instead of grinding away the protective hard outer covering of the tooth (enamel), you grind on plastic. It can also help treat TMJ disorders by relaxing the jaw joints and “de-programming” the muscles to prevent extra movements that can wear the jaw joint and inflame muscles causing them to be tight and often painful.

How do I know if I need a night guard?

There are many reasons a night guard might be right for you. While it can vary from person to person there are several common symptoms that affect the majority of patients with grinding & clenching:

• Headaches or toothaches upon waking
• Sore muscles or tender jaw joints
• Popping, grinding or clicking of the jaw joint
• Abnormal tooth wear. Your teeth may have a flat worn appearance or look very short.
• Damage or wear to your teeth or dental restorations
• Pain throughout the face, head, neck and shoulders
• Your sleeping partner may report that you make grinding noises in your sleep.

What Happens If I Grind My Teeth and Don’t Wear a Night Guard?

The action of grinding- where your upper and lower teeth move back and forth with great force against each other- causes your teeth to flatten. Allowed to persist, grinding causes temperature sensitivity, pain because the wear gets down to the nerve, cracks in the teeth, receding gums and eventually lost teeth. To fix these, patients will need crowns, bridges, veneers, implants, extractions & root canals. Grinding can also cause migraine headaches and pain in the shoulders, neck, back and ears.

Athletic/Sports Guard 

Dental injuries are common in collision or contact sports and recreational activities. In fact, it is estimated by the American Dental Association that mouth guards prevent approximately 200,000 injuries each year in high school and collegiate football alone. Properly diagnosed, designed, and custom fabricated sports mouth guards are essential in the prevention of athletic oral/facial injuries. Dr. Larhs promotes the importance of safety in maintaining oral health and the use of a properly fitted sports mouth guard.

+ Therapeutic TMJ Botulinum A injections (BTX, e.g. Botox®)

Subconscious parafunctional habits, such as clenching and grinding your teeth, will build up the chewing muscles - much like weight training builds muscle in the rest of the body. Some of the chewing muscles extend to the temples and side of the head. Bigger, stronger chewing muscles result in bigger, stronger clenching/grinding - leading to an often painful vicious cycle.

Botulinum A injections (BTX, e.g. Botox®) will help with targeted weakening of the muscles involved, thus literally breaking the cycle. Although this muscle weakening effect is transient and the injections may need to be repeated after some months, the muscles decrease in size (much like any muscle that we don't work out) and require lower dose injections at less and less frequent intervals.

Here are several of the major benefits BTX offers TMJ sufferers:

• Elimination of headaches caused by nighttime grinding.
• Minimization of lockjaw.
• Reduced discomfort when using the jaw.
• Reduced shoulder and neck pain.
• Substantially reduced jaw tension.

What’s involved when getting Botox® injections?

• Prior to administering BTX injections, the dentist needs to check the patient’s suitability for treatment. When used in conjunction with certain medications and substances, BTX may not produce the desired results. It is exceptionally important therefore, to be honest about prior medical history. BTX is not recommended for pregnant or lactating women.
• The BTX injections take minutes to administer, depending on the amount required. Because it is non-surgical, the BTX procedure will be performed at the dental office. Driving ability will not be impaired by the treatment, so there is no need for a designated driver. The injections are no more painful than a bug bite or pinprick.
• Normal activity can be resumed immediately after the BTX treatment, but strenuous activity and rubbing/touching of the face should be avoided for 4 hours after treatment. It may take several days to feel the full benefits of the treatment, but BTX will continue to work for approximately 4 months.