Because many common symptoms ofTMJproblems can be the result of other medical conditions, those who represent themselves as TMJ Doctors (or TMJ Specialists) must be able to not only recognize common TMJ problems, but also must be adequately trained and have sufficient past experience to enable them to accurately diagnose the vast number of other problems that can produce these common TMJ symptoms:
Whether the symptoms you are concerned about are due to a facial migraine, a nerve pain problem, disease in a salivary gland or sinus, a thyroid condition, brain tumor, or strained Temporomandibular joints and jaw muscles, the TMJ Doctor you see must be skilled in making what is called a differential diagnosis. From a patients perspective, that means you need to know with a degree of medical certainty that your TMJ problem istrulydue to a local muscle and joint problem, and not due, instead, to some underlying medical disease process.
He or she should also be involved with teaching, lecturing, and/or publishing, as these positions and efforts are a clear indication that there is a commitment to learning and advancement of knowledge.
Most important, dont be fooled by the TMJ Doctor who has high-tech computerized equipment that (allegedly) determines whether your bite is bad or if your jaw is in the wrong position. Though imaging technology (CT scans and MRIs) is often important in making an accurate diagnosis, the vast majority of all TMJ problems can be diagnosed accurately with a careful history and examination. The adage, The diagnosis is in the history if the doctor chooses to listen holds true in just about all these situations.
Lastly, because most TMJ problems respond to treatment over time and with supportive measures to heal the injured TM joints and muscles, treatment most commonly should not require changes to your teeth or bite. If your TMJ Doctor recommends ongoing bite adjustments (grinding the tooth surfaces with a drill), crowns to fix your bite, or extensive orthodontics as the primary focus of care, these should be looked at suspiciously, and you should definitely seek a second opinion.
Few parts of your body play as many roles in everyday life as your mouth, teeth, jaws, facial muscles, and other related structures. Daily acts of self-expression, such as talking, laughing or smiling, use these structures to shape the sounds we make and help mold our appearance. They also work together to help you enjoy your favorite foods. As you can see, your face and jaw play a vital role in some of the most important aspects of your life.
If, however, you suffer from facial pain or problems with your temporomandibular joints (TMJs) your whole world can change. These painful conditions can disrupt nearly every aspect of your daily life. In addition to causing you physical discomfort, facial pain, and TMD can significantly alter your diet, lead to medication overuse, limit intimacy and ultimately be responsible for emotional suffering and frustration. Thats where Dr. Donald R. Tanenbaum can help.
Dr. Tanenbaum is a Board-Certified Specialist in Orofacial Pain. His extensive training and over three decades of experience make him uniquely qualified to diagnose and treat facial pain, TMD, muscle pain disorders, nerve pain disorders, tension headaches, snoring, and sleep apnea. Equally important, he treats his patients with the compassion, understanding and personal attention they want and deserve.
While attending Columbia College of Dental Medicine in New York City, Dr. Tanenbaum envisioned having a practice that focused on facial pain, TMD and sleep-related breathing disorders. Since opening his doors over 35 years ago, he has achieved that goal. Throughout the years, Dr. Tanenbaum has watched this highly unique area of dentistry evolve and mature. His continual training and ongoing education have enhanced his knowledge and helped him stay on top of the latest diagnostic and treatment methods.
Dr. Tanenbaum is a past president of the American Academy of Orofacial Pain and an active member of the American Academy of Orofacial Pain, the American Board of Orofacial Pain, the American Academy of Sleep Medicine, theNew York Academy of Dentistry, and the American Dental Association.
Your care with Dr. Tanenbaum starts with an in-depth health history and discussion of your condition. He will then perform a comprehensive examination and obtain images to help identify the source of your pain or dysfunction. Dr. Tanenbaum offers a variety of hands-on testing methods and will utilize only those that are appropriate to your unique condition.
Dr. Tanenbaum has authored numerous scientific articles and co-authored a groundbreaking book,Doctor, Why Does My Face Still Ache?He lectures at national Orofacial Pain conferences, medical grand rounds, dental societies, and study clubs.
He is past president of the American Academy of Orofacial Pain and a member of the American Academy of Orofacial Pain, the American Board of Orofacial Pain, the American Academy of Sleep Medicine, the New York Academy of Dentistry, and the American Dental Association.
Director of annual Facial Pain/TMD/Sleep lectures for General Practice Dental and Pediatric Dental Residents within the Department of Dental Medicine, Northwell Health System at Long Island Jewish Medical Center, New Hyde Park, NY.
Botox is the most recognized name in a drug class called neurotoxins. It was first approved in2002as a cosmetic treatment to reduce facial wrinkles and frown lines. Soon after, it was discovered that Botox can be useful in treating a wider variety of muscle problems such as migraine headaches, cervical dystonia, excessive sweating, bladder overactivity, vocal cord paralysis, and the symptoms of TMJ, to name a few.
Today, Botox and other neurotoxins are widely promoted as treatments to manage the symptoms of temporomandibular problems (TMJ). If you are considering Botox for TMJ, its important to understand what it is and how it works.
The most common words used to describe Botoxs impact on muscles are weaken, relax, inactivate, and partially incapacitate. In essence, Botox reduces the ability of specific muscles to contract to their full extent. Therefore, it can be an effective way to treat muscle stiffness, spasm, and overactivity.
Patients can experience pain relief after Botox injections because the drug leads to a reduction in lactic acid and other pain-producing substances found in over-contracted muscles. Botox also appears to reduce the release of pain-producing chemicals associated with peripheral nerve endings. This is why Botox, as a result of ongoing research, is being utilized as an option to treat neuropathic or neuropathy pain.
Botox works by blocking electrical signals from nerves to muscles. Although the brain may be telling muscles to contract with normal force, the muscles do not completely receive that message as long as the Botox is active. After an injection, Botox typically does not start working for three to five days and usually remains active for approximately three to five months.*
Botox, when injected by a trained clinician, stays where it is put. It does not roam throughout the body or spread to adjacent muscles, assuming the proper volume and techniques are used. While swelling and bruising can result, its often dependent on the clinicians technique and the depth of the injections.
The majority of patients who ask for Botox are suffering from chronic jaw muscle pain, tightness, and soreness due to persistent muscle tension. This muscle tension is often due to bruxism, which is the grinding or clenching of the teeth, at night, during the day, or both. Other overuse behaviors, including excessive gum chewing, cheek and tongue biting, ice chewing, jaw muscle bracing, and nail and cuticle biting, can also cause jaw muscle pain during the day.
To treat TMJ symptoms, Botox is typically injected into the masseter and temporalis muscles, which are responsible for closing the jaw from an open position. Sometimes, Botox is also injected in the lateral pterygoid muscles, the ones responsible for mouth opening and side-to-side jaw motion.
Botox can be beneficial when first-line therapies have already been pursued with limited or no benefit. First-line therapies for TMJ include education, habit modification, exercises, oral and topical medications, dietary caution, physical therapy, and oral appliances.
Botox alone will not commonly help inflammatory pain in the TM joints or predictably reduce the clicking and locking of the TM joints associated with loose ligaments and changes in the shock-absorbing discs position.
Botox is often used to help break a cycle of pain, reduce suffering, and buy time for the patient, but only when other therapies have been ineffective. Patient participation to reduce the risk factors that cause the jaw muscles to contract must continue in order to maximize the benefit of the Botox and reduce the need for ongoing injections.
Because Botox is most commonly used for patients who have suffered for a long time due to both known and unknown factors, one injection series typically will not, on its own, solve the problem. Symptoms that have been reduced and or eliminated after the first injection session can, and often, return at variable degrees of intensity requiring subsequent injections. This occurs most commonly when the risk factors leading to muscle pain have not been controlled or eliminated.
Several ongoing studies have been designed to determine if Botox because it reduces muscle pull, could compromise the bone density of the TM joints. At the moment, results have been inconclusive. However, because of these concerns, there should be a baseline x-ray of the TM joints and follow up x-rays if Botox injections are ongoing.
Over time, Botox changes the jaw muscles composition, increasing the volume of collagen and fat, and shrinking the size of muscle fibers. A series of injections in the masseter muscles can slim a facial profile without compromising jaw function or eating ability.
However, when the temporalis muscles are also injected due to cosmetic concern of bulkiness and/or headache pain, care must be taken to avoid a hollow, caved-in appearance over time. This is another reason to choose an experienced, trained clinician.
Botoxs use in children and young teenagers should be avoided. As the bone mass of the TMJs has not fully matured at these young ages, reducing muscle pull around the TM joints as a result of Botox injections is contraindicated.
In summary, Botox is not a cure, but an extremely valuable tool in unwinding years of jaw muscle pain for patients who continue to suffer. Botox is one of many tools orofacial pain specialists like me use to help our patients who suffer from TMJ problems.
Reviews
Rating 3.8 out of 5 based on 19 reviews
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newest oldest highest lowestDeb Brown
a year ago
Look no further than Dr. Donald Tanenbaum if you are suffering with jaw pain. Dr. Tanenbaum wasted no time diagnosing the issue and putting me on a path to recovery. I had been suffering with excruciating jaw and ear pain. I was at my wits end! I struggled to find a doctor who would hear me out before jumping to conclusions. Dr. Tanenbaum listened. He was also very compassionate. He spoke to me on a level I could understand rather than using medical jargon that was over my head. With Dr. Tanenbaum's expertise, plus Physical Therapy, I'm thrilled to say that I am pain-free! Becoming a specialist in treating orofacial pain requires a commitment above and beyond dentistry. There are not enough doctors like this out there. I consider myself very lucky to have found Dr. Tanenbaum.
Ashley Mercado
2 years ago
Horrible experience and I didn't even go to the appointment. Had to cancel the morning of because of a funeral and they still charged me $400 to cancel the appointment...ridiculous cancellation fee which is almost how much the appointment itself would have cost. They asked if I wanted to reschedule and I said absolutely not.
T Fan
2 years ago
Dr. Tanenbaum is one of the most humble, honest and caring practitioners I have known. As a former associate of his, I have seen him help patient after patient.... after patient... over many years. I only wish I had the knowledge and the patience he possesses to treat the ever so challenging and complex conditions of facial pain and TMJ disorders. When you see Dr. Tanenbaum, you are receiving over three decades of education, training, knowledge and experience that make this gentleman's expertise surpass many by far. If you are suffering from a TMJ disorder or facial pain, I hope you are lucky enough to become one of his patients.
T Fan
3 years ago
Dr. Tanenbaum is one of the most humble, honest and caring practitioners I have known. As a former associate of his, I have seen him help patient after patient.... after patient... over many years. I only wish I had the knowledge and the patience he possesses to treat the ever so challenging and complex conditions of facial pain and TMJ disorders. When you see Dr. Tanenbaum, you are receiving over three decades of education, training, knowledge and experience that make this gentleman's expertise surpass many by far. If you are suffering from a TMJ disorder or facial pain, I hope you are lucky enough to become one of his patients.
Ashley Mercado
3 years ago
Horrible experience and I didn't even go to the appointment. Had to cancel the morning of because of a funeral and they still charged me $400 to cancel the appointment...ridiculous cancellation fee which is almost how much the appointment itself would have cost. They asked if I wanted to reschedule and I said absolutely not.
Charlie Batista
3 years ago
I originally posted my review on February 17, 2020, however it mysteriously disappeared from Google. Last year I was referred to Dr. Tannembaum's practice by my primary dentist after he suspected that my oral-facial pain was originating from my temporomandibular joints. When I visited Dr. Tannembaum's office, he examined my teeth and took a panoramic x-ray of my mouth. Afterwards, he determined that my pain and associated symptoms were due to emotional stress and recommended that I seek cognitive behavioral therapy. I followed Dr. Tannembaum's advise but the symptoms persisted. A few months later, I was examined by a Neuromuscular Dentist who determined that my symptoms were originating from a misaligned bite. This diagnosis was confirmed with panoramic oral x-rays and other specialized tests, which are unique to measuring the functionality of the mastication muscles. That doctor recommend that I wear a customized bite splint and referred me to a Cranio-Cervical Physical Therapist. This course of treatment has proven effective towards relieving my symptoms. Had Dr. Tannembaum diagnosed me correctly, my condition would have improved sooner. I wasted my time and money by visiting Dr. Tannembaum's practice.
Daniella Weiss
3 years ago
I had severe pain from TMJ and the exercises and night guards for my teeth that Dr. Tannenbaum gave me changed my life
Charlie Batista
4 years ago
I originally posted my review on February 17, 2020, however it mysteriously disappeared from Google. Last year I was referred to Dr. Tannembaum's practice by my primary dentist after he suspected that my oral-facial pain was originating from my temporomandibular joints. When I visited Dr. Tannembaum's office, he examined my teeth and took a panoramic x-ray of my mouth. Afterwards, he determined that my pain and associated symptoms were due to emotional stress and recommended that I seek cognitive behavioral therapy. I followed Dr. Tannembaum's advise but the symptoms persisted. A few months later, I was examined by a Neuromuscular Dentist who determined that my symptoms were originating from a misaligned bite. This diagnosis was confirmed with panoramic oral x-rays and other specialized tests, which are unique to measuring the functionality of the mastication muscles. That doctor recommend that I wear a customized bite splint and referred me to a Cranio-Cervical Physical Therapist. This course of treatment has proven effective towards relieving my symptoms. Had Dr. Tannembaum diagnosed me correctly, my condition would have improved sooner. I wasted my time and money by visiting Dr. Tannembaum's practice.
Daniel Gatta
4 years ago
For a few months I was having terrible pain and tightness in my neck and jaw area. After a few visits with treatment from Dr. Tanenbaum I experienced a great deal of relief in those areas. Highly recommend!
Daniella Weiss
4 years ago
I had severe pain from TMJ and the exercises and night guards for my teeth that Dr. Tannenbaum gave me changed my life
Lauren Daitz
4 years ago
I have struggled with TMJ for years, as well as other issues that affect my neck and jaw. My regular dentist gave me something to protect my teeth, but the pain became unbearable. He suggested a specialist, and recommended I go see Dr. Tanenbaum. I am so lucky! He looks at TMJ from a thorough, holistic perspective. He listed to my complaints, and provided a comprehensive plan involving relaxation, mouth guards, and meditation. In just a couple of months, I am feeling so much better!
Mikey Malaszczyk
4 years ago
Dr. Tanenbaum saved my life. After randomly developing tinnitus while at college with no seeming cause (and thus no way to alleviate it), I developed TMJ from over-clenching my jaw from the stress of it. As a result, not only was I in constant discomfort from the tinnitus but in chronic pain in my head, jaw, neck, and even shoulders and there was no escape. Dr. Tanenbaum was the first doctor I saw who seemed to understand how this was affecting me, and set me on the right course. He made a bite plate (which I now swear by), sent me to physical therapy, and was even able to convince my parents, who were understandably apprehensive about certain medications, of how dire my situation was and thus paved the way for me to get the right psychiatric care to deal with the tinnitus. Although I'm not 100% better yet and am still under his care, Dr. Tanenbaum has greatly alleviated both my physical and emotional discomfort. I would recommend him to anyone; it is absolutely worth the money.
Nency Konsky
4 years ago
Dr. Tanenbaum is simply the best. He is gentle and patient. He has great bedside manner and really listens to his patient's concerns. I was in pain for months until I finally got referred to Dr. Tanenbaum. He has helped me tremendously. I would like to thank him and his staff (everyone is incredible and so nice)! I highly recommend him for anyone suffering with TMJ.
Lauren Daitz
4 years ago
I have struggled with TMJ for years, as well as other issues that affect my neck and jaw. My regular dentist gave me something to protect my teeth, but the pain became unbearable. He suggested a specialist, and recommended I go see Dr. Tanenbaum. I am so lucky! He looks at TMJ from a thorough, holistic perspective. He listed to my complaints, and provided a comprehensive plan involving relaxation, mouth guards, and meditation. In just a couple of months, I am feeling so much better!
Michele Trombetta-Lipinsky
4 years ago
I have been a patient of Dr. Tanenbaum's with much success for about 15 years now. I only wish I had seen him sooner instead of exhausting other options that didn't work. A great specialist and the only one I would see for TMJ issues.
Daniel Gatta
4 years ago
For a few months I was having terrible pain and tightness in my neck and jaw area. After a few visits with treatment from Dr. Tanenbaum I experienced a great deal of relief in those areas. Highly recommend!
Nency Konsky
5 years ago
Dr. Tanenbaum is simply the best. He is gentle and patient. He has great bedside manner and really listens to his patient's concerns. I was in pain for months until I finally got referred to Dr. Tanenbaum. He has helped me tremendously. I would like to thank him and his staff (everyone is incredible and so nice)! I highly recommend him for anyone suffering with TMJ.
Mikey Malaszczyk
5 years ago
Dr. Tanenbaum saved my life. After randomly developing tinnitus while at college with no seeming cause (and thus no way to alleviate it), I developed TMJ from over-clenching my jaw from the stress of it. As a result, not only was I in constant discomfort from the tinnitus but in chronic pain in my head, jaw, neck, and even shoulders and there was no escape. Dr. Tanenbaum was the first doctor I saw who seemed to understand how this was affecting me, and set me on the right course. He made a bite plate (which I now swear by), sent me to physical therapy, and was even able to convince my parents, who were understandably apprehensive about certain medications, of how dire my situation was and thus paved the way for me to get the right psychiatric care to deal with the tinnitus. Although I'm not 100% better yet and am still under his care, Dr. Tanenbaum has greatly alleviated both my physical and emotional discomfort. I would recommend him to anyone; it is absolutely worth the money.
Michele Trombetta-Lipinsky
5 years ago
I have been a patient of Dr. Tanenbaum's with much success for about 15 years now. I only wish I had seen him sooner instead of exhausting other options that didn't work. A great specialist and the only one I would see for TMJ issues.
TecaTime
5 years ago
Doesn't take insurance and overcharges.
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