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Dr. Caroline Downing
103/156 Military Rd, Neutral Bay, NSW
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TMJ Disorders

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Jaw Disorders

Headaches when you first wake up, tightness in the muscles of your head and neck, clicking and popping in your jaw joint, limited opening, pain in your jaw joint or difficulty in holding your jaw open are all signs and symptoms of jaw joint issues also known as Cranio-mandibular disorder (CMD).

What Is CMD?

Sometimes there are tooth related or bite related causes for CMD. Some people, due to personality type, carry out night time grinding (bruxing) and this can create CMD symptoms.

It is a complex area with many schools of thought on management of these cases. After 25 years of treating CMD patients I have a high success rate of successful management and resolution.

Patients often underestimate how painful and damaging CMD can be. In some cases it can be so debilitating that patients are unable to open their mouths or carry on with normal day to day activities.

Jaw Pain

CMD can be episodic and is often made worse by stress. Discrepancies in the way our teeth come together, the direction our muscles move and the internal arrangement of the jaw joint can all influence the health of this system.

I use occlusal splint therapy, behavioural modification and neuromodulators (botox) to manage these issues.

Frequently Asked Questions

What is an occlusal splint?

An occlusal splint is a clear hard plastic removable layer that is worn over the top or bottom teeth. It produces an even, symmetrical and simultaneous contact between teeth when your jaw is in its correct position and allows the muscles to act in the correct orientation. It is part diagnostic and part therapeutic in that it allows muscle relaxation and resolution of internal derangement of the TMJ. It also allows us to diagnose any tooth related causes for CMD.

How do neuromodulators (botox) help with jaw issues?

In some people who are bruxers (teeth grinders) the muscles that control this action around the cheeks and the temples can become enlarged and very painful due to overwork and build- up of lactic acids. These muscles often feel hard to touch as they are in spasm. The addition of neuromodulators reduces the muscle firing and allows the muscle to relax. It does not stop the muscle from working and MUST be used in combination with occlusal splint therapy and correct diagnosis.

Will my jaw issue just go away?

CMD can resolve sometimes as it is often episodic and occurs in relation to stress. As it is often related to certain personality types there is generally a family predisposition. High achievers, goal orientated and successful people have a higher incidence of CMD. We often try some behaviour modification first to manage the issue before further treatment.

What are the effects of jaw issues on my health?

When your jaw is not working correctly you may find that

• You cannot chew effectively

• You have headaches, pain and general discomfort

• If you grind your teeth, the teeth will become sensitive, you will crack teeth and fillings, you may cause the gum to recede and you will wear away the enamel from your teeth

• The muscles around your lower cheek area may become enlarged and painful

• You may suffer from headaches, ringing in your ears and ear ache

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Dr. Downing's Reviews

Read Real Patient Stories About Their Experience with Dr. Downing and Team...

Excellent dental care for all members of our family and lots of proactive advice, strongly recommend mdt

Patina M.

ENJOYABLE!!! – and that’s an amazing thing to say of a dental appointment

Ken B.

Painless and Dr Caroline always explains things so it’s easy to understand

Alicia D.

ASK DR. DOWNING call her office at 02 8188 4520 or send a message.