Residency Trained to treat TMJ and TMD,
Dr. Stephanie Vondrak


TMJ Video

Credentialed in TMJ Therapy and the treatment of Head and Neck pain, Dr. Stephanie Vondrak has completed over 500 hours of advanced education in TMJ treatments and earned Fellowship Status with the American Academy of Craniofaical Pain. Dr. Vondrak completed advanced dental education on the treatment of Temporomandibular Joint Disorders, occlusion (bite), Sleep Disordered Breathing, and Invisalign Orthodontics.

Dr. Vondrak specializes in the treatment of:

  • Temporomandibular Joint Disorders
  • Occlusion (bite)
  • Sleep Disordered Breathing
  • Invisalign Orthodontics

Through her educational pursuits, Dr. Vondrak has mastered the skills necessary to help those suffering from TMJ symptoms find relief and comfort. Her office provides quality care focused on individual symptoms and pain relief.


The following information will help you understand Temporomandibular Joint Disorder as well as Dr. Vondrak's systemic health-centered treatment approach. If you are interested in making an appointment with Dr. Vondrak for evaluation of your TMJ symptoms please do not hesitate to call (402) 289-2313.

TMJ Symptoms

Overview of TMJ / TMD


Most Common Symptoms:

  • Head and Neck Pain
  • Headaches
  • Ear Pain
  • Popping, Clicking or Locking of Jaw Joints
  • Ringing in the Ears
  • Jaw Muscle Fatigue

More: Understanding TMJ / TMD Symptoms


Most Common Disorders:

  • Displaced disc(s) in the TMJ joint(s)
  • Trigger points in muscles (myofascial pain)
  • Inflammation in groups of muscles (myositis)
  • Uneven bite
  • Destructive occlusion
  • Clenching and or grinding of your teeth
  • Forward head posture
  • Sacroiliac dysfunction
  • History of trauma

More: How TMJ / TMD is Diagnosed


Treatment Options Offered:

  • Splint therapy
  • Heat therapy and relaxation techniques
  • Injection therapy using Xeomin/Botox

More: TMJ / TMD Treatment Options

Understanding your Temporomandibular Joint (TMJ) and Crainofacial Pain


The Temporomandibular joint is a complex, joint system attaching your lower jaw (your mandible) to your skull. The TMJ joints function similar to other joints in your body allowing movements like opening your mouth and moving your jaw side to side. These movements are controlled by muscles known as the muscles of mastication. These muscles allow you to chew and talk. Additionally, you have muscles on your face known as your facial muscles and muscles in your neck often referred to as your postural muscles. All of these muscles and your TMJ joint (bone and cartilage) make up your ORAL SYSTEM.


Why is the ORAL SYSTEM important?


The broad term "TMJ DISORDER" refers to the functional disorder (breakdown) in the coordination of - the components of - the ORAL SYSTEM. In other words, movements between the muscles of mastication, the cartilage in the TMJ joint known as the disc and hard structures of the jaw (bone and teeth) are not moving in coordination with one another. This means at least one of the components of the ORAL SYSTEM is compromised. This compromise can cause pain like facial pain, TMJ pain, head and neck pain, headaches, ear pain, popping or clicking of your jaw joints or ringing in the ears. At Vondrak Dental, our goal is to properly diagnose your TMJ Disorder for accurate, effective treatment options. WE want you to FEEL better!



Understanding Your Symptoms


TMJ pain is different for each individual. Some people feel pain in their jaw joints but more commonly, individuals experience pain in their face, ears or neck. Often TMJ pain causes headaches across the forehead, at the temples or in the occipital region (back of the head). Explaining the type of pain you are experiencing and the location of your pain or headaches will help Dr. Vondrak determine your diagnosis and treatment options.


Some patients do not qualify their symptoms as "painful." These individuals usually describe feeling tension or tiredness in their jaws especially in the mornings, saying, "It is too much work to chew their food". These symptoms are important to Dr. Stephanie Vondrak as well. Dr. Vondrak’s goal is to understand what you, the patient, is experiencing, how and when these symptoms occur and for how long they have been bothering you. With a detailed history, Dr. Stephanie Vondrak will begin to assess your specific TMJ needs and the treatment options that are right for you.


Problems with clenching and/or grinding of teeth are also likely when you are experiencing TMJ symptoms. Indications that you are clenching and/or grinding your teeth include: waking up with sore fatigued muscles, waking up with headaches or jaw pain, your jaw popping, clicking or locking upon waking, or fullness in the ears first thing in the morning. If you have symptoms of clenching and/or grinding of your teeth, these symptoms will be addressed in your treatment recommendations. As discussed below, different types of custom appliances (splints or guards) can be made to decrease your symptoms as well as to decrease the intensity and severity of your clenching and/or grinding.


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TMJ Exam

TMJ Diagnoses


As previously stated, symptoms of TMJ disorder vary from patient to patient. However, many of the symptoms have similar origins. Most commonly found are individuals with a displaced disc(s) in the TMJ joint(s), trigger points in muscles (myofascial pain), inflammation in groups of muscles (myositis), or a combination of the above. According to your specific diagnosis, treatment options will be given and a plan of action to treat your pain discussed. Contributing factors in your diagnosis include: uneven bite, destructive occlusion, clenching and or grinding of your teeth, forward head posture, sacroiliac dysfunction, and/or a history of trauma. If for example, you have a narrow arch form or teeth that are severely tipped in, these findings will be included in your diagnosis and treatment suggestions given. Dr. Stephanie Vondrak believes in addressing the needs of the entire ORAL SYSTEM for effective, long-term results.



RECORDS

At Vondrak Dental, your RECORDS appointment is the first step in obtaining your TMJ Diagnosis. At this visit, Dr. Stephanie Vondrak will spend one-on-one time with you completing a detailed history and listening to your specific concerns. Dr. Vondrak will complete a comprehensive TMJ exam including: evaluation of your muscles of mastication, your postural muscles, your occlusion, your TM joints, the range of motion of your jaw, your posture, etc… Models of your teeth and measurements of your bite will be taken. X-rays of your teeth may be recommended as well.


With this information, Dr. Vondrak will use her care, skill and judgement to determine your clinical diagnosis and possible treatment options. When splints are recommended, Dr. Vondrak makes every effort to fabricate splints quickly often helping individuals find relief within days of their initial visit. If injection therapy is indicated, some situations allow for injections during the Records appointment.


At Vondrak Dental, we understand that many of our patients have been looking for answers to their TMJ/head and neck pain for many years. We understand the desire you have to feel better quickly and will make every effort to address your needs as quickly as possible.



IMAGING OF THE JOINTS

Following your RECORDS appointment, Dr. Vondrak will likely refer you to have imaging of your TMJ joints completed. She will either recommend an ICAT scan or an MRI. The purpose of imaging is to verify your clinical diagnosis. Once the imaging of your joints is completed Dr. Vondrak will receive a disc of the images to review as well as a Radiology report. These findings will be discussed with you at your next visit.


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TMJ Treatment Options


Dr. Vondrak has mastered the skills necessary to help those suffering from TMJ symptoms find relief and comfort. Her office provides quality care focused on individual symptoms and pain relief.



SPLINT THERAPY


Custom lower splint made at Vondrak Dental

Splint Therapy is completed over a period of months and is similar to "physical therapy" for the jaws. Splint therapy involves wearing a custom-made splint to relax muscles and correct jaw position. Dr. Vondrak personally designs and fabricates all splints in her office with the goal of stabilizing the oral system and eliminating pain. Splints are designed to meet the needs of your specific diagnosis. For example, if you have a displaced disc an ARS (Anterior Repositioning Splint) may be recommended to re-position your jaw in an attempt to re-position your displaced disc. If your diagnosis is muscle related, a "stress reducing splint" may be recommended to decrease the forces on your muscles allowing relaxation and pain relief.


Types of Splints that may be recommended include: ARS (Anterior Repositioning Splints), MAGO (Maxillary Anterior Guidance Orthotic), Flat plane splints, Tanner appliances, Thermoflex protective guards, NTI-like splints, or a combination of the above. Many patients wear splints 24 hours a day during active TMJ therapy for the purpose of stabilizing the jaws in a "healing position." Once splint therapy is complete, patients often wear a nighttime appliance only like a retainer to maintain the health of their TMJs.


The length of Splint therapy is usually 4-6 months. Dr. Stephanie Vondrak will review the details of your diagnosis and treatment length depending on your specific needs. During your splint visits, we will assess the following: the fit and effectiveness of your splint(s), improvements in ROM (range of motion), improvements in muscle health, and a decrease in overall symptoms. Adjunct therapies like spray and stretch or lidocaine trigger point injections may be completed as well. Dr. Stephanie Vondrak may ask you to complete a diet or exercise log if she feels this will help you achieve a better long-term result. Additionally, you may be given home exercises designed to improve posture and range of motion.



HEAT THERAPY AND RELAXATION TECHNIQUES

At Vondrak Dental, we provide a comfortable quiet atmosphere to allow you to relax and concentrate on feeling better. We understand the stresses of daily life and how stress is a contributing factor to headaches, and jaw pain. Through heat therapy and relaxation techniques, we can help you feel better and progress through your splint therapy with excellent results.



Botox/Xeomin Injection Therapy
Injection Points of Botox/Xeomin Therapy

INJECTION THERAPY USING XEOMIN/BOTOX

Xeomin/Botox prevents muscle contraction by inhibiting neurotransmitter release. When used to control pain, Xeomin is injected in hyperactive, sore muscles. The injected muscles then relax and feel better. Therapeutic Xeomin injections are effective in decreasing headaches and controlling pain in muscles of the face, head, neck and shoulders. Xeomin injections will last approximately 3 months. New injections can be completed after 3 months for desired results. READ MORE



THERAPEUTIC INJECTIONS

Adjunct treatments to ease muscle pain are also provided at Vondrak Dental. These therapies include: Lidocaine trigger point injections, Therapeutic Botox/Xeomin injections, Heat Therapy, Spray and Stretch Techniques and more. Vondrak Dental believes in treating the whole patient and providing many treatment options to ease TMD, headaches, and head and neck pain.


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