The Brad Weisman Show

TMJ Disorders and Sleep Apnea: Treatments with Dr. Tammy Balagtek

February 29, 2024 Brad Weisman, Realtor
The Brad Weisman Show
TMJ Disorders and Sleep Apnea: Treatments with Dr. Tammy Balagtek
Show Notes Transcript Chapter Markers

Discover the hidden connections between your jaw pain, headaches, and sleep quality as Dr. Tammy Balagtek takes us on an insightful journey into TMJ disorders and their treatments. Don’t suffer in silence; one in four people experience TMJ issues, and many don't realize the root of their discomfort. Through an engaging conversation, Dr. Balagtek breaks down the jaw joint's complexities, explaining the multifaceted approach to treatment that extends beyond the dental chair to encompass overall health and well-being.

We often overlook the powerful link between our craniofacial health and sleep disorders.  Dr. Balagtek reveals how nighttime teeth grinding isn't just a nuisance—it's a sign of airway restriction and can indicate a more severe condition like sleep apnea.  Our discussion uncovers the transformative power of custom oral appliances and non-invasive therapies, showing that relief from chronic pain and sleepless nights might be a well-fitted mouthpiece away.

Wrapping up our time with Dr. Balagtek, we reflect on the profound impact that modern dental medicine can have on our lives.  My wife's journey to finding solace from persistent pain underscores the potential for change.  Whether you're struggling with jaw discomfort or sleep disturbances, this episode is an essential resource, providing strategies for recovery and a blueprint for a healthier, pain-free existence. Tune in for a conversation that could steer you toward the comfort and rest you deserve.
#tmj #bradweisman #thebradweismanshow #drtammybalagtek #sleepdisorders #sleepapnea

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Welcome to The Brad Weisman Show (formerly known as Real Estate and YOU), where we dive into the world of real estate, real life, and everything in between with your host, Brad Weisman! 🎙️ Join us for candid conversations, laughter, and a fresh take on the real world. Get ready to explore the ups and downs of life with a side of humor. From property to personality, we've got it all covered. Tune in, laugh along, and let's get real! 🏡🌟 #TheBradWeismanShow #RealEstateRealLife #realestateandyou

Credits - The music for my podcast was written and performed by Jeff Miller.

Speaker 1:

from real estate to real life and everything in between, the Brad Wiseman show and now your host, brad Wiseman. All right, here we are back in the studio again, how this is gonna be a really cool show. This is gonna be different than any show we have ever done before. In fact, you probably will realize that, because look what I have in my hands here. I have something with their teeth. They're not mine, they're actually Hugo's teeth. Hugo, these are your teeth. Right, that's right.

Speaker 2:

I'm sorry, hugo, but.

Speaker 1:

I had to use something as a sample, but no, we have Tammy Balachek here. Dr Balachek, she's here right now to talk about it's the Center for TMJ, tmj and sleep disorders. You actually well, I've known you for a long time, but you actually helped out my wife at one point. She had TMJ and we came to you, or she came to you and you made it all better. So it just has made me interested in this from that point on. So how you doing?

Speaker 2:

awesome. You're awesome. You're doing well. Thank you for having me and she brought toys.

Speaker 1:

This is the first guest that they get a lot toys, so so what am I looking at here?

Speaker 2:

you are looking at a plastic model of teeth okay and there is a clear aligner on top of that that's the invisible like an invisible line, like that.

Speaker 1:

So this is what what we have here. We have this thing here and what we're looking at is a set of teeth with the invisible line on there, and this is something they're using now to straighten teeth right, correct?

Speaker 2:

yeah, yeah, we wear a series of aligners and it'll straighten the teeth amazing, amazing.

Speaker 1:

Well, let's go back to TMJ, because that's the one that seriously blew my mind because of the amount of well, how many people have it?

Speaker 2:

there's a lot of people have it right the studies say maybe one in four people have a TMJ problem. How many that?

Speaker 1:

in. So that's one of four. How many that don't know? They have this because when I was looking at the, at the, what you could suffer from that, the TMJ it is incredible. I mean some of the stuff that stuck out to me neck and throat pain, I get that tired, tight jaws, pain behind the eyes. I mean that blew my mind. What is TMJ?

Speaker 2:

she'll tell you all right, good question question. Tmj is the name of the jaw joint, so I'm gonna hold this skull up here okay and from the side view, this hole would be our ear canal right and then, right in front of our ear, is our jaw joint, and that's the joint that connects the lower jaw to kind of like a hip joint almost right just like a hip, or okay, it's a ball in a socket joint okay have the ball part on the lower jaw and then the socket is the ear bone. So in your list of symptoms, that's where patients can have ear pain, yeah, or clogged ear feeling, and then there's a piece of cartilage in between, so there's supposed to be like a disc or meniscus in there.

Speaker 1:

Yeah, and that's a protective mechanism now, what do you find is is the norm. Is it that the cartilage isn't there? Is it that it's just misaligned from birth? Is it like? What are the causes of this?

Speaker 2:

it can be any stages in between, so the cartilage could be in place and someone could be clenching really hard okay muscle inflammation, leading to headaches. It could be the cartilage is slipping out of place and that causes popping and clicking sounds in the jaw and then it gets inflamed so it hurts, right, or the cartilage can get all the way out of place and then you get bone rubbing on bone and that's that's okay, that's arthritis and that's bad.

Speaker 1:

That's like a bad hip or a bad knee or whatever, because there's nothing there to protect the bone. Bone-on-bone. Now is there surgery that they do for these things too.

Speaker 2:

There is surgery, but it's not typically recommended. And that's because the jaw joints unique, because we have the teeth and the mouth as the end point. So if you did surgery but didn't correct the bite or how the teeth fit together, it may not help the alignment of the jaw Amazing. But something interesting about the jaw that the hips and knees can't do is it can generate new tissue. So there's a different type of cartilage that covers the jaw joint.

Speaker 1:

Yeah.

Speaker 2:

And it can actually make new bone and a disc in there with proper positioning. Really. So, yes, really, our knees can't do that. No hips can't do that.

Speaker 1:

Interesting See. Look at that, hugo, you didn't know that? No, I didn't know that that is pretty interesting, so it can actually regrow it can? That's amazing. Okay, so what do you find? People are coming into you with, like, what is the main symptom? People come in and go. I, just I, this is just driving me nuts, or I can't handle this. Is it, what is it? Headaches? Is it, what is it?

Speaker 2:

It's usually the point where their jaw gets locked and they can't open, and it actually gets locked. Yes, locked meaning they can't open it normally, so they have to limit how they eat their food. It's very painful because it's stuck and they can't chew right. So that's usually the point where patients come in.

Speaker 1:

Can you unstick that when they come in? We can. Yes, they punch them in the jaws. What they do, hugo, she just hauls off and nails them right. Not like popping a shoulder. No, it's not Okay. You don't just give them chewing gum or something. No, oh man.

Speaker 2:

We use a cold laser or an ultrasound on the joint to relax everything, and then we show them an exercise to do.

Speaker 1:

Wow.

Speaker 2:

And then, if that doesn't work, we prescribe appliances. So, the appliances. Just showing on the skull here can move the mouth open a little bit, which then moves the jaw to give room for that cartilage.

Speaker 1:

Unbelievable, yeah, and I think that's what Jess had, If I'm not mistaken. I know she had a lot of headaches, a lot of pain, like, like severe pain in the jaw and and I just remembered that. You know, and I have to say I'll be honest, at first I was not a believer. I was like you're telling me that this thing that you're putting in your jaw at nighttime or in your teeth at nighttime, is at it, right there, this piece of plastic.

Speaker 2:

That's it.

Speaker 1:

That piece of plastic is what's going to make you get rid of these bad headaches and the pain in your jaw. And there was a lot of things going on in her ears. She had pain in her ears and it was amazing. And the only reason I trusted is because I knew Tammy for years. I sold her house, or sold her house actually years ago. So I was like, okay, I trust her, she knows what she's doing, and it worked. It really worked. It relieved her pain and discomfort and grinding and all that stuff and to this day, you know, it's amazing she's now doesn't have to wear the appliance and it's still. It's still great. So that's the appliance, right there.

Speaker 2:

This is a sample appliance. This is an upper and a lower that connect to the teeth, and then it keeps the lower jaw in place. So it prevents it from falling out of position at night. Amazing, amazing, there's other appliances there's single arch ones which just go on the top teeth.

Speaker 1:

Okay.

Speaker 2:

These are commonly used for grinding at night.

Speaker 1:

A lot of people grind, don't they? And then they do. Why do we grind?

Speaker 2:

Well, that's a great introduction to sleep disorders. Yeah so at night, when we fall asleep, if the lower jaw and the tongue drop out of position, and I'm just going to hold up this view here. There's a nice view you can see, the airway is getting closed off. So you're showing, but is that the back of the?

Speaker 1:

tongue. So what she's showing on here is the back of the tongue, or the back. It's cutting off the airway.

Speaker 2:

Right. So the only body part that can move to fix that or give us more airway is this lower jaw, which connects at the jaw joint.

Speaker 1:

Why does it look like that? Guys are really fat tongue? Is that the way our tongues look when we're sleeping?

Speaker 2:

Because it goes back in there Our tongue is a large muscle and it fills the entire mouth, so then, when we relax, it loses its tone.

Speaker 1:

It looks like he has like something in his mouth. It's crazy. Okay, got it.

Speaker 2:

So clenching and grinding could be a response to the airway closing and then patients are basically doing CPR on themselves all night by moving the tongue and jaw forward for more breathing.

Speaker 1:

And that's not good.

Speaker 2:

That's not good.

Speaker 1:

Yeah, cause that's where you can really run into some problems.

Speaker 2:

Right, right. That can cause heart issues. It can cause stroke. There's a lot of let's go.

Speaker 1:

let's go back to the TMJ, and then we're going to go back into the sleep apnea too, Cause there, cause, there's some stuff about the sleep apnea and snoring thing which I never knew. What happens if you leave these things untreated, like the TMJ, what? What does it get to a point Like do you see people coming in that are really severe?

Speaker 2:

We do. The main thing that drives patients to us is the pain, the pain. So you can have an arthritic jaw that doesn't have a cartilage, but if it's not inflamed, it may not hurt, Right right. So the breakdown is that once the cartilage is out of place, then the bones can rub on the bone and cause the arthritis.

Speaker 1:

Got you.

Speaker 2:

But it's the inflammation in there that drives patients to come in. So we see 12 year olds with arthritis. Really, we see 80 year olds with arthritis. Interesting and it's all based on how much inflammation they have.

Speaker 1:

Amazing. Now, what about chewing gum? Because I chew gum a lot. Oh, did you see that face she made? She made a face that was like hmm.

Speaker 2:

We actually recommend if you can chew gum and you can use your jaw, go for it oh really. Because patients who have arthritis and they don't use their jaw. It forms scar tissue and adhesions in there and then it gets worse. I love chewing gum.

Speaker 1:

Thank God she didn't diss the gum chewing Go for it, yeah, and it's sugar free because you are a dentist. You are a dentist also, right? Yeah, so it doesn't hurt anything. No, that's fine. Okay, I was worried about asking that question because I like to chew a lot of gum and I was like, oh man, if she tells me that's going to hurt my jaw, it's going to really be bad.

Speaker 2:

Nope, you're good to go.

Speaker 1:

Good, good, good. I like chewing on things that are really hard. Is there anything that we shouldn't be chewing on to stay away from this kind of stuff, or that can make our situation worse?

Speaker 2:

Well, from a dental standpoint, chewing on ice is not a good thing, because ice will cause the teeth to get so cold. And then if there's any like fracture lines, or these lines they could break. So ice is not good in general.

Speaker 1:

Okay.

Speaker 2:

Any habits that move the jaw, like a pencil or even fingernail biting, you're moving the jaw position, so then that can cause the cartilage to move around.

Speaker 1:

So from that standpoint it's more about the structural way that your jaw moves of what you're chewing on Now, when you wear those up, is there a point where, like I've heard of people saying, they have like an underbite or an over? Is there a way that they can fix those things too? Obviously?

Speaker 2:

Sure, you can have orthodontics.

Speaker 1:

Yeah, now do you do that, we do. That's what I thought, okay.

Speaker 2:

Yeah, because a lot of patients who go through the TMJ treatment. They have crooked teeth to begin with and their jaws are out of alignment, and then, when the jaw's in alignment, they want better chewing functions. So then, they get their teeth fixed. Yeah, orthodontics.

Speaker 1:

Wow, amazing. All right, so let's jump back into the snoring and sleep apnea, because this was interesting for me. I read it on your website that I always thought that, basically, snoring and sleep apnea were the same thing, and it's not exactly the same thing, correct, it's actually different. So you could actually be a snorer without stopping breathing.

Speaker 2:

Many times in an hour, true, right. And you could have sleep apnea and not snore, and not snore. You could be a silent apnea.

Speaker 1:

That really blows my mind even more. You could be a silent sleep apnea. Yeah See, I always thought I was a person that was like, like really going at it. You know, that was the person that was like having a hard time, that's amazing.

Speaker 2:

Well, that's the stereotype, and that's why women are often underdiagnosed, because they're not loud snores.

Speaker 1:

Yeah.

Speaker 2:

And they might clencher, grind their teeth to clear their airway, but they might actually have sleep apnea.

Speaker 1:

Yeah. So going back to sleep apnea and how bad it can be, you can actually you can die from it.

Speaker 2:

You can die from it. Yes, if you stop breathing long enough and it shuts down the systems in your body, you can die from it.

Speaker 1:

It's amazing. And also high blood pressure, right.

Speaker 2:

High blood pressure, stroke, memory loss, feeling like you're in a fog, moodiness, anxiety, crazy All those things are symptoms.

Speaker 1:

Yeah, it's amazing. So now go back to. So what you do for sleep apnea is you're using an appliance, like you had said, to pull that jaw, to pull the jaw forward or to pull the tongue up and jaw forward, instead of other things like the CPAP machine, which looks like your Darth Vader, basically, or now it looks like you're a fighter pilot, did you see? Like you know, in Top Gun they wear those things when they that they breathe in. That's what the sleep apnea things look like the CPAP. Oh, you have a CPAP, exactly. Well, I have a picture of one.

Speaker 2:

So this is the CPAP mask. And it attaches to the nose, or the nose and mouth, and then there's a bedside unit that makes air pressure.

Speaker 1:

Right.

Speaker 2:

So because the airway is collapsing and the tongue's closing off the airway, this air pressure is blown through the throat and it keeps some pressure there, like blowing up a balloon, and then that keeps the airway open.

Speaker 1:

It's amazing. It has to be a little uncomfortable, I would think, or something.

Speaker 2:

I don't know A lot of patients, don't tolerate them well. Yeah, I would think, and you must tend to lay on your back, because if you turn on the side, the seal will break.

Speaker 1:

And then it doesn't work.

Speaker 2:

It can be ineffective.

Speaker 1:

Yeah, so then what's the other thing you got here?

Speaker 2:

Well, this is showing how the oral appliance works. So the oral appliance is a mechanical way to open the airway. So it hooks onto the teeth and then it pulls the tongue and jaw forward and opens up the airway.

Speaker 1:

Now does that uncomfortable? How does that feel inside your mouth? Does it feel like it's you're choking it on? No, just pulls the tongue.

Speaker 2:

You don't even feel it on the tongue it's just the action of the jaw and tongue moving forward that it creates more space In there.

Speaker 1:

Wow, have you ever used one?

Speaker 2:

I do. I wear one of these. I have mild sleep apnea.

Speaker 1:

Okay, okay.

Speaker 2:

I had some teeth pulled when I had my braces, which made my mouth smaller, so my tongue doesn't have enough room in there. Oh my, god. So at night it falls back, so I actually wear one of these appliances. Amazing and it keeps my airway open, and and you feel it.

Speaker 1:

you feel the difference.

Speaker 2:

Yeah, oh yeah, I can't sleep without it.

Speaker 1:

Yeah, and how much easier. Like what you, what you can't see, like you're listening to this, you know the sleep apnea machine is not something you're traveling with very easily right Right okay, whereas what I'm sure what you're showing me here is basically just like wearing invisalign on the top and bottom, basically that's what it looks like.

Speaker 2:

You just put it in your carry-on bag and in a case, and yeah, yeah.

Speaker 1:

Yeah, it's crazy, that's amazing. Let's go back to snoring. Does snoring, does what that appliance help with? Snoring then too.

Speaker 2:

Yes, this appliance works with snoring, so snoring is the first stage of an airway issue. And it's because there's a narrowing of the airway so it could be in the nose if there's a deviated septum.

Speaker 1:

I have one of those.

Speaker 2:

It could be the back of the throat, so that you feel a piece that hangs down can get inflamed, and it could be the tongue. So when the airways narrow, the air has to go faster and it rushes and it vibrates and causes the snoring sound. Well, as the tissues get more and more relaxed or the airways more compromised, then it leads into sleep apnea because the body is not responding to open it up anymore. So the patient might just stay asleep and then they stop breathing for 10 seconds could be 20 seconds. It's a long time that that we stop breathing and then the brain has to send out adrenaline which says red alert and wakes us up. Oh wow, interesting toss and turn, or Glent your grind or kick our jerk.

Speaker 1:

So that's why we do. That is because your body sent out the sign of hey, you're not breathing. You idiot, you better wake up. I hope exactly so that's like, yeah, it's the fight or flight thing, it's you got, you got to do something.

Speaker 2:

Exactly, and that's why patients are so exhausted the next day, because their body's been running this race all night.

Speaker 1:

And then okay, so alcohol. Not saying that I drink any, I'm just saying that sometimes I do, but it does make your snoring worse.

Speaker 2:

It does it relaxes the tissues.

Speaker 1:

So it makes it worse.

Speaker 2:

Gotcha, I thought so alcohol, smoking, any of that stuff, all the bad stuff. Medications sure yeah.

Speaker 1:

All the bad stuff, amazing. All right, so the other thing I saw on here that that it said on your website physical medicine. How do you say this word? Modality modalities is what I was going to say. What is that?

Speaker 2:

That's just a fancy word for Like the cold laser or an ultrasound and what do we use that for? So for patients who have jaw pain and inflammation, yeah, I do treatments so just like if you had a bad knee or a bad neck and you went to a chiropractor or someone and they did some therapy on it. It's the same thing for the jaw.

Speaker 1:

Amazing. And then you do orthodontics and what's the craniofacial pain? Is that just basically all the pain that you get from Yep?

Speaker 2:

that's just the name for pain around the face that's associated with the jaw.

Speaker 1:

What's the best thing to take if you're having that kind of pain before you get the appliance and just to have it bearable?

Speaker 2:

Yeah, usually just try an anti-inflammatory.

Speaker 1:

Yeah, like an Advil or something like that, right.

Speaker 2:

Right, tylenol doesn't do much because it's just for pain relief. Yep, but Advil or Motrin or leave are better.

Speaker 1:

Yeah, anti-inflammatories. Yeah.

Speaker 2:

Amazing, yeah. And then just trying, even like an over-the-counter mouth guard, sometimes can be enough to break the cycle. Yeah, but the ones that we make are all custom made Absolutely.

Speaker 1:

So what do we do if we have this issue? What do we do? We feel like we're doing something. Can we come in to you and you can kind of do a check on everything to see what's going on?

Speaker 2:

Sure yeah, our first appointment is a comprehensive exam, so I'll spend a good amount of time examining the patient looking at their bite, their muscles, how wide they can open, and then we give ideas right there on the treatment plan, and we even have temporary devices that a lot of patients leave with that day. Oh wow.

Speaker 1:

That's cool.

Speaker 2:

We can do a laser treatment or other things. We can get their jaw unlocked at that appointment. So we have a lot of time to try and work with them that day.

Speaker 1:

Yeah, and then what happens then? Then they say, okay, I need, I need something for this. Then you do like a mold or their teeth.

Speaker 2:

Yeah, so we are all digital. Now we do not do impressions anymore. What I don't think you've ever had a goopy impression. Yeah, they're horrible. They're horrible, right? Yeah, they're horrible. No goopy impressions anymore. No, now we use camera pictures. So it's called a scanner and it just goes along and scans the teeth into 3D and then we 3D print the models.

Speaker 1:

So this is an example of a 3D printed mold so that's somebody's teeth.

Speaker 2:

Yeah, that's somebody's teeth. That was printed instead of made of Ooh, they have.

Speaker 1:

they need some things done here. I don't know, we won't say whose teeth they are A little crowding there A little in the front, very crowded. I mean, I'm not a dentist, but I have noticed that, yeah, interesting, so you make that there. How does this camera get in your mouth, or is it around the outside?

Speaker 2:

No, it's in, it's on the inside. It has a wand and then you put it inside the cheek and you just go along the side and it takes hundreds of pictures and stitches them all together.

Speaker 1:

That's incredible. No more goopy. Yeah, no more goopy. That is amazing. See, now that that's that's amazing. Now is there more? Is there more technology coming out with this whole thing? I mean, you're, you're kind of doing everything.

Speaker 2:

Well, 3D printing and is the next. So so a lot of these appliances can be made in a 3D printer and then they fit. We don't have to make the mold, then we can just 3D print the appliance.

Speaker 1:

Just for right Cause you don't need the mold at that point, right, yeah, wow so that's new. Wow.

Speaker 2:

And there are milled appliances, which is a different process, where you take a chunk of plastic and then a computer cuts it out. Amazing, and they fit very nicely. That's amazing.

Speaker 1:

It's incredible where things have gone. Well, I gotta tell you I want to say thank you for coming out today. Sure, thank you. Now say again how we get in touch with you. What's the best way? Website is it? Phone number Is there?

Speaker 2:

like how do I do Website? We do have a number 1-888-TMJ-SLEEP.

Speaker 1:

Okay, that's easy to remember, that's very easy to remember.

Speaker 2:

And then the website is TMJSleepcentercom.

Speaker 1:

Yes, yes, you guys do great work. I knew it because my wife was in pain and she's no longer in pain, which is great, so what a success story. It's awesome. Thank you for coming out today and bringing all your fun toys. It was fun. Thank you, it's great. Thank you so much, awesome. All right, there we have it. That was incredible. Center for TMJ and sleep disorders. It's Dr Tammy Balacheck. She does an amazing job. She brought all kinds of things here. If you're having any kind of problems, either jaw or sleeping, or snoring or whatever is going on, I would definitely look them up because they know what they're doing there. All right, that's about it. See us every Thursday at 7 PM. Facebook, youtube, instagram, everywhere you want to find us. All right, bye.

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