The headache, facial, and neck pain patients we see in our office have, in most cases, been treated by numerous other practitioners. The TMJ/TMD problems are overlooked by most neurologists, orthopedists, headache specialists, physical therapists, chiropractors, dentists, and alternative medicine practitioners. With the high incidence of clenching, and the associated stress on the TM joints, facial and neck muscles, tendons and ligaments going undetected, it explains the vast number of TMJ/TMD patients.These patients seek our help because they still have pain.

TMJ/TMD mimics other problems. The Journal of the AMA dubbed TMJ "The Great Impostor" because of the mimicking and misdiagnosing¹.To obtain successful treatment a practitioner must have excellent diagnosis. The key is: DIAGNOSIS! DIAGNOSIS! DIAGNOSIS!

A proper diagnosis encompasses your health history including past medical and dental treatment, history of trauma (auto accidents, falls, etc.), clinical exam, and radiographic (x-ray) examination. Based upon these findings, other diagnostic tests may be required. A skilled team of professional associates assist Dr. Keropian to ensure that our patients receive the most effective diagnosis and treatment for their specific therapy needs.

Once a diagnosis is obtained, a course of treatment can be determined. Our staff will carefully detail each patient's therapy program in an Individualized Treatment Plan which is prepared and discussed at the examination appointment. In most cases, the patient requires an oral orthotic (mouthpiece) to reduce pressure on the "jaw joints" and reduce stress on the facial musculature. Physical therapy or chiropractics in conjunction with the oral orthotic is a must. The muscles have to be treated to break the pain being generated.

Many of our patients have been treated with oral orthotics(mouthpieces) before. Their treatment was unsuccessful. The key is the design of the mouthpiece based on a very thorough diagnostic process. It is amazing the number of patients we see who been treated with a mouthpiece and had no x-rays taken of their temporomandibular joints.

Each pain patient is very unique. Everyone has a set of circumstances that sets them apart from everyone else. One person may have great health but lots of pain, while some one else may have a myriad of health problems that could effect head and neck pain. These could include stress, sleep patterns, nutrition, female hormone problems, ailments (diabetes, arthritis, diseases such as lymes, and many more), and structural imbalances such as one leg longer than the other or one hip or shoulder higher than the other. Therefore, each individual has to be evaluated and diagnosed very thoroughly, and then a specific treatment plan can be formulated.

Dr. Keropian's education alerted him to these multitudes of problems. It is these total health problems tied into problems in the jaw joints and/or with the muscles, tendons, and ligaments of the head that make this a difficult and interesting arena to treat. It is the tying in of multiple disciplines with excellent diagnosis that will put us on the correct treatment path for each individual.

Based on your bodies response to treatment, we may choose other paths of treatment. These could include special therapies to the joints and facial musculature, manipulations of the jaw, changes in the mouthpiece, nutritional recommendations, and other treatments deemed necessary.

The Center has treated over 10,000 patients suffering from TMJ related problems during the last 20 years. In the majority of the cases, we have made remarkable strides in relieving the cycle of pain experienced by the patients - and we have done so without surgical intervention. In 99 .9% of cases, I have seen patients who were unable to work and participate in life with their families because of the effects of the constant pain period. With our diagnosis and treatment, they were eventually able to return to a job following treatment. We hope to do the same for you.

¹Morgan DH: The Great Impostor - Diseases of the Temporomandibular Joint. JAMA 22:2395, 1976