Dr Gary Adams and Dr Viet Le welcome you to TMJ Sleep and Breathe Center located in Vienna Virginia. We treat adults and kids. Adults who suffer from TMJ pain, teeth clenching, mouth breathing and sleep apnea. Kids with crooked teeth, mouth breathing, bad posture and tied tongues. We use palatal expanders, orthodontics, myofunctional therapy, posture correction and breathing exercises. A beautiful smile and a balanced body makes a healthy life.

Our most popular adult expanders are DNA appliances and Homeoblock devices. We also use palatal expanders for kids including ALF appliances, Twin Block, Schwarz and Myobrace. Our treatment protocols enlarge the upper airway, stop mouth breathing and align the bite, teeth, head, neck, pelvis and back. Our patients experience relief from TMJ pain, headaches, sleep apnea and neck and back pain. Poor posture can be caused by airway obstructive disorders such as mouth breathing, sleep apnea and UARS. 

Our Treatment Goals:

• Treat TMJ pain, head and neck problems
• Improve smile esthetics
• fix reverse lower jaw position and facial profile
• Correct tongue function and posture
• Restore nasal breathing patterns
• Stabilize the bite
• Improve overall posture

Conditions We Treat:

• Crowded and misaligned teeth
• Reverse jaw position and poor facial profile
• TMJ pain
• cross bite, under bite, deep bite and over bite
• Sleep apnea problems
• bruxism and teeth clenching
• tied tongue and lips
• Mouth breathing
• Airway resistance
• Posture problems related to airway obstruction
• Head, neck and back pain

Our Holistic Approach to Treatment

We use a combination of palatal expanders, myofunctional therapy, breathing exercises and posture correction therapy. Our dentist, chiropractor and myofunctional therapist will perform a comprehensive evaluation and diagnose the root cause of your symptoms. The team will determine the best therapy based on each patient’s diagnosis and treatment goals.

Comprehensive Patient Assessment

Structural assessment of the teeth, jaws and facial profile

We will evaluate the bite and dental arches. Discover conditions such as under bite, over bite, cross bite, deep bite, teeth wear, missing teeth, cavities, common dental infections. We will note narrow and deep palates, reverse lower and upper jaw positions and small facial profile.

Breathing pattern, tongue function and airway assessments

We will take a conebeam CBCT image to measure the nasal and oral pharyngeal airway spaces. We evaluate muscle and soft tissue tone of these same areas. We will do an assessment of tongue function and breathing patterns.

Full posture evaluation

Assessment of head, neck, back, pelvic posture. Essentially we will look for skeletal and structural imbalances from head to toe.

Child and Adult Palate Expanders and Orthodontics

We use a holistic approach to treating adults and children. Expanders can be used to correct many structural problems with the jaws, teeth positions and facial profile. Sleep, breathing and posture depend on structural balance and health of the teeth, jaws and facial bones.  Some of the palatal expanders we use include ALF, Vivos DNA, Homeoblock, Schwarz, Myobrace and Crozat appliances. No one appliance or treatment is the best for every case. There is no one size fits all miracle device.

But, structural corrections alone will not produce a stable, functional and healthy result. Myofunctional and breathing therapy as well as posture correction need to be performed as well. All parts of the body are connected. Dysfunction of the jaws head and neck usually are caused by problems with the airway, breathing patterns and skeletal system. It is all connected and needs to be treated.

Kids usually present with milder symptoms such as crowded teeth, bite imbalances and mouth breathing? Usually kids can be treated with orthodontic expanders, tongue and lip tie releases (aka frenectomies or frenulectomy) and myofunctional therapy. Kids who are treated by the age of 12-14 can usually get a perfect correction.

Adults can have all the same problems as kids, but usually there are layers of other problems from years of breakdown. Adults can some or all of the following presentations:

• teeth clenching
• jaw pain with popping, clicking and deviation on opening the mouth
• headaches
• neck and back tension
• forward head posture
• gum recession
• history of lots of dental work
• just to name a few of the more common symptoms

Myofunctional Therapy – Tongue Function is the Key

What is a tongue tie? 

It is a tight fiber that attaches the tongue to the front part of the lower jaw bone. The presence or absence of a tongue tie is not what is important. How well the tongue functions and moves is what matters. Tongue muscle tone, strength and range of motion are critical. Healthy swallow pattern. Can the tongue easily lift up into the palate and create an air-tight seal? Does the tongue have a wide shape and good tone during movement? Or does it get pointy and curl down when it is pushed out of the mouth?

Tied tongues do not move well. Tongue pressure during talking, swallowing and eating stimulates spacious development of the mouth, nose and face at a very young age.  If the tongue cannot move well, the jaws and face will not grow large enough for healthy breathing patterns. People will have small breathing passageways. They will get choked by a large tongue especially during sleep. The tongue is the root cause of mouth breathing, airway resistance, snoring and many sleep problems.

What is Myofunctional Therapy?

Myofunctional therapy is basically physical therapy for tongues. Tongue function is evaluated. Exercises are given to improve tongue:

• Range of motion
• Strength and muscle tone
• Swallow patterns
• Tongue posture flush on the palate
• Participation during healthy breathing patterns

When a tongue tie causes the tongue not to function properly, a qualified dentist and myofunctional therapist will order a functional tongue untie procedure. A functional procedure verifies the tongue can move properly during the surgical procedure. Laser assisted techniques are done quickly, painlessly and without any bleeding. Success of the procedure hinges on the the tongue being untied and the patient performing myofunctional tongue exercises after the procedure.

Mouth Breathing vs Nose Breathing

Nose Breathing

Nasal breathing promotes healthy growth and development starting at a very young age. Nose breathing uses muscle groups in the abdomen, ribs, shoulders, neck and face. Healthy coordinated muscle patterns during breathing support good upright comfortable posture.

Mouth Breathing

Mouth breathing uses a different muscle pattern than nasal breathing.  Mouth breathing causes people to slouch and have forward head posture. People who mouth breath end up with small jaws, crooked teeth, poor airways, bad posture, sleep problems and bruxism. This is because muscle patterns used during mouth breathing causes the bones in the face, chest, back and neck to grow to be the wrong size and shape. Muscle pressure stimulates our bones to grow to a certain size and shape.

What is the role of the tongue?

The tongue puts pressure on the upper jaw and teeth. The pressure promotes growth of a wider palate wider palate and upper jaw. The hard palate forms the base of the nose. As the palate grows wider, people can fit more air through larger nasal spaces. If enough oxygen fits through nasal spaces, it is not necessary to open the mouth to breathe. If the nasal passageways are too small, the mouth will need to open to meet oxygen demands.

Posture Restoration Therapy

Many of our patients go back and forth between the dentist and chiropractor complaining about neck and back pain and headaches. The dentist usually hears about teeth clenching, TMJ and headaches. The chiropractor gets complaints about neck and back pain. The root cause of all the pain is poor skeletal development at a young age. People use the wrong muscles patterns to breathe when mouth breathing.  Also, when breathing is restricted, different muscles need to be used in a more forceful way. The unhealthy muscle pressure literally causes the bones in the head, neck and back to grow to be the wrong size and shape for good posture. Over time, the body fatiques from performing with less than optimally shaped posture and function.