Meet Dr. Nojan Bakhtiari, DDS, FAAOP – TMJ Specialist Facial & Oral Pain Specialist
Dr. Nojan Bakhtiari is a board-certified TMJ and Oral Facial Pain specialist. He focuses his practice on TMJ disorders, oral pain, facial pain and associated headaches. He treats patients in New York City. His practice is conveniently located in midtown Manhattan three blocks from Grand Central Terminal and Bryant Park.
- Assistant Clinical Professor, Columbia University College of Dental Medicine
- Treasurer and Committee Chair, NYU Dentistry Alumni Association
- Diplomate, American Board of Orofacial Pain
- Fellow, American Academy of Orofacial Pain
- Chair of Membership Committee, American Academy of Orofacial Pain
Dr. Nojan shares his in-depth knowledge of the TMJ, oral and facial pain as Assistant Clinical Professor at Columbia University College of Dental Medicine. He taught for 5 years at Yale-New Haven Hospital as a clinical attending and course director. He is one of very few diplomates of the American Board of Orofacial Pain and a Fellow of the American Academy of Orofacial Pain.
As an expert in the field, he has been invited to lecture at New York University, New York-Presbyterian Brooklyn Methodist Hospital, New York State Dental Association, Woodhull Hospital, Lincoln Medical Center, and numerous dental societies and conferences (including Greenwich and Stamford Dental Societies, New Haven Dental Association, Connecticut Society of Oral and Maxillofacial Surgeons, New England Dental Society Annual Meeting).
Who should see Dr. Nojan?
If you are experiencing any of the following symptoms or looking to know more about why your jaw pain, you should schedule a consultation:
- TMJ pain
- Lock jaw, limited jaw opening or jaw popping
- Teeth grinding (bruxism) and clenching
- Muscle spasms of the jaw, head and neck
- Myofascial pain or muscle pain
- Ear pain without any ear pathology
- Trigeminal neuralgia
- Burning Mouth Syndrome
- Traumatic trigeminal neuropathies following an injury or surgical procedure
- Sleep Apnea
What are treatment options offered by Dr. Nojan?
Dr. Nojan offers the best and advanced treatment options available for TMJ, facial pain, oral pain and headaches. Treatments offered by Dr. Nojan Bakhtiari are personalized to you when looking to know more about why your jaw pain, and may include:
- Oral appliance therapy (custom mouthguards, nightguards, splints)
- Therapeutic injections
- Trigger point injections for muscle pain
- Nerve blocks
- Steroid injections for TMJ joint and tendons
- Botox for TMJ, nerve pain, jaw pain and headaches
- Therapeutic ointments and medication for oral, facial and TMJ pain
Overview of Treatments for TMJ, Facial Pain and Oral Pain
Dr. Nojan offers the most advanced and evidence-based treatment options for TMJ, facial pain, oral pain and related headaches.
“Don’t leave TMJ and orofacial pain treatments to guesswork.”
Treatments will always be personalized to you, your condition and your treatment approach preferences. We understand that some patients do not like taking medications, while others are afraid of needles, or have life-styles that prevent them from wearing a bite guard. Learn more about what happens at your first visit with Dr. Nojan Bakhtiari, DDS, FAAOP. For that reasons, we offer the full range of treatment options and learning about why your jaw pain while also including:
- Oral appliance therapy(comfortable and custom bite guards, nightguards, splints)
- Therapeutic injections(such as trigger point muscle injections, nerve blocks, and botox®), PRP
- Steroid injections jaw joint (TMJ) and associated tendons
- Compounded Topical Pain Medications and mouth rinses
- Jaw stretching exercises and physical therapy modalities
TMJ Treatment options vary depending on the individual suffering from TMJ and the specifics of their condition. Since TMJ/TMD can affect the musculature, tendons, bones and joint of the jaw, a thorough examination and diagnosis is paramount prior to initiating any treatment. Treatments include therapeutic injections of muscles and the joints, custom fabricated orthotics (also called splints, mouth guards, nightguards or occlusal guards), medications, creams, botox©, jaw stretching exercises, and physical therapy.
TMJ therapies should never include grinding down of otherwise healthy teeth. It is ill-advised to suggest to a patient that grinding of their otherwise healthy natural teeth is related to the TMJ pain they are perceiving. This treatment philosophy of “correcting the bite”, by either grinding down teeth (occlusal adjustments), restoring teeth with crowns, or moving teeth with braces or invisalign©, has been debunked in the dental and scientific literature.
What to expect at your first visit to our office
At your first visit to our office, Dr. Bakhtiari and his team will thoroughly examine your jaw, face, TMJ, bite and mouth. He will determine the source and cause of your discomfort, and devise a customized treatment solution that will work for you to help with why your jaw pain.
The initial consultation includes:
- Review of your medical history
- Detailed evaluation of your pain, discomfort and/or other symptoms
- Cranial nerve screening
- Muscle palpation of the muscles of your jaw, head and neck
- TMJ evaluation: evaluating the health of your jaw joints including their range of motion, tenderness and any clicking/popping sounds
- Additional imaging if necessary: X-rays, panoramic, CT scans, MRIs
- Additional testing as needed: diagnostic topical anesthetics, muscle and nerve blocks, blood tests
We will identify the source of your discomfort and devise a treatment plan to provide you with relief.
What is TMJ?
TMJ is an acronym for a group of disorders pertaining the temporomandibular joint (TMJ), jaw muscles, face muscles, ligaments and associated structures. The term temporomandibular joint is derived from the temporal bone, the mandible (the lower jaw bone) and the joint that connects the two bones. Patients suffering from TMJ can experience symptoms ranging from mild to severe pain in the jaw and face, limited opening of the jaw, lock jaw, jaw clicking, jaw popping and headaches.
The pain involves the chewing muscles and jaw joints. Additionally, pain can be experienced in the area in front of the ear (the pre-auricular area) and around the ear. Most often the pain is muscular in nature and affects the chewing muscles, which include the masseter, the temporalis, and the pterygoid muscles.
The pain is usually aggravated by jaw movements such as chewing and yawning. The pain is described as achy, pressure, sharp and/or dull pain (in contrast to electric or throbbing pain, which would indicate other conditions or when wanting to know more about why your jaw pain. The painful episodes can last short periods of time, and improve on their own, or span long periods of time and become chronic.
What are causes of TMJ Pain?
TMJ can have many different causes. The muscular type of TMJ disorders can be related to overuse of your chewing muscles, muscle knots (trigger points), injury, muscle enlargement, or medical comorbidities. Overuse can occur as a result of eating chewy hard foods, yawning wide, excessive talking, nail biting, and habits such as clenching or grinding your teeth. The joint related type of TMJ can be caused by injury, osteoarthritis, rheumatoid arthritis, underdevelopment, or disc problems (internal derangement that result in clicking and popping sounds). The pain usually intensifies when the patient is very stressed, sleeps poorly, is anxious/depressed, or suffers from other medical problems. Medical comorbidities can include migraines, fibromyalgia, lower back pain, and past injuries to the face, head and jaw. Additionally, TMJ pain can aggravate neck pain, and vice versa. The reason for this is that the nerves that innervate the TMJ and neck directly communicate with one another in the pain centers of the brainstem.
What are the TMJ treatment options?
How is TMJ diagnosed?
TMJ is best diagnosed by a thorough history, interview, and clinical examination. The clinical examination includes the TMJ specialist palpating the musculature, tendons, bones and joints of the jaw. A trained TMJ specialist will also conduct a cranial nerve screening checking for any abnormalities, evaluate your neck, and ask about headaches and sleep problems.
Depending on those findings, Dr. Bakhtiari may request diagnostic imaging (x-rays of the jaw, CT scans, or MRI) and blood tests. Diagnosis of TMJ disorders does not always require advanced and expensive imaging, and never requires expensive gadgets. While these gadgets appear impressive, they have not been shown to be objective or accurate.
Can TMJ cause headaches? Are TMJ and migraines related?
A commonly asked question is whether TMJ can cause headaches or if the two are related. TMJ disorders can cause a category of headaches classified as ‘TMD related headaches’ that are perceived in the temples, in front of the ears, the lower and upper jaws. This type of headache condition tends to be the most intense in the morning when waking up. One of the challenges of TMJ diagnosis is that TMJ can mimic headaches and vice versa. For that reason, some patients who suffer from headaches are incorrectly treated for TMJ (for example with a mouthguard) with little to no improvement in their symptoms. Additionally, any pain in the trigeminal nerve distribution (jaw muscle pain, toothaches, joint pain, sinus issues, etc.) tends to intensify headache symptoms in a patient who is already suffering from a migraine or tension-type headache.
Dr. Bakhtiari has extensive experience and training in diagnosing and treating TMJ and headaches. He will help you determine whether your headache, jaw and facial pain, is due to a migraine, tension-type headache or due to TMJ.