Laforte ii & mandibular osteotomy 23 yrs ago. bite evening up now - bruxism/tongue biting @night. could braces/2nd surgery be required? tmj too now.

Need evaluation: You should have a thorough exam by a dentist who has experience in bite adjustment /equilibration and TMJ to address your problem properly.

Probably not: Research in the last 10 years indicates that bruxing or TMJ symptoms rarely are related to a person's bite. Known causes of bruxing include stress and sleep apnea. Clenching is a significant factor in TMJ symptoms. See a dentist who can diagnose your TMJ symptoms and effectively treat bruxism. Check www.Aaop.Org or www.Aacfp.Org for a list of dentists in your area.

No: Bimaxillary osteotomies and orthodontics should have addressed your malocclusion. It is more likely the bruxism is causing your problem. Good luck!

Probably not: A huge percentage (30-65%) grind their teeth when sleeping, get evaluated by your dentist for possible night guard!

No: Bruxism is considered a sleep disorder that is neurologic in origion and has no relationship to condition of a particular bite or surgical correction. See a dentist who has experience in the management and suppression of damaging clenching activity particularly one well trained in dental sleep medicine.

Unlikely.: Unlikely. Complex problem. See TMJ expert. Any dentist can be a TMJ expert with the proper training and experience. Most commonly, oral surgeons, prosthodontists, and orofacial pain specialists. Ask your MD, your dentist and your dental society for referrals.

See OFP specialist: Orofacial Pain practitioners are dedicated exclusively to the treatment of orofacial pain, bruxism and TMJ disorders. Find a doctor close to where you live or work.