The Gelb Center’s specialist doctors for TMJ, headaches, and sleep disorders (including sleep apnea) have seen and treated a broad spectrum of illnesses and trauma, as their field of study spans from TMJ disorders, headaches, to myofunctional therapy, to breathing related sleep disorders & snoring, with emphasis on how they relate to fatigue, focus, pain, and the effects all of these can have on a person’s quality of life.
Oral Appliances for TMJ: The Gelb appliance, Gelb NYU, and MORA appliances all re-position the jaw to decrease clicking and decompress the auriculotemporal nerve. These appliances are being manufactured and milled by Prosomnus® Sleep Technologies as the ACG-Day appliance. Stabilization appliances can also be used for TMD, airway, myofascial pain and cognitive behavioral habit control as the ACG-Full. The Farrar appliance is now fabricated in a Milled technique with no clasps as the ACG-Night.
TMJ Sleep Appliances: Breathing related sleep disorders are often diagnosed in conjunction with TMJ disorders. Oral sleep appliances can be prescribed in these cases.
TMJ Physical Therapy: Manual therapy can be used in myofascial release, mobilization of the TMJs, and deep muscle therapy. Postural correction, Feldenkrais, the Alexander technique, cold laser, ultrasound, stim, heat and cold are also used. Some therapists also find craniosacral therapy to be helpful.
Migraine Treatments: Headaches that are throbbing in nature accompanied by nausea and vomiting, as well as phono- and photophobia, can be classified as migraines. An aura may or may not precede the migraine and there is often a dull headache following the migraine. There are new abortive medications as well as preventive medications for migraine headaches. Some of these medications can also help relieve tension headaches.
Most migraine patients are under the care of a neurologist or family doctor and have had a brain scan that is within normal limits. Some migraineurs have low magnesium levels according to Mauskop. We have found that Botox injections have been helpful for other refractory patients.
We see many patients with a migraine or mixed headache history who still have negative input into their trigeminal system. By minimizing this trigeminal convergence, we can often reduce or eliminate migraine headaches. Patients, however, still need to be mindful of food sensitivities and other triggers such as alcohol.
Neck Pain Treatments: By stabilizing the jaw and alleviating harmful trigeminal input, neck pain can often be successfully treated by chiropractors, osteopaths and physical therapists. Our trained specialists take a thorough trauma history and look at the cranial system as well.
Headache Treatments: By working with our team of physical therapists, chiropractors and dentists, we can determine the source of your headache. Our nutritionist will also be able to balance your biochemistry and reduce inflammation. An appropriate diagnosis can then be made and treatment recommended.
Our physical therapy and chiropractic team is trained to manage myofascial pain and cervical dysfunction through a variety of modalities such as myofascial release, applied kinesiology, and cranial treatment. Doctors Michael and Harold Gelb correct disc displacements, locking and compressed TM joints, decreasing trigeminal convergence. Trigger point injections, pain blocks and Botox are also used where indicated to manage headache pain.
Our team philosophy is to make the best diagnosis, implement minimally invasive treatment in the shortest amount of time and free the patient from the healthcare system with ongoing headache relief. To begin, we will work to determine what type of headache you are suffering from. We often deal with tension headaches and migraines, and also help alleviate neck pain that may be causing a headache.
Therapeutic Botox™: The use of therapeutic Botox for chronic myofascial pain, headaches, and hypertrophic masseter and temporalis muscles has been used successfully over the last five years throughout the United States. Following the work of Dr. Andrew Blitzer and Dr. Andrew Blumenfeld, as well as headache doctors like Dr. Alex Mauskop in numerous headache centers throughout the United States, Botox is commonly used for the treatment of tension type headaches, migraine headaches, and chronic TMJ and myofascial pain. Therapeutic Botox is injected into the masseter muscles and temporalis muscles as per the protocol of Dr. Andrew Blumenfeld and Dr. Andrew Blitzer. Therapeutic Botox has also been used in the corrugator, procerus, and frontalis muscles throughout the United States for the treatment of frontal temporal headaches. Other headache centers have also injected Botox into the trapezius muscles and posterior cervical muscles. At The Gelb Center, Botox has greatly enhanced the efficacy for patients with chronic tension type headaches and facial pain secondary to bruxism or parafunction.
Diagnostic Blocks for Headaches or TMJ: Diagnostic lidocaine blocks are used systematically to identify the source of one’s pain. For example, the neck muscles commonly refer headache pain in the temples and forehead. Blocking trapezius and sternocleidomastoid muscles can alleviate tension type headaches. The greater occipital nerve radiates pain over the top of the head to the supraorbital region. Once the source of the pain is identified, treatment can be directed to the appropriate area. If the pain can be duplicated, it usually can be alleviated.
Trigger Point Therapy for TMJ or Headaches: Trigger Point Therapy involves the injection of a procaine and saline solution into tender points to eliminate pain and re-educate the muscles into pain-free habits. After several treatments, the swelling and stiffness of neuromuscular pain are generally reduced, range of motion is increased, tension is relieved, and circulation, flexibility and coordination are improved. The trigger point is most effective for neck, low back, shoulder and rotator cuff pain.
Physical Therapy: Manual therapy can be used in myofascial release, mobilization of the TMJs, and deep muscle therapy. Postural correction, Feldenkrais, the Alexander technique, cold laser, ultrasound, stim, heat and cold are also used. Some therapists also find craniosacral therapy to be helpful.
Topical Compounded Therapy for TMJ and Facial Pain: The Gelb Center works with top pharmacies which specialize in compounding medications to help our patients with complicated neuropathic, TMJ and myofascial pain. Materials are prepared that can be incorporated into our customized appliances to aid in the direct application of the painful site.
Oral Appliance Therapy for Sleep Disorders: The Gelb Center of New York has been using and developing oral appliances for sleep medicine for over 27 years. Oral appliances work by maintaining a forward position of the tongue and soft palate as well as widening the lateral pharyngeal walls. It accomplishes this feat mechanically as well as by stimulating the oropharyngeal muscles. At The Gelb Center, various appliances are used.
Oral appliances work by maintaining a forward position of the tongue and soft palate as well as widening the lateral pharyngeal walls. It accomplishes this feat mechanically as well as by stimulating the oropharyngeal muscles. At The Gelb Center, various appliances are used.
Dr. Michael Gelb, along with ProSomnus Sleep Technologies, has launched the ACG® Airway Centric® System. The ACG® System is the first Day and Night appliance solution that offers an integrated approach to addressing airway issues. It includes five appliance variants that complement the traditional ProSomnus [IA] platform.
The day appliances help to balance the nervous system and reduce pain while opening the airway. They focus on improving performance and energy levels as well as decreasing symptoms such as headaches, neck pain, jaw clicking and difficulty concentrating.
The nighttime devices alleviate Obstructive Sleep Apnea (OSA), decrease arousals or disturbed sleep, stop snoring and improve oxygenation, promoting more restorative sleep.
Prosthodontics for Sleep Disorders: Prosthodontics is one of the nine dental specialties recognized by the American Dental Association. Graduate programs in prosthodontics include classroom lectures and seminars, laboratory and clinical training in aesthetics, crown and bridgework, porcelain laminate veneers, complete and partial dentures, dental implants, TMD-jaw joint problems, traumatic injuries to the mouth and associated structures, congenital or birth abnormalities, snoring and sleep disorders and continued care. The restorative efforts help provide proper facial support and the enhancement and stability of the patient’s smile.
At The Gelb Center, we offer the latest in prosthodontics, giving you the best possible option for your dental health and well-being. We take pride in ensuring careful attention to your bite and jaw position. Very often when the teeth or jaw are out of position, patients have all types of head, neck, and postural issues. The teeth can be fabricated so that the jaws meet in harmony with the head and neck muscles of the temporomandibular joint. We place the teeth in an ideal position which in most cases is also the most aesthetic as well. Advanced 3D Imaging and software, as well as our physical therapy and cranial practitioners, help optimize treatment results.
Prosthodontics Services: Our prosthodontics dental services include, but are not limited to:
- Surgical Placement and Restoration of Dental Implants
- Dentures & Partial Dentures
- Crown & Bridgework
- Mini Implant Dentures
- Implant-Supported Dentures and Bridges
- Preview transitional devices and restorations (Jason Kim Oral Design)
Our prosthodontist uses biocompatible materials to build up the teeth to allow the jaws to function optimally while remaining pain free. Occlusal Stabilization can be achieved with oral appliances, orthodontics, or prosthodontics. It must be in harmony with the jaw, TMJ and cervical spine.
Sleep Appliances: Breathing related sleep disorders are often diagnosed in conjunction with TMJ disorders. Oral sleep appliances can be prescribed in these cases.
Snoring Treatments: Oral appliances – nonsurgically positions tongue, soft palate and lateral pharyngeal walls to open airway.
Continuous Positive Airway Pressure (CPAP) Machine: For those patients suffering from sleep apnea, a CPAP machine is often used as a treatment option. With the CPAP Machine, users will experience a continuous level of positive airway pressure while they sleep.
Smile Design: Smiles can now be simulated, displayed on a computer and set in wax to be created just for you. At The Gelb Center, we model a three dimensional smile that is in harmony with the TM joints, cervical spine and airway to aim for optimal health. What good is a gorgeous smile in a body suffering from headache, TMJ pain, snoring, sleep apnea, tinnitus or an earache? At The Gelb Center, we place the teeth in an ideal position. Advanced 3D Imaging and software, as well as our physical therapy and cranial practitioners, help optimize treatment results.
Dental Hygiene: The Gelb Center for sleep apnea, chronic headache and TMJ in NYC introduces our wonderful works with Top NYC Dental Hygienist, Khrystyna Vyprynyuk. Fully licensed and certified, not only does Khrystyna provide excellent dental cleanings, periodontal care and teeth bleaching, she offers her dental patients careful, clear instruction on practicing good oral hygiene related to overall wellness.
Many recent studies have shown the relationship between proper dental hygienic care and heart disease, and other systemic conditions. Let Khrystyna, assisted by The Gelb Center, prepare a plan for a healthier smile.
Polysomnogram (PSG) or Sleep Study: Many patients come to The Gelb Center with a copy of their PSG and a diagnosis of sleep apnea. The American Academy of Sleep Medicine (AASM) recommends oral appliances as a primary treatment for mild and moderate sleep apnea. The PSG measures how many obstructive breathing events occur each hour as well as oxygen desaturation levels throughout the night. The percent of the night in Stage 1, 2, 3, 4 NREM, as well as REM, is measured. Patients who snore and obstruct while laying on their back do better with oral appliance therapy. Lack of stage 3 and 4 NREM can lead to fatigue and widespread muscle pain. Restorative sleep is when repair and regeneration occur and a human growth hormone is released.
Orthodontic Services Include:
- Dentofacial Orthodontics: the orthodontic guidance of facial growth and development for a more attractive appearance and employs special techniques aimed at realigning teeth and jaws.
- Invisalign®: We are one of the only orthodontists in NYC successfully treating very complex cases for teeth straightening with Invisalign®, and based on our experience and skills, local and overseas orthodontists seek our Invisalign advice o best practices for treatment. We are one of the first providers to successfully treat more than 2000 Invisalign® cases in New York.
If you currently experience TMJ pain, chronic headaches, sleep disorders including sleep apnea, neck or facial pain, or would like to learn more about our orthodontic service please feel contact the best in class, top rated specialist, Dr. Michael Gelb’s NYC or White Plains, New York office, The Gelb Center, today.
The Gelb Center of NYC
635 Madison Avenue, 19th Floor
New York, NY 10022
P: (212) 752-1662
The Gelb Center of White Plains
12 Old Mamaroneck Road, Suite 1C
White Plains, NY 10605
P: (914) 686-4528