What's new in TMJ and Breathing

Special Announcement – Dr Ledermann Specialist in Orofacial Pain Designation

We recently announced that Dr. Roy Hakala was designated as a Specialist in Orofacial Pain (OFP). We are excited to report that Dr. Kim Ledermann has also received this honor in recognition of her dedication over the past 10 years to ongoing advanced education and treatment of TMJ disorders, orofacial pain and headaches, and sleep breathing disorders. As with Dr. Hakala, Dr. Ledermann is board certified in both craniofacial pain and dental sleep medicine.

Dr. Hakala and Dr. Ledermann are two of the first practitioners in the country to be granted specialty status in this emerging field, which has not yet been formally designated by the American Dental Association. Congratulations to Dr. Hakala and Dr. Ledermann!



NWHSU Homecoming 2018

We enjoyed talking with other professionals at the Northwestern Health Sciences University Homecoming last weekend!


Special Announcement – Dr Hakala Specialist in Orofacial Pain Designation

We are proud to announce that the Minnesota Board of Dentistry recently designated Dr. Roy Hakala as a Specialist in Orofacial Pain (OFP). Since the American Dental Association has not yet designated OFP as a specialty field, this represents a particular honor presented after consideration of his commitment to advanced education in the field both as a student and as a lecturer, his 43 years of treating orofacial pain including TMJ disorders and sleep breathing disorders, and his establishment of our dedicated Minnesota Craniofacial practice in 1994.

Dr. Hakala is one of the first practitioners in the country to be formally granted specialty status in orofacial pain. Congratulations, Dr. Hakala!

Baby Sophia!

We are excited to announce that Ashley, our wonderful scheduling coordinator, had her baby girl on January 6!

Can Hot and Cold Packs Relieve TMD Pain?

The pain can be unbearable, so what options do you have for relief? You might have tried ibuprofen, or other pain relievers, to no avail—there’s still that constant ache hanging out. The pain of temporomandibular joint disorder (TMD) can be frustrating at times, but we have another option that might help: hot and cold packs. With the use of hot and cold packs, you can find relief from your TMD pain.

Hot and Cold Packs for Pain Relief

For many people who suffer from TMD, symptoms experienced can be difficult to manage. If you suffer from jaw pain, it is important to understand the risks faced and how you can manage pain using some home remedies. However, sometimes you will need more than just a home remedy, so be prepared. Let’s answer the question, are hot and cold packs effective in providing relief from pain?
Yes! Hot and cold packs do not treat symptoms of TMD, but they do work to help alleviate the aches and pains you might be experiencing.

Start by applying a hot pack (moist heat is best) to the neck, temples, or facial muscles for 10-20 minutes. Next, perform recommended stretches and/or exercises to help in the process to keep the temporomandibular joint (TMJ) from remaining stiff. After stretching is complete, apply ice directly to the joint, which is right in front of your ear. This routine should be repeated a few times each day to help alleviate your pain and stiffness caused by TMD. But remember, this won’t eliminate your symptoms completely, so seek treatment as soon as you can.

Oral Appliances for Long-term Care

A long-term solution for treating your TMD is through oral appliance therapy. Yes, hot packs and ice might help briefly when it comes to aches and pains, but this should not be the only form of treatment you seek. The availability of oral appliance therapy allows Dr. Ledermann and Dr. Hakala to help in the treatment of your TMD symptoms. Oral appliance therapy can successfully manage and treat complex conditions, such as TMD—better than the temporary relief from hot and cold packs.
Contact the Minnesota Craniofacial Center, P.C. for more information on TMD and oral appliance therapy.

Untreated Sleep Apnea Can Lead to Health Complications

f you let sleep apnea go untreated, it could be dangerous to your health. Untreated sleep apnea can lead to a variety of health conditions, such as an increased risk of heart disease or diabetes. These health conditions should not be ignored. To help you gain a better understanding of health complications with untreated sleep apnea, we’ve put together some helpful information on health problems linked with sleep apnea:

High Blood Pressure

Obstructive sleep apnea (OSA) causes people to wake up frequently throughout the night, which can contribute to high blood pressure. The act of waking up so often at nighttime can cause hormonal systems to go into overdrive, which results in high blood pressure levels. The sudden drops in blood-oxygen levels that occur during sleep apnea episodes increase blood pressure and place a strain on your cardiovascular system.

Heart Disease

Sleep apnea can also lead to heart attacks. As a result, many people die in the middle of the night due to low oxygen or the stress of waking up frequently. Heart disease is the leading cause of death in America, while stroke takes fourth place for the cause of death—high blood pressure is a major risk for both conditions. It is vital that you understand the connection between heart disease, high blood pressure and stroke, and seek treatment immediately.

Type 2 Diabetes

If you suffer from Type 2 diabetes, you might also suffer from sleep apnea, which can lead to obesity. And, as you might know, obesity is another leading cause of sleep apnea. Not only do diabetes and sleep apnea have obesity in common, they share a long list of other potential complications, including:

  • High blood pressure
  • Cardiovascular disease
  • Eye disease
  • Changes in glucose metabolism
  • Weight control problems

Treating sleep apnea is important in getting a good night’s sleep, but it can also help treat and maybe even eradicate many other diabetic complications.


As we previously mentioned, obesity is a leading cause and side effect of sleep apnea. Adding on weight, raises the risk of sleep apnea, while losing weight can help cure sleep apnea—it’s important to pay attention to your weight. When people are severely overweight, they can fail to breathe rapidly enough or deep enough.

This then results in low blood oxygen levels and high blood carbon dioxide levels. And when this happens, many obese people stop breathing altogether for short periods of time during sleep. In return, extreme strain is placed on the heart, which can lead to symptoms of heart failure.

Acid Reflux

While there is no proof that sleep apnea causes acid reflux or persistent heartburn, it has been shown that people with sleep apnea do complain of acid reflux. As a result, treatment of sleep apnea appears to improve acid reflux and vice versa. The association with sleep apnea and acid reflux is relatively new, but we have been aware of it for some time now. Some of the connections include:

  • Interrupted sleep
  • Relaxation triggers
  • CPAP side effects

Taking the next step by treating sleep apnea and acid reflux will help you maintain a healthy, active lifestyle without complications.

Every health complication of sleep apnea can lead to another health complication (and another). By understanding the connections, you can better care for your health and further prevent other complications. Contact Dr. Kim Ledermann or Dr. Roy Hakala, our dentists in St. Paul, MN, at Minnesota Craniofacial Center, P.C. for more information on sleep apnea and how treatment can help.

Drop Your Gum Chewing Habit to Prevent Jaw Complication

“POP!” “SNAP!” “CRACK!” The sounds of gum chewing are far too familiar. However, while chewing bubble gum might be a daily habit for most people, it can pose a threat to your jaw health. If you chew gum and suffer from headaches or jaw pain, you might want to think again about picking up a new pack of gum. A person who suffers from temporomandibular joint disorder (TMD) might find it painful to chew gum while others gladly chew it daily. Before you reach for your next stick of gum, consider these negative side-effects:

Health Warnings

Your salivary glands are stimulated to produce saliva whenever you chew. Producing a steady stream of saliva for chewing gum is a waste of energy and resources that could otherwise be used for essential metabolic activities.

If your gum is “sugar-free” and sweetened with aspartame, be aware that this substance has been linked with cancer, diabetes, neurological disorders, and birth defects.

If your gum is sweetened with sugar, know that regular intake of refined sugar is  associated with tooth decay and many systemic conditions.

The Development of Pain with TMD

The act of chewing gum leads to jaw muscle imbalance. This is especially true if you find yourself chewing on one side more than the other. When this occurs, it can cause the development of temporomandibular joint disorder (TMD), which can be extremely painful. Anytime a muscle or joint is overused, it can lead to contracted muscles and related pain, such as headaches, earaches, and even toothaches. IF this pain or misuse of muscles is not properly treated, it can lead to intense facial pain or extreme discomfort in the back of the neck.

Sometimes the initial cause or development of TMD is unknown—this is normal. TMD symptoms can worsen because of:

  • Stress
  • A poor diet
  • Lack of sleep
  • Bad posture

The constant, long-term use of chewing gum can be an aggravating factor for TMJ pain, facial pain, and other disorders. By contacting Dr. Ledermann or Dr. Hakala at Minnesota Craniofacial Center, P.C. you can take the next step toward improving your jaw pain. Before you unwrap another stick of gum are you experiencing any stiffness, soreness, or pain? If so, stop and take a break from chewing gum. Minnesota Craniofacial Center is available to help you find relief.

Visit Our St. Paul Dentist for Sleep Apnea and Snoring

If you snore or have sleep apnea, where do you go for help? Many people might immediately call their family doctor or ENT specialist, but there is another key option: your dentist. Yes, your dentist can help treat sleep apnea. While it might come as a shock, not only do dentists treat oral conditions, but they can provide you with oral appliance therapy for treatment of your sleep apnea and snoring.

Sleep Apnea has Dental Origins

Caused by a collapse of the upper airway when the muscles relax during sleep, sleep apnea can cause you to stop breathing throughout the night (and not just once). Your tongue is the largest muscle (it’s much larger than you think), and the most likely culprit for stoppage in breathing. The tongue is present in the mouth, but it also extends down the throat and beyond—throughout most of the length of the collapsible upper airway.

Our Role in Sleep Apnea

Dr. Kim Ledermann and Dr. Roy Hakala, our St. Paul, MN dentists, have received specialty training in oral appliance therapy for the treatment of sleep apnea. With our advanced training and extensive knowledge and experience, we can provide you with a custom-fit FDA-approved dental device to help control the collapsing of the tongue into the airway. An oral appliance allows you to stop snoring, and sleep and breathe easier throughout the night—you can wake up refreshed and ready to take on the day.

With the availability of oral appliance therapy, we can help prevent the collapsing of the tongue into the airway by moving the jaw forward, and allowing the air to flow from the mouth to the lungs. This helps you to breathe properly at nighttime and helps to decrease the occurrence of snoring—it’s a far less invasive and more predicable solution opposed to surgery.

If you suspect you might have sleep apnea, contact the Minnesota Craniofacial Center, P.C.. Together we can determine if you need to receive further diagnosis from a sleep study and find out if oral appliance therapy is an option for you. Remember, you should never have to put up with a lack of sleep—or quality sleep for that matter.