Dr. Demerjian Center For TMJ And Sleep Therapy

Burbank: (818) 238-9865 | Glendora: (626) 852-1865

2701 W Alameda Ave. #606, Burbank CA 91505

175 N. Pennsylvania Ave. #4, Glendora CA 91741

  • Meet Dr. Demerjian

    Learn about Dr. Demerjian, his practice, and his treatment for TMD and other TMJ-related disorders.

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  • Snoring?

    It may not just be an annoying sleep habit. Find out how we can help!

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The TMJ Connection

The face of dentistry continues to evolve as technological and medical advances rapidly emerge. We are proud to say that we have kept abreast and that we continue to offer our patients all the advantages of the latest treatments and technology.

About Dr. Demerjian

Dr. G. Gary Demerjian started his practice in 1990. Since 2004, he has focused his practice to the treatment of TMJ Disorders, Headaches, Facial Pain, Sleep Apnea, Movement Disorders and Orthodontics.

He has taken over 2000 hours of postgraduate education courses, in the area of TMJ, Craniofacial Pain, Sleep Disorders and Orthodontics.

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Medical Services

Dr. Demerjian currently treats adolescents and adults with tmj/mpd-mayofascial pain disorders using custom fabricated orthotic appliances, myriad of therapeutic techniques and orthodontics. His sleep-disordered breathing treatments utilize using multiple dental sleep appliances and therapeutic techniques. He also treats patients suffering from neurologic disorders with dental management of the disorder through his TMJ treatments.

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Make an Appointment

Learn about alternative treatment options available to you with a consultation from Dr. Demerjian

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About Us

The face of dentistry continues to evolve as technological and medical advances rapidly emerge. We are proud to say that we have kept abreast and that we continue to offer our patients all the advantages of the latest treatments and technology - treatment of headaches, neck and facial pain, snoring and sleep apnea solutions, dental orthopedics and therapeutic medical modalities.

About Our Office


Make an appointment with us any time. Most patients are referred to us for diagnosis and treatment, but a referral is not required.

Treatment Options

Treatment plans are developed based on a specific diagnosis and desired outcomes. Until you have been thoroughly evaluated by our office, we cannot determine your treatment plan or the cost of your treatment because our fees are based on the severity and complexity of each case.

Insurance Coverage

It is unusual for treatment to be covered fully by medical and/or dental insurance plans, however, we will provide you with all of the documentation you need to file with your insurance company, so that you have the best possible chance of coverage. We also cannot accept direct insurance assignment because benefits information is inconsistent. Read more

Insurance Concerns

In addition to communicating directly with your employer (if you are covered by an employer-sponsored health plan) and your insurance company, California residents may also wish to express their concerns to the California State Insurance Commissioner. Written complaints should be addressed as follows: State Insurance Commissioner CALIFORNIA

Virtual Tour

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Our Mission

Key to our mission is our ongoing effort in expanding our expertise as providers of advanced dentistry. Not only have we continued to incorporate the latest technologies into our practice – we’ve continued to master the skills in bringing our patients the benefits of those techniques. Our guiding principle is that our commitment to quality and our philosophy of excellence be evident in all that we do.

Armed with the desire and commitment to bring real world non-surgical solutions to his patients dental and health problems, Doctor Demerjian has over 2000 hours of continued education with a concentration in TMJ/ TMD, dental orthopedics and sleep disordered breathing. It is with that desire that Doctor Demerjian continues to attend over 100 hours of continued education courses a year.

Many patients are delighted to find a doctor as versatile as Doctor Demerjian but are even more delighted when they find a solution to their headaches, earaches, neck aches, dizziness, fainting, pain behind the eyes, difficulty swallowing, clicking and locking jaw problems. Patients with these symptoms are encouraged to call our office for an appointment. Many of the above problems can be related to jaw problems. In many cases, the lower jaw is not in the correct position in relation to the upper jaw, which causes muscle spasms with resultant painful symptoms.

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For 20 years, I saw about ten or more different general dentists for routine cleanings and/or other procedures such as crowns, extractions etc. Over time, each procedure seemed to alter my bite. As time went on, I began breaking crowns, needing bridges and breaking those as well. A few years ago, I also started experiencing pain on the left side of my neck, shoulder and upper back, with some occasional numbness down my left arm and thumb, I was also tripping and falling on the trails and my vision was off. I had to get computer glasses. I thought falling on the trails was due to me not paying attention. I thought the pain and vision issues were due to my prolonged hours in front of the computer for work or school. I saw optometrists, chiropractors, massage therapists and physical therapists who all gave me great suggestions and routines to follow, but the pain and discomfort never went away.

This past year, the discomfort got so bad, I could not sleep through the night, waking up every two hours to try to find a better position. It all came to an alarming point when I had to have a bridge replaced and the dentist that replaced it made the bridge so bad it forced me to see a prosthodontist. A what? yes, I had never heard of such a specialist. And given all I had been through with tooth doctors, I was going to take my time to find someone that really knew what they were doing.

In the last six months, I saw three prosthodontists and all three had very different approaches. But one thing was clear, they all needed me to be evaluated by other specialists before they could start any work. I had to see an endodontist to ensure no other teeth were compromised (check), a periodontist to ensure good and healthy gums (check) and a radiologist for a Jaw MRI (check). All of it was incredibly frustrating and costly, and worse, after five months, none of those things addressed the pain and discomfort. I even began having headaches and little muscle spasms around the jaw area. I also could not eat solid food. But there was one last referral to a TMJ specialist. Little did I know that should have been the first. Whoa!

At my first visit with Dr. Demerjian, he ran some tests, read my MRI and was able to assess my jaw issues. He gave me literature that explained the jaw relationship to my pain and vision situation. I had no idea TMJ could affect your balance (no wonder I was falling), strength (couldn't grip stuff with my left hand or do push ups), vision (had to get computer glasses). But he said he could help me. All things considered, I was skeptical. I had impressions taken and returned within a week to get my day and night orthotic appliances and to have a CT Scan to see what else might be going on.

A week later, I returned for my orthotic. I was blown away. There was an immediate release of pressure in my neck and shoulder area, the muscle spasms were no where to be found and I felt incredible jaw support. What? The pain and numbness were also gone. This is crazy. And for the first time, that night, I was able to sleep without waking up until morning. A week into the process, I have had minor fine tuning, but there is no more pain. I expect to wear the orthotic appliances for three to six months until my jaw gets used to the balance and then proceed with any restorative work by the prosthodontist.

Amazingness! In two weeks, Dr. Demerjian relieved over 15 years of pain no other doctor was able to alleviate. I am incredibly grateful for the work Dr. Demerjian is doing and urge anyone with clicking or even the slightest thought of a bite issue to see him first before getting any dental work done. Enough can't be said about the financial, emotional and physical pain you will experience by neglecting to see someone who focuses his practice exclusively to TMJ related issues. Hope this was useful and look forward to hearing about your experience.


S.E. Beckmann (May 2014)


Dr. Demerjian,

Thank you for being such a wonderful and knowledgeable doctor/dentist/orthodontist all in one! You have truly helped Brooke's jaw pain. And now you are straightening her teeth as well as re-aligning her jaw. You are amazing! I don't know what we would have done if we hadn't found you. Thank you for your kind care.
- E. W. Tehachapi, CA


When I was seven, I was kicked in the face and suffered a broken nose. Since then, I have suffered from migraine headaches. They have severely hampered my quality of life because I have spent countless hours in bed unable to function. Some headaches have caused me to stay in bed for several days. I get severe photophobia and nausea when I do get a migraine.

By the time I was sixteen, I was going to a neurologist regularly. I have had three MRI's done on my head to rule out any irregularities. I have been on beta-blockers, anti-seizure medication to help prevent my migraines, Imitrex nasal spray for really bad migraines, and other heavy pain medication. I had pretty much tried everything I could think have when a friend told me that it could be TMJ. I figured it couldn't hurt to get an examination, so I was referred to Dr. Demerjian by my dentist. On my first visit, I went through some tests to see where my problems were. I did have problems with clenching my teeth which caused a lot of my headaches. After a few visits, I was given two mouth guards to wear: one during the day and the other while I sleep. The day mouth guard was not bad at all. No one could tell that I was wearing it and it only took a little while to get used to. The night mouth guard is great because I am able to wear it comfortably while I sleep.

I started noticing some considerable improvements after about one month of wearing the mouth guards. I used to get one or two migraines a week and after about a month of wearing the mouth guards, my migraines reduced to about one or two a month. I have been wearing the mouth guards for about five months now, and I get maybe one migraine a month. I know that I will never get rid of my migraine headaches totally, but I can definitely deal with one headache a month.
- B. M. San Fernando, CA


TMJ is short for the TemporoMandibular Joint (jaw joint). TMD stands for TemporoMandibular Dysfunction. TMJ and TMD have been used synonomously to refer to a number of craniofacial problems and pains associated with the temporomandibular joint. The temporomandibular joints are located on either side of the face and connect the lower jaw to the skull. They are the most unique and complex joints in the entire body.

What is TMJ / TMD?

Dr. med. Health Clinichover background

The TM joints work in synergy with the facial bones and multiple pairs of muscles to allow opening and closing of the mouth, chewing, swallowing and speech, as well as to enable the forward, backward, rotational, and side-to-side movements of the lower jaw.

Any disturbance to the perfect facial balance can trigger the cycle characteristic of TMJ disorders, which affects muscles and joints on all areas of the face, neck, and back. When muscles and joints are not working together correctly, muscle spasm can result which produces pain and dysfunction. Due to this complex system, a problem in one area can cause symptoms elsewhere.

In a normal joint, the disc, a thin piece of cartilage, acts as a cushion or shock absorber between the condyle and the glenoid fossa. It is held in place and guided by muscles and ligaments. When the lower jaw opens and closes, the disc stays between the condyle and the glenoid fossa at all times.

The following are contributing factors to TMJ disorder: trauma to the head and face, whiplash, uneven bite (malocclusion), bruxism (grinding your teeth), clenching etc. When trauma to the TM joints is prolonged, the body begins to compensate by involving muscles in other areas: the face, neck, throat, upper and lower back, arms, etc.

TMD is often a chronic and degenerative disease. Anyone experiencing headaches, earaches, dizziness and clicking or popping in the jaw joints should schedule an appointment for a thorough examination with a qualified dental professional, before their symptoms become more severe.

Signs and Symptoms

TMJ disorders have been called the “Great Impostors” because many of the symptoms have overlapping characteristics, which often mimic other conditions. Indeed, it is quite common for people to seek the care of a medical doctor or medical specialist in search of a cure or answer. Most, however, never think to contact a dentist trained in TMD since the symptoms are primarily medical in nature.

Do you suffer from any of these?

• Headaches • Jaw joint clicking or popping
• Facial Pain • Neck pain or stiffness
• Jaw joint pain • Worn, loose or sensitive teeth
• Limited ability to open and close your mouth • Difficulty eating, chewing or swallowing
• Dizziness or vertigo • Pain whenever you talk or smile
• Earaches (or ear congestion) • Poor posture

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According to statistics published in the Journal of the American Dental Association in 1990,* 44% to 99% of TMJ problems are caused by trauma. By trauma, we mean an injury as obvious as a blow to the jaw with a fist or something as subtle as a whiplash injury, with or without direct trauma to the head or jaw. (*JADA 1990;120:267) An overwhelming majority of patients who sustain whiplash injuries in motor vehicle accidents (MVA) also dislocated one or both temporomandibular joints at the same time without having impacted their face or head against the steering wheel, door column, windshield or other parts of the car.

Some of the causes of TMD include:


TMD diagnosis is a complex and often daunting process. This explains why physicians and dentists who are not board-certified orofacial and craniofacial pain specialists may miss a potential TMJ disorder in a patient that is suffering from chronic head, neck and/or facial pain.

How is the diagnosis made?

The usual evaluation of the TMJ involves a physical examination of the muscles of the head, face, neck and shoulder with manual palpation. The doctor feels for muscle spasm and rules out "trigger points" which can refer pain to other areas. Ranges of Motion Studies–measurements of jaw movement when moving side to side and on full opening of the mouth, are assessed. General skeletal alignment is also assessed. Additionally, radiographs allow us to see actual pictures of the joint components and their relative state of health. In many cases, additional tests may be recommended. At our office we also utilize the latest in computer diagnostics to measure and record jaw joint activity and jaw movement.

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Before we are born, a strong cord of tissue called a frenulum is located in the center of the mouth to guide development of mouth structures. As we develop, the frenulum recedes and thins. The lingual (tongue) or labial (lip) frenulum is easily felt and plainly visible if you look in the mirror under your tongue and upper lip. In some children, however, the frenulum is especially tight or fails to recede and may cause problems with tongue / lip mobility. The tongue and lip are a complex group of muscles vital to proper oral function. Tongue-tie can lead to serious nursing, eating, dental or speech problems for some individuals. Find out how this procedure helps newborns with breastfeeding, tongue movement, and jaw development.

Lip-Tie (Maxillary Frenum)

The maxillary frenum is the membrane between the lip and the gum. When it is very tight it may interfere with a baby’s ability to latch correctly on the breast, and interfere with the ability to maintain good oral hygiene and proper dental development.

Lip-tie release may improve feeding, brushing, gum recession, spaced teeth, etc.

Tongue-Tie (Lingual Frenum)

The lingual frenum is the cord that stretches from the tongue to the floor of the mouth. If the tongue is attached too tightly to the floor of the mouth, its mobility is restricted, often causing difficulty with breastfeeding, chewing, speech, oral hygiene, etc.

Tongue-tie release (frenectomy) may improve these problems when followed by stretching exercises and follow-up with your Lactation Consultant..

Common Symptoms

For infants...

• Problems latching on the mother's breast • Poor weight gain
• Colic and / or reflux symptoms • Inability to feed from a bottle or hold pacifier in mouth


For older children...

• Narrow upper jaw • Difficulty moving tongue from side to side
• Inability to touch roof of mouth • Inability to stick out tongue beyond the upper gums


For Moms...

• Creased, flattened or blanched nipples after nursing • Severe pain when infant attempts to latch
• Poor or incomplete breast drainage • Mastititis or nipple thrush

Effects on Child's Development

A new baby with a too-tight tongue and/or lip frenulum can have trouble sucking and may have poor weight gain. If they cannot make a good seal on the nipple, they may swallow air, causing gas and stomach problems. Nursing mothers who experience significant pain while nursing or whose baby has trouble latching on should have their child evaluated for tongue- and lip-tie. Although it is often overlooked, it can be an underlying cause of feeding problems that not only affect a child’s weight, but lead many mothers to abandon breastfeeding altogether.

At its most basic level, not being able to latch on the mother’s breast can cause the tongue and lip muscles to function differently, and may compromise proper development of the teeth and jaw. Subsequent oral complications may include bite problems (overbite and underbite), TMJ and underdeveloped jaws, narrow arches, crowded teeth, and even breathing issues such as snoring and sleep apnea.

Some older children with tongue-tie may develop slight speech impediments—difficulty articulating certain sounds may be noticed (if your three-year-old’s speech is not understood outside of the immediate family circle, evaluation may be warranted). Appearance can also be affected by persistent dental problems such as a gap between the top or bottom two front teeth. The frenulum can also pull against the gingiva (gums) on the front or back of the teeth, causing recession. In addition to the aesthetic problem, this can lead to sensitivity and pain. The tight lip frenulum may trap food, plaque and other bacteria against the teeth and is a major factor in Early Childhood Caries (nursing / bottle cavities).

We use the latest progressive techniques such as lasers and electrocaudery. There is minimal discomfort, with faster healing time, no bleeding, and no sutures needed. In some cases, latching can occur immediately after the procedure.


Movement Disorders

There are several diseases and disorders that have been linked to problems with TMJ. The following list provides a look into these diseases and shows the connection that TMJ/TMD with specific facets of the disorders.

Parkinson's Disease

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Parkinson’s Disease (PD) is a progressive neurological disorder that affects movement. Its symptoms may include tremors, rigidity, and blank faces. Slowing or jerky movements are also characteristic of this disease. Comorbidities of Parkinson’s include difficulty sleeping, forward head posture, problems with balance, and other neurologic problems. Symptoms of the disease usually begin between 50 and 60 years old, although some have experienced earlier symptom onset (WebMD, 2010). Various diagnostic tests are used to determine PD, although there are many disorders that resemble Parkinson’s symptoms.

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Cervical Dystonia (CD), or Spasmodic Torticollis, is characterized by abnormal movement or positioning of the head and neck muscles. These sustained muscle contractions result in abnormal head postures which vary depending on the muscles that are affected. CD is the most common form of focal dystonia (it affects one area of the body) and is found in twice as many women as men (Sims, Stack, & Demerjian, 2012). Symptoms of CD include rotational twisting (laterocollis), backward rotation (retrocollis), or frontal rotation (anterocollis), of the head / neck and/or a combination of these. Pain or head tremor is often associated with those that have sustained contractions and there is often associated dystonia in the upper muscles of the same side (segmental dystonia) (Sims & Demerjian, 2012).

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Fibromyalgia is a chronic disorder characterized by pain and tenderness in the joints and muscles of the entire body. It is accompanied by fatigue, loss of sleep, headaches, and has also been linked to depression and anxiety (A.D.A.M. Medical Encyclopedia, 2012). Fibromyalgia is believed to be the result of amplified pain sensations that affect the way the brain processes pain signals (Mayo Clinic, 2011), although it has also been attributed to physical or emotional stress, repetitive injuries, or illness (NIAMS, 2011). Symptoms of fibromyalgia mainly involve pain. Tender points, or painful areas, can be found in the soft tissue of the neck, shoulders, back, hips, elbows, and knees. From these areas, the pain surges to different parts of the body and may feel like a deep ache or a shooting “burning” pain (A.D.A.M. Medical Encyclopedia, 2012). Fibromyalgia affects more women than men, most commonly occurring around middle-age (NIAMS, 2011). It is also more likely to develop in those who have a family member with the disorder and those that have a rheumatic disease (Mayo Clinic, 2011).

Tourette Syndrome

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Tourette Syndrome (TS) is a neurological disorder characterized by involuntary movements (tics) and vocalizations. Tics occur frequently and rapidly and can present itself on the face, specific body parts, or the entire body. These uncontrollable motor movements may start as an eye blink or a nose twitch, but can progress to more complicated movements such as kicking or stamping (nTSA, 2012). Verbal tics, such as groaning or throat clearing, usually accompany these involuntary movements. Echolalia, or the spontaneous utterance of sounds, is a well-documented symptom of TS (Sims & Demerjian, 2012), although corpolalia, or involuntary swearing, which is popularly associated with the disorder, is a rare occurrence (nTSA, 2012). Symptoms of TS include either simple or complex tics and often get worse with intense emotions, excitement, or anxiety (NINDS, 2012).

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Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD), is a nerve disorder that produces chronic pain in an area of the body and is believed to occur as a result of injury or dysfunction to the nervous system (NINDS, 2012). Common features of CRPS include severe skin discoloration and temperature changes over the affected body part, followed by an intense burning sensation, sensitivity to touch, and swelling (NINDS, 2012). CRPS has two forms: CRPS I occurs as a result of a minor injury and CRPS II occurs due to injury to a nerve (A.D.A.M. Medical Encyclopedia, 2012). CRPS affects both men and women of any age, although many experts agree that it is more common among young women (NINDS, 2012).

Sleep Disorder

Sleep is as important to your health as diet and exercise. Without enough sleep, it's impossible to live your life to its fullest. By the most basic definition, anyone who doesn't get enough quality sleep has a “sleep disorder” – a broad term that is used to identify a range of problems.


Sleep problems have many causes:

It could be a problem with your airway and/or your breathing, such as snoring and obstructive sleep apnea. It could be a problem with the way signals travel to and from your brain, such as narcolepsy. It could be a condition that causes uncontrollable leg movements at night – that is, restless legs syndrome. Or it could be one of the many problems that lead to insomnia, such as stress.

Sleep disorders are common among patients who suffer from allergies, ulcers, arthritis, heart disease, asthma, hyperthyroidism, kidney disease, Parkinson's disease, and Alzheimer's disease.

If you or someone you love is suffering from a lack of restful sleep, a smart first step is to discuss your concerns with a dentist who is trained in dental sleep medicine. He or she will review your dental and medical history, evaluate your airway and nasal passages using state-of-the-art technology and, if warranted, recommend treatment or refer you to the right kind of sleep specialist.

Known Sleep Disorders



According to the American Sleep Apnea Foundation, more than 12 million Americans suffer from sleep apnea, and it is estimated, conservatively, that 10 million Americans remain undiagnosed. Are you one of them?

When the muscles of the jaws, soft palate and the tongue become too relaxed during sleep, they can sag and partially or completely block your airway. As you struggle to breathe, your body becomes distressed and you become partially awake, nearly every time this event occurs. These episodes can occur hundreds of times each night, keeping you from reaching the deep, restorative sleep your body requires and putting a great deal of stress on your heart. Since this can have serious consequences, we urge anyone who is concerned about the quality of their sleep to contact their physician or a dental professional with advanced training in dental sleep medicine.

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After a thorough examination of the airway and nasal passages, if the problem is found to be in the nasal passages or adenoids and tonsils a referral will be given to an otolaryngologist (ENT) with the testing results for the ENT to be able to determine the degree of obstruction and necessity for surgery.

However if SDB is due to a malformation of the teeth and jaw then we will be able to evaluate the child for oral appliance therapy. With oral appliance therapy we can correct structural problems such as recessed jaw, narrow arches that may be leading to airway narrowing or collapsing.

CPAP Intolerant


CPAP is an extremely effective therapy; however, nationally only 45% of patients using CPAP machines continue to use them.

The American Sleep Disorders Association is recommending dental appliance treatment for patients with severe OSA who are intolerant of, or refuse treatment with, CPAP.

A CPAP (continuous positive airway pressure) is a machine that delivers lightly pressurized air through a hose to a small nose mask. The flow of the air acts like an “air splint” to keep the upper airway open and prevent apnea (i.e., shortness of breath). CPAP machines have 99% efficiency in restoring normal breathing during sleep. They have also undergone many improvements since an Australian invented the first one from a vacuum cleaner and a length of hose. However, the rate of patient compliance with CPAP is less than 50%.

Thanks to advances in dental sleep medicine, qualified dentists can effectively treat many patients who suffer from snoring, obstructive sleep apnea, upper airway resistance syndrome and other sleep-disordered breathing problems using oral appliance therapy.

An oral sleep appliance is similar in appearance to an athletic mouthguard, and it is worn during sleep to maintain airway patency. Oral sleep appliances are safe, less expensive vs. CPAP or surgery, and easy to use.

There are also few, if any, side effects. However, one size does not fit all. There are currently six (6) different FDA-approved oral appliances we can use to treat sleep-disordered breathing. Regardless of the appliance selected, to be effective, it must be properly customized and precision fit for each patient. For some patients, an oral sleep appliance can eliminate the need for CPAP or surgery. For patients with more severe sleep problems, an oral appliance can be an effective and convenient adjunct therapy.

Pediatric Sleep Disorders

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Children can also snore and suffer from obstructive sleep apnea. Often they are highly allergic and their airway is blocked due to enlarged adenoids, tonsils or swollen nasal mucosa. The snoring or labored breathing can also be due to structural problems of the jaw and teeth. Sleep Disordered Breathing ranges in severity, from snoring to different digrees of airway obstruction. This is why it is important to have a dentist trained in SDB to evaluate the situation.

Some of the things to pay attention to at home are:


  • Abnormal sleep position
  • Restless sleep
  • Difficulty waking up
  • Bed-wetting
  • Headaches during the day
  • Stop breathing during the night
  • Irritability
  • Difficulty in concentrating at school
  • Hyperactivity
  • 81% of snoring children with ADHD could have their ADHD eliminated if their habitual snoring were effectively treated. (Chervin, R.D., et.al., Symptoms of Sleep Disorders, Inattention and Hyperactivity in Children, 1997, Sleep 20(12): 1185-1192).
  • Using a dental sleep appliance can eliminate the need for surgical removal of the tonsils in some cases.
  • Nighttime bedwetting ceased in 10 cases studied when oral therapies were used to reduce nasal constriction. (Timms, D., Rapid Maxillary Expansion in the Treatment of Nocturnal Enuresis. The Angle Orthodontist, 1990, 60(3).

Unlike adults, children who suffer from  sleep-disordered breathing are often likely to exhibit  hyperactivity during the day.

Restful sleep is essential to your child's health

Undiagnosed and untreated pediatric sleep disorders have been linked to a spectrum of health and behavioral issues, including

  • Attention Hyperactivity Deficit Disorder (ADHD)
  • Nocturnal Enurosis (Nighttime Bed Wetting)
  • Weight Gain or Obesity
  • Nightmares


Dental Orthopedics

Orthopedics simply put is changing the size, shape, and relationship of the bones of the face and jaws to create symmetry and balance. The simple concept of Orthopedics suggests that dental overcrowding is not due to there being too many teeth, but to the fact that facial growth has not reached its full genetic and growth potential. It takes into consideration airway issues, upper and lower jaw relationship and proper tongue position. Orthodontics simply put is the movement and correct alignment of the teeth.

What is Dental Orthopedics?

Orthopedics simply put is changing the size, shape, and relationship of the bones of the face and jaws to create symmetry and balance. The simple concept of Orthopedics suggests that dental overcrowding is not due to there being too many teeth, but to the fact that facial growth has not reached its full genetic and growth potential. It takes into consideration airway issues, upper and lower jaw relationship and proper tongue position. Orthodontics simply put is the movement and correct alignment of the teeth.

Both disciplines deal with malocclusion or “bad bite”



Orthopedics looks at the whole person and as such can be applied to all age groups. Our team will be looking for all aspects of dental, facial, cranial and skeletal structural imbalances. As the baby develops into an infant, external factors (mouth breathing, thumb sucking, ear, nose and throat (ENT) problems etc) effect normal growth. When the baby molars and first permanent molars erupt into contact it locates and locks in the early skeletal development. The teeth will make contact regardless of the size and position of the upper and lower jaws and at this stage, the dental interface becomes essential for the first time. It is possible to interpret the extent of the bony discrepancy for each individual. This is achieved by clinical examination by the Dentist, followed by the taking of study models and cephlometric radiographs.

Causes and Symptoms

What caused the problem in the first place?

No one knows the exact cause of every orthodontic problem. Some causes are very evident, such as thumb sucking. Most are much more complex, However, the old cliche' that the patient inherited daddy's teeth and mother's jaw is simply not correct. You are never too old to be evaluated for craniofacial or dental orthopedic problems. You are never too old to correct a problem non- surgically.



Malocclusions are usually inherited or acquired.

Acquired malocclusions can be caused by accidents (called "trauma"), sucking of the thumb, finger or pacifiers, tonsils and adenoids that obstruct the airway, and disease or premature loss of primary or permanent teeth.

Inherited malocclusions that determined how well your teeth fit together are largely determined by such attributes as tooth and jaw size. For example, people can inherit large teeth and small dental arches, or the reverse. A "poor bite" is often caused by teeth that have too much or too little room in the jaw. Other common causes of crooked teeth are factors that move the teeth out of place, including oral habits and early tooth loss, which leads to tooth shifting.

Regardless of whether malocclusions are inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance as well.


On assessing the face it is possible to see many features that might be construed as not normal, such as:


Teeth that do not meet normally will lead to the following symptoms

  • Narrow palate with a high arch
  • Mouth breathing and poor lip seal
  • Lower jaw well behind upper jaw
  • Lower jaw well in front of upper jaw
  • Lower jaw deviating to one side
  • Temperomandibular joint dysfunction
  • Overcrowded teeth

ENT problems

  • Facial disharmony
  • Problems with biting the cheek or roof of the mouth
  • Over crowded teeth-permanent teeth erupting out of their normal position
  • Poor function of the teeth
  • Headaches and various facial pains
  • Speech difficulties
  • Self- consciousness

Warning Signs


Functional habits include thumb sucking, mouth breathing or a tongue thrust habit which can contribute to the unfavorable growth of the jaws. Oral habits can commonly cause the upper front teeth to stick out and can contribute to speech problems. The best way to intercept a habit is to first make certain that the child has a proper size airway and can breath through the nose. In cases where there are serious allergies, swollen adenoids or tonsils, a referral to an Ear, Nose & Throat Specialist must be done.

These are all signs that your child may need early intervention!

Dental Orthopedics works with your child's growth and development to guide the jaws to their proper size.


Early Treatment

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Early orthopedic treatment usually starts before the eruption of the permanent teeth or when the child has very few permanent teeth present. Our goal is to guide the growth of the upper and/or lower jaw to make adequate space for the eruption of all the permanent teeth. We feel that children should be evaluated by the age of four to see if there is a bone problem (orthopedic) or a tooth problem (orthodontic).

It is always less expensive to correct a problem when the patient is younger rather than wait for the problem to become more serious in the future.

Dr. G. Gary Demerjian D.D.S.

Dr. Demerjian is an expert in Neuronatomy, Pain Patterns, Trigger Points, the Trigeminal Branch/Nerve and how it correlates to Neurologic Disorders. He has published several articles and research papers including how the trigeminal system is conncected to neurologic disorders.


Dr. Demerjian has taken over 2000 hours of postgraduate education courses, in the area of TMJ, Craniofacial Pain, Sleep Disorders and Orthodontics. He is knowledgeable in neuro-anatomy, pain patterns, trigger points, the trigeminal branch/nerve and how it correlates to neurologic disorders. In 2014, he has joined Fontana Kaiser and worked as Project Scientist for the Department of Oral Biology in the UCLA School of Dentistry.


Since 2004, he has limited his practice to the treatment of TMJ Disorders, Headaches, Facial Pain, Sleep Apnea, Movement Disorders and Orthodontics. Along with two busy practices, Dr. Demerjian also lectures on topics in Temporomandibular Joint Disorders and its correlates on neurologic disorders.


Dr. Demerjian currently treats adolescents and adults with tmj/mpd-mayofascial pain disorders using custom fabricated orthotic appliances, myriad of therapeutic techniques and orthodontics. His sleep-disordered breathing treatments utilize using multiple dental sleep appliances and therapeutic techniques. He also treats patients suffering from neurologic disorderswith dental management of the disorder through his TMJ treatments. He has published several articles and research papers including how the trigeminal system correlates to neurologic disorders.


Bonita High School, La Verne, California 1980-1984

University of La Verne, La Verne, California 1984-1985

Loma Linda University, Loma Linda, California 1985-1987

University of the Pacific School of Dentistry, San Francisco, California 1987-1990

Post-Graduate Achievements

Diplomate/Master - American Board of Craniofacial Pain

Diplimate - American Board of Craniofacial Dental Sleep Medicine

Diplomate - American Board of Dental Sleep Medicine

Diplomate - American Academy of Pain Management

Diplomate – American Board of Forensic Dentistry

Diplomate – American College of Forensic Examiners

Fellow - American Academy of Craniofacial Pain

Fellow - International College of Craniomandibular Orthopedics

RPSGT - Registered Polysomnographic Technologist

Master - Electro-Diagnostic Modalities – Bio-Research Institute

Certified Forensic Consultant

Certified - Academy of Laser Dentistry

Affiliations and Associations

American Academy of Craniofacial Pain

American Academy of Pain Management

International College of Craniomandibular Orthopedics

American Academy of Orofacial Pain

American Academy of Dental Sleep Medicine

American Academy of Sleep Medicine

American Association for the Advancement of Science

American College of Forensic Examiners International

International Association of Orthodontics

American Academy of Functional Orthopedics*

American Dental Association

California Dental Association

San Gabriel Valley Dental Society

American Academy of Cosmetic Dentistry*

Academy of Laser Dentistry*


Demerjian GG, Barkhordarian A, and Chiappelli1 F.Testing patient targeted therapies in patients with temporomandibular joint disorder with the arthrokinetic reflex: individual patient research Journal of Translational Medicine 2016, 14:231.

Sims AB, Stack BC, Demerjian GG. Spasmodic Torticollis: The Dental Connection; Cranio Journal 2012, 30:188-93.

Barkhordarian A, Ajaj R, Ramchandani M, Demerjian G, Cayabyab R, Danaie S, Ghodousi N, Iyer N, Mahanian N, Phi L, Giroux A, Manfrini E, Neagos N, Siddiqui M, Cajulis O, Brant X, Shapshak P, Chiappelli F. Osteoimmunology in HIV/AIDS: A Translational Evidence-Based Perspective, Pathology Research International 2011, E. pub 2011 May 21.

Demerjian G, Sims A, Stack B. Proteomic Signature of Temporomandibular Joint Disorders(TMD): Toward diagnostically predictive biomarkers, BioInformation 2011, 5:282-4.

Barkhordarian A, Demerjian G, Jan A, Sama N, Nguyen M, Du A, Chiappelli F. Stakeholder engagement analysis - a bioethics dilemma in patient-targeted intervention: patients with temporomandibular joint disorders, J Transl Med. 2015; 13: 15.

Chiappelli F, Barkhordarian A., Demerjian G, Bach Q, Vandan Kasar. Cluster Randomized Stepped Wedge Blinded Controlled Trials (CRSWBCT) In Comparative Effectiveness Research (CER) – Part II: Implications for Temporomandibular Joint Disorders (TMD) Research, Transl Med (Sunnyvale) 2015, 5:3.

Chiappelli F, Barkhordarian A. Demerjian G, Bach Q, Vandan Kasar. Cluster Randomized Stepped Wedge Blinded Controlled Trials (CRSWBCT) In Comparative Effectiveness Research (CER) – Part I: Toward a Revision of CONSORT, Transl Med (Sunnyvale) 2015, 5:3.

Volunteer Work


Dr. Demerjian grew up in Pasadena and his family moved to La Verne in 1981. He has been practicing dentistry in the city of Glendora since 1990 and in the San Fernando Valley since 2001. He is an avid Martial Arts practitioner, holding several Black Belts in numerous styles. He serves as the head instructor for Marquez School of Hope, teaching karate to all students including to the specially challenged. He is on the Dental Advisory Committee at Citrus College and the Sleep Panel at the Pomona Valley Hospital. He maintains active membership in numerous scientific organizations.


Learn more about TMJ: Here are some of the current articles, news information, research, and videos regarding TMJ and how it relates to different disorders and related aspects of dental orthopedics.

Trigeminal Neuralgia and TMJ

On October 28. 2016

By Sara Berg

Trigeminal neuralgia and TMD

The temporomandibular joint (TMJ) and the trigeminal nerves are some of the most important structures of your face. With that being said, when pain is experienced it can take a toll on your everyday life. However, what is the difference between temporomandibular joint disorder and trigeminal neuralgia?

When the TMJ is out of alignment or compromised in other ways, it can affect many other areas of the head and neck. Since the trigeminal nerve innervates with the TMJ it can also innervate so much of the face and neck. As a result, pain all over the head and face can result when there is any sort of disorder present in this structure.

Read more

Chronic Pain and TMJ

On October 28. 2016

By Sara Berg

Chronic pain and TMD

Many people suffer from recurring head, face, neck or jaw pain, but can’t seem to find help or have been told it is all in their head and there is nothing that can be done to fix the pain. With many people being victims of unresolved chronic pain following car accidents or other forms of trauma, it is important to find a proper diagnosis to help eliminate chronic pain.

The temporomandibular joint (TMJ) is the most complicated joint in the body. When damage occurs to the TMJ, it can be noticed through early clicking or popping sounds during jaw movement. Early detection can help to prevent more serious problems from developing. Chronic pain can develop with TMD, which is why it is important to get treatment immediately.

TMD is not just a single disorder; it is actually a group of painful conditions that can affect your jaw joint and chewing muscles. Because the muscles in your face and jaw are intertwined, if your jaw is misaligned, it can lead to a series of problems from your head to your back and beyond. Let’s take a look at a few different places chronic pain can occur and its relationship to TMD.

Neck and Shoulder Pain

If your jaw bone does not close evenly it can create pain in your neck and shoulders. And when the jaw muscles don’t properly function, the surrounding tissue may experience chronic stress, pain and swelling. Since your jaw muscles run from one ear to the other, as well as interact with muscles in the neck, symptoms of jaw distress may surface in the neck and shoulders. If you are experiencing unexplained pain in your neck and/or shoulders, you may be suffering from TMD.

Because of the complex anatomic, neurological and physiological relationships within your head and neck, the symptoms of TMD can appear to be those of other diseases. For this reason, it is important to visit Dr. Demerjian as soon as possible for a proper diagnosis.

Read more

The Importance of Participating in Pain Research

On September 29. 2016

By Barby Ingle, Columnist for the Pain News Network

Over the years I have participated in many research studies and potential new treatments. One such study was just published in the Journal of Translational Medicine by Drs. Garabed G. Demerjian, Andre Barkhordarian and Francesco Chiappelli.

So many people over the years meet me and soon realize that I have a device called an oral orthotic in my mouth. This “OO” as I lovingly call it has helped me so much, and now there is published research behind what it is doing for me.

Back in 2002 when I developed Reflex Sympathetic Dystrophy, I lost partial vision in my right eye. I saw many eye doctors and ENT (ear, nose and throat) specialists who were unable to pinpoint where the breakdown in the nerves were. They hypothesized that it was due to inflammation from the RSD cutting off a nerve pathway.

Read more at the Pain News Network

iPain Webinar Series - Neuro-Inflammation TMJ Connection

On March 22, 2016

By International Pain Foundation

I participated in the International Pain Foundation's iPain Webinar Series to talk about the connection of neuro-inflammation and TMJ. Watch the 3-part series here.

Mission Trip

On May 7, 2013

By Dr. Gary Demerjian

My two passions are treating people who have TMJ with co-morbid neurologic conditions and serving the needs of the impoverished.

I had the privilege of being a part of something where giving of myself, my talents and my time over one weekend served many people. On April 12-14th, I flew to Mexico to serve with a Medical Missions team. The organization was Manos Con Alas Ministries, meaning Hands with Wings. It is a Christian faith-based non-profit California corporation, dedicated to bringing health services and simple shelter to the impoverished.

This trip was to Casa del Pastor, a home in Baja California, Mexico for women and their children, who are abandoned and abused. Its goal is to minister to their spiritual needs while helping with their physical needs.

Our goal was to serve and treat as many people as possible. There is a great need there for medical and dental care. We worked out of a make shift clinic, out of a trailer, to meet their basic medical and dental needs. All we did was giving basic services such as fillings and extractions.

The people on this trip were Dr. Michael N. Budincich a Chiropractor, Dr. Mark De Leon and I were the Dentists, two dental assistants and several helpers and translators.

Between Dr. De Leon and I, we served the dental needs of fifty people. Dr Bud saw twenty-five chiropractic patients.

Living With Hope with host Trudy Thomas

On May 3, 2013

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My guest today is Dr. Gary Demerjan. I will also be joined by Barby Ingle, Executive Director of the Power of Pain Foundation.

Dr. Demerjian's practice is limited to the treatment of TMJ Disorders and Sleep Disordered Breathing. He has extensive experience in treating adolescent and adult patients suffering from TMJ Disorders, Headaches, Facial Pain, Sleep Apnea, Movement and Neurologic Disorders through non-surgical, custom fabricated orthotic appliances, orthodontics as well as various other therapeutic techniques.

Dr. Demerjian has taken over 1000 hours of postgraduate education courses, in the area of TMJ, Craniofacial Pain, Sleep Disorders and Orthodontics. He is knowledgeable in -anatomy, pain patterns, trigger points, the trigeminal branch/nerve and how it correlates to neurologic disorders.

Dr. Gary Demerjian on TMJ and Oral Orthotics

On December 9, 2012

With 6 Comments

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A few months ago I had the great privilege of meeting TMJ Specialist, Dr. G. Gary Demerjian, who spoke to me of a new frontier in non-invasive neuro-muscular medicine and dentistry. With a thorough understanding of the TemporoMandibular joint and the surrounding nerves, Dr. Demerjian and his colleagues are able to treat many chronic, painful, and debilitating conditions, thought to be incurable, with a device called an oral orthotic. I have personally gone through the assessment for this device, and had a very positive experience. With that in mind, this article will be the first of a three part series, and will provide all the necessary background information about the TemporoMandibular joint, information on the screening process, and a bit about the device.

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Featured Video

On January 8, 2013

By Admin

An alternative treatment to medications, Botox or surgery. See how his torticollis corrects and shoulder spasms stop immediately with Dr. Demerjian's custom orthotic specifically adjusted TMJ treatment.

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