About Orofacial Pain & TMJ

Insurance & Appointments

Treatment Questions

  • Orofacial pain is one of 12 recognized dental specialties by the American Dental Association. The specialty focuses on diagnosing and treating chronic pain and dysfunction from the neck up, including musculoskeletal disorders, neuropathic conditions, neurovascular issues, and sleep disorders.

    In simple terms, orofacial pain specialists treat TMJ disorders, muscle pain, nerve pain, chronic headaches, and obstructive sleep apnea.

  • An orofacial pain specialist is a dentist who has completed advanced training beyond dental school. This includes a two-year residency program at a CODA-accredited university focused specifically on diagnosing and treating complex pain conditions affecting the head, face, neck, and jaw.

    Board-certified orofacial pain specialists like Dr. Kruman are diplomates of the American Board of Orofacial Pain (ABOP), which requires passing rigorous examinations and maintaining continuing education in pain management.

  • You should see an orofacial pain specialist if you're experiencing any of the following symptoms that persist for more than two weeks:

    • Chronic jaw pain, clicking, popping, or locking in your TMJ

    • Frequent headaches or migraines that don't respond to standard treatment

    • Facial pain, especially around the temples, jaw, or cheeks

    • Difficulty opening your mouth fully or pain when chewing

    • Ear pain or ringing without an ear infection

    • Neck pain that radiates to your head or jaw

    • Morning headaches or jaw soreness (may indicate teeth grinding)

    If you've seen other healthcare providers without finding relief, an orofacial pain specialist (like Dr. Kruman in Walnut Creek) can provide a comprehensive evaluation and specialized treatment plan.

  • TMJ stands for temporomandibular joint—we all have two of these joints located just in front of each ear. These joints connect your jawbone to your skull and allow you to chew, talk, yawn, and open your mouth. When people say "I have TMJ," they usually mean TMJ disorder or TMD (temporomandibular disorder), which refers to pain and dysfunction in the jaw joint and surrounding muscles.

    TMD can cause jaw pain, clicking or popping sounds, limited jaw opening, headaches, ear pain, and difficulty chewing.

    As a board-certified orofacial pain specialist serving the Bay Area, Dr. Kruman diagnoses the specific type of TMD you have and creates a personalized treatment plan to address your symptoms.

  • Dr. Kruman treats a wide range of chronic pain conditions affecting the head, face, neck, and jaw, including:

    TMJ Disorders (TMD):

    • Jaw pain, clicking, popping, or locking

    • Limited jaw opening

    • Jaw muscle tension and pain

    Headaches:

    • Chronic migraines

    • Tension-type headaches

    • Cluster headaches

    • Trigeminal autonomic cephalalgias

    Facial Pain:

    • Trigeminal neuralgia

    • Atypical facial pain

    • Myofascial pain syndrome

    Nerve Pain:

    • Burning mouth syndrome

    • Neuropathic facial pain

    • Post-traumatic nerve pain

    Sleep Disorders:

    • Obstructive sleep apnea (oral appliance therapy as a CPAP alternative)

    Dr. Kruman serves patients throughout the Bay Area, from Sacramento to South Bay, with office locations in Walnut Creek and telehealth options available for California residents.

  • Symptoms vary depending on the specific condition and structures involved, but common signs include:

    • Jaw symptoms: Pain, clicking, popping, grinding, limited opening, locking

    • Head pain: Headaches, migraines, temple pain, pain behind the eyes

    • Facial symptoms: Burning sensations, shooting pain, numbness, tingling

    • Neck pain: Muscle tension, stiffness, pain that radiates upward

    • Ear symptoms: Fullness, ringing (tinnitus), pain without infection

    • Sleep issues: Snoring, gasping, teeth grinding (bruxism), morning headaches

    If your pain persists beyond two weeks or significantly impacts your quality of life, schedule a consultation for a comprehensive evaluation.

  • Treatment is tailored to your specific diagnosis and individual needs. Dr. Kruman uses evidence-based approaches that may include:

    Conservative treatments:

    • Custom oral appliances (TMJ splints, sleep apnea appliances)

    • Physical therapy exercises and stretches

    • Lifestyle modifications and self-care strategies

    • Stress management techniques

    Advanced interventions:

    • Botox injections for muscle pain and chronic migraines

    • Trigger point injections for muscle tension

    • Nerve blocks for neuropathic pain

    • Medication management when appropriate

    Diagnostic tools:

    • Advanced imaging (MRI, CBCT) when needed

    • Comprehensive pain evaluations

    • Sleep study coordination for suspected sleep apnea

    During your initial consultation at our Walnut Creek office, Dr. Kruman will conduct a thorough evaluation and create a treatment plan tailored to your specific condition and goals.

  • Yes, Dr. Kruman accepts Kaiser insurance for orofacial pain treatment at our Walnut Creek location.

    For patients with other insurance plans or self-pay patients, we provide a detailed superbill at the end of each visit that you can submit to your insurance company for potential reimbursement. Many patients find that orofacial pain treatment is covered under medical insurance rather than dental insurance, as we treat medical conditions like chronic pain, headaches, and sleep apnea.

    We recommend contacting your insurance provider before your appointment to verify coverage for orofacial pain services. Our office staff can provide the necessary procedure codes to help you check your benefits

  • Treatment costs vary depending on your specific diagnosis and treatment plan. Here are some general ranges:

    Initial consultation: Includes comprehensive evaluation, diagnosis, and treatment planning. Contact our office for current pricing.

    Common treatments:

    • Custom oral appliances: Varies based on complexity and type

    • Botox or injection therapy: Depends on number of injection sites needed

    • Follow-up visits: Shorter than initial consultation

    For Kaiser patients, services are billed through your Kaiser insurance. For self-pay patients, we offer transparent pricing and will discuss all costs before beginning treatment. Many patients find that investing in specialized orofacial pain treatment provides significant relief and improves quality of life compared to years of unsuccessful treatments elsewhere.

  • We accept major credit cards, debit cards, checks, and cash. For Kaiser patients, services are billed directly to Kaiser.

  • You can book an appointment in several ways:

    We see patients at our Walnut Creek office and also offer telehealth appointments for California residents.

    New patient appointments typically take 60-90 minutes to allow for a comprehensive evaluation.

  • Your initial consultation is comprehensive and typically lasts 60–90 minutes.

    Dr. Kruman will:

    1. Review your medical history: Discuss your symptoms, pain patterns, previous treatments, and medical background

    2. Conduct a thorough examination: Evaluate your jaw joints, muscles, bite, posture, and range of motion

    3. Perform diagnostic tests: May include palpation, movement assessments, and bite analysis

    4. Discuss findings: Explain your diagnosis in clear, understandable terms

    5. Create a treatment plan: Develop a personalized plan based on your specific condition and goals

    6. Answer questions: Address all your concerns and explain next steps

    Most patients leave the first appointment with a clear understanding of their condition and a roadmap for treatment. Some treatments can begin the same day, while others may require custom appliances or additional diagnostic imaging.

  • Please bring:

    • Photo ID

    • Insurance card (if using Kaiser or planning to submit for reimbursement)

    • List of current medications and supplements

    • Any relevant medical records, imaging, or test results

    • List of previous treatments you've tried

    • Pain diary if you've been tracking symptoms (helpful but not required)

    • List of questions or concerns you want to address

    Arriving 10-15 minutes early to complete any remaining paperwork is appreciated.

  • Depending on your diagnosis, some treatments can begin at your first appointment, such as:

    • Injection therapy (if appropriate for your condition)

    • Instructions for exercises and self-care techniques

    • Prescription for medications (if needed)

    Custom oral appliances typically require impressions at the first visit and are ready within 2–3 weeks. Dr. Kruman will explain the timeline for your specific treatment plan during your consultation.

  • Treatment duration varies significantly based on:

    • Your specific diagnosis

    • How long you've had symptoms

    • Severity of your condition

    • Your body's response to treatment

    Some patients experience significant relief within a few weeks, while chronic conditions may require several months of treatment. Dr. Kruman will give you a realistic timeline during your initial consultation and adjust the plan as needed based on your progress.

    Most treatment plans include:

    • Initial intensive phase (usually 2–4 weeks)

    • Monitoring and adjustment phase (1–3 months)

    • Maintenance and prevention phase (ongoing as needed)

  • House calls are not currently offered. All in-person patients are seen at our Walnut Creek office, which is centrally located to serve patients throughout the East Bay, Sacramento area, and South Bay.

    However, we do offer telehealth appointments for California residents who may have difficulty traveling or prefer virtual consultations for follow-up visits. Initial evaluations are best conducted in person for a thorough examination, but many follow-up appointments can be done via telehealth.

  • Yes! While our physical office is located in Walnut Creek, Dr. Kruman serves patients throughout a wide geographic area, including:

    • East Bay (Walnut Creek, Concord, Pleasant Hill, Lafayette, Orinda)

    • Sacramento and surrounding areas

    • South Bay (San Jose, Palo Alto, Mountain View)

    • San Francisco and Peninsula

    • Napa Valley

    • All of Northern California

    Telehealth appointments are available to all California residents, making it convenient for patients who live farther from Walnut Creek or have difficulty traveling. Many patients find that the specialized expertise is worth the drive, especially after struggling to find effective treatment closer to home.

  • Dr. Kruman is licensed to practice in California and is unable to see out-of-state patients due to licensing regulations. However, orofacial pain specialists practice throughout the United States and globally, so you likely have qualified specialists in your area.

    To find an orofacial pain specialist near you:

    • Visit the American Academy of Orofacial Pain website (AAOP.org) and use their "Find a Specialist" tool

    • Look for board-certified diplomates of the American Board of Orofacial Pain (ABOP)

    • Ask your dentist or physician for a referral to a local specialist

  • For Kaiser patients, you will need a referral from your primary care physician or dentist as required by Kaiser's policies.

    For self-pay patients or those with other insurance, a referral is not required. You can schedule an appointment directly with our office. However, having a referral from your dentist or physician can be helpful as they may provide relevant medical records and history.

  • We understand that unexpected situations arise. We ask that you provide at least 24 hours notice if you need to cancel or reschedule your appointment. This allows us to offer the time slot to another patient in need.

    Late cancellations or no-shows may result in a cancellation fee, as this time has been reserved specifically for you. Please contact our office as soon as possible if you need to make changes to your appointment.

  • While general dentists treat teeth and gum conditions, orofacial pain specialists focus specifically on diagnosing and treating complex pain conditions affecting the jaw, face, head, and neck. This includes two additional years of specialized training in pain management, TMJ disorders, headaches, and neuromuscular conditions.

    Think of it this way: if you have a cavity, see your general dentist. If you have chronic jaw pain, facial pain, or headaches that haven't responded to other treatments, an orofacial pain specialist has the advanced training to identify the root cause and provide specialized care.

  • While night guards from general dentists can help with teeth grinding, they're not specifically designed to address TMJ disorders or complex pain conditions. An orofacial pain specialist:

    • Conducts a comprehensive evaluation to determine the exact cause of your pain

    • Creates custom appliances designed specifically for your TMJ condition (not just tooth protection)

    • Can adjust appliances precisely based on your jaw position and symptoms

    • Offers multiple treatment options beyond appliances (injections, physical therapy, medications)

    • Has specialized training in managing complex pain conditions

    Many patients come to Dr. Kruman after trying night guards without success. The specialized approach often makes the difference in finding lasting relief.

  • Most orofacial pain treatments are not painful. In fact, the goal is to reduce your pain! Here's what to expect:

    • Oral appliances: No pain involved; there may be an adjustment period as you get used to wearing the appliance

    • Injections (Botox, trigger points): Brief discomfort similar to any injection; most patients tolerate this very well

    • Physical therapy exercises: Should not cause pain; you may feel mild stretching or muscle fatigue

    • Examinations: Dr. Kruman uses gentle techniques; let him know if anything is uncomfortable

    Dr. Kruman prioritizes your comfort throughout treatment and will always explain what to expect before any procedure.

  • This depends on your specific condition:

    Many patients achieve long-term relief after completing a treatment program and may only need occasional maintenance or use of appliances during stressful periods.

    Some chronic conditions may require ongoing management, similar to other chronic health conditions like high blood pressure or diabetes. However, treatment can significantly reduce pain and improve quality of life.

    Prevention is key: Once your pain is under control, Dr. Kruman will teach you strategies to prevent flare-ups, including stress management, posture correction, and self-care techniques.

    The goal is always to help you achieve the maximum relief with the minimum ongoing treatment necessary.

Ready to find relief from chronic pain?

Contact our Walnut Creek office today to schedule your comprehensive evaluation:

Serving patients throughout the Bay Area, Sacramento, and Northern California.