Dr. Demerjian Center For TMJ And Sleep Therapy

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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.

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?

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TRAUMA

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:

• whiplash injury and automobile accidents
• intubation procedures in hospitals
• trauma to the head, face, or jaw

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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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.

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..

For infants...

For older children...

For Moms...

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.

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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).

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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 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.

• Snoring
• Upper Airway Resistance Syndrome (UARS)
• Obstructive Sleep Apnea (OSA)
• Central Sleep Apnea
• Sleep Bruxism
• Excessive Daytime Sleepiness

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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.

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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.

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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.

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

• Why should I consult a dentist about my sleep concerns?
• If I snore, does that mean I have obstructive sleep apnea?
• Can a dental appliance stop snoring?
• Can a dental sleep appliance replace my CPAP machine?

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”

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ORTHOPEDICS... CHANGING THE SIZE, SHAPE AND RELATIONSHIP OF THE BONES TO THE FACE AND JAW…IN MOST CASES THIS CORRECTION CAN BE ACCOMPLISHED WITH FUNCTIONAL APPLIANCES AS OPPOSED TO SURGERY

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.

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.

MALOCCLUSION

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.

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 from from 2014-2018.

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

Diplomate, American Board of Craniofacial Dental Sleep Medicine

Diplomate American Board of Craniofacial Pain

Diplomate American Academy of Integrative Pain Management

Diplomate, American Board of Forensic Dentistry

Diplomate American Board of Forensic Examiners

Fellow American Academy of Craniofacial Pain

Fellow International College of Craniomandibular Orthopedics

Registered Polysomnographic Technologist (RPSGT)

Certified Forensic Consultant-American College of Forensic Examiners

Certified - Academy of Laser Dentistry

Master – Electro-Diagnostic Modalities – Bio-Research Associates Inc.

Current Member

Evidence-Based Dentistry Practice Based Research Network

American Academy of Craniofacial Pain

American Academy of Orofacial Pain

American Academy of Dental Sleep Medicine

American Academy of Sleep Medicine

Pomona Valley Medical Center Sleep Panel

American Academy of Advancing Science

American Dental Association

California Dental Association

San Gabriel Valley Dental Society

Full Bright Association- Greater Los Angeles Chapter

Past Member

American Academy of Pain Management

International College of Craniomandibular Orthopedic

International Association of Orthodontics

American Academy of Functional Orthopedics

American Academy of Cosmetic Dentistry

Academy of Laser Dentistry

Upcoming Presentations:

“TMJ Correlation to Neurologic Disorders” Tri-County Dental Society July 2020

Professional Presentations:

“TMJ Correlation to Neurologic Disorders” International Pain Summit 2019, UCLA Meyer & Renee Luskin Conference Center, Los Angeles, CA November 16

"TMJ Disorders Basics for the General Practice and Recent Findings" Dr. Ammar Study Club November 14, 2019

“Correlation of Temporomandibular Joint Disorders to Movement Disorders” Nierman Conference, Orlando Florida October 26, 2019

"TMJ Disorders Basics for the General Practice and Recent Findings" Dr. Abari Orthodontic Study Club, November 7, 2019

“Oral Appliance Therapy” Rancho Dental Society, March 8, 2019

“Temporomandibular Joint Disorders” Yerevan, Armenia July 2, 2018

“TMJ, Chronic Pain and Neurological Disorders” Armenian American Medical Society, Las Vegas, September 30, 2017

“Arthrokinetic reflex of the TMJ in Relation to Cervical Dystonia” National Spasmodic Torticollis Association, Long Beach 2017

“Sleep Apnea, Co-morbidities & Treatment from the Dental Prospective” AAMS 12TH Annual Las Vegas, September 12TH, 2015

“Systemic Correlates of the Temporomandibular Joint” Power of Pain Conference, November 2014

“TMD: Clinical Implications and Interventions” UCLA Translational Science in Dentistry November 4, 2014

“TMJ Sequela” UCLA Oral Biology February 10, 2014

“TMJ Disorders” UCLA Oral Biology February 3, 2014

“TMJ” UCLA Oral Biology, January 27, 2014

11th Armenian Medical World Congress; Los Angeles, California July 2013 “Temporomandibular Joint Disease: Treatment with dental Orthopedics” “Temporomandibular Joint Disorders, Orthopedics and Joint Disease Correlates to Systemic conditions” “Arch Expansion and Mandibular Orthopedics for Pediatric Sleep Apnea”

AAAS-PD 94th Annual Meeting. “Patient –Centered Diagnosis and Therapies of Systemic Sequalae of Temporomandibular Joint Disease”; Las Vegas, Nevada: June 2013

“Systemic Correlates of the Temporomandibular Joint” Advanced Oral Biology Course, UCLA January 2013

“Systemic Correlates of the TMJ”; Power of Pain Conference, November 2012

“Temporomandibular Joint: a potential Treatment for Spasmodic Torticollis” NSTA Annual Symposium; New Orleans, Louisiana; October 2012

“Temporomandibular Joint”: Advanced Oral Biology Course, UCLA; January 2012

“Temporomandibular Joint; a potential treatment for Spasmodic Torticollis” NSTA Annual Symposium, Las Vegas, Nevada; October 2011

“TMJ Treatments and Systemic Correlates” ACI Study Club, Chino Hills; September 2011

AAAS-PD 92nd Annual Meeting “Systemic Correlate of the Temporomandibular Joint” San Diego; June 2011

“TMJ Treatments in Parkinson Patients”, Arcadia and Pasadena Parkinson Support Group; March 2011

“TMJ, Reticular Formation and Parkinson’s” Parkinson’s Resource Organization January 2011

“TMJ Treatments with Movement Disorder Patients”; UCLA Research Group November 15, 2010

“What to look for & do to avoid TMJ flare ups” Armenian Dental Society September 2010

“TMJ and Dystonia”, NSTA Annual Symposium, Baltimore, Maryland; September 2010

“TMJ and Arch Expansion in Children and Adults with Sleep Disorders”; Pomona Valley Hospital Sleep Panel, 2009

“TMJ”; Armenian Dental Society August 2008

Barkhordarian A, Demerjian G, Chiappelli F. Translational research of temporomandibular joint pathology: a preliminary biomarker and fMRI study. J Transl Med (2020) 18:22.

Demerjian GG et.al. (eds.), Temporomandibular Joint and Airway Disorders, Head and Neck Manifestations of Temporomandibular Joint Disorders. Springer Nature 2018.

Demerjian GG, Barkhordarian A, and Chiappelli F. Editors. “Temporomandibular Joint and Airway Disorders, A Translational Perspective” Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Demerjian GG, Barkhordarian A, and Chiappelli F. “Neuroanatomy of the Trigeminal Nerve and Proximal Innervations of the TMJ.” Chapter 1, Pg. 3-15. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Barkhordarian A, and Chiappelli F, Demerjian GG. “Neuroanatomy and Neurophyiology of the Trigeminal Network System.” Chapter 2, Pg. 17-38. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Barkhordarian A, and Chiappelli F, Demerjian GG. “Neuroimmune and Systemic Manifestations of Neuroinflammation in the Temporomandibular Joint and Related Disorders.” Chapter 3, Pg. 39-60. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Demerjian GG, Sims AB, Patel M, Balatgek T, Sabal L. “Head & Neck Manifestations of Temporomandibular Joint Disorders.” Chapter 5, Pg. 73-93. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Sims AB, Demerjian GG. “Temporomandibular Joint Dysfunction, Trigeminal Nerve Inflammation, and Biomechanical Dental Treatments for the Suppression of Neurological and Neuropsychiatric Symptoms.” Chapter 6, Pg. 95-123. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Patel M, Demerjian GG, Sims AB. “The Relationship of Temporomandibular Joint, Orofacial Pain and Sleep Apnea.” Chapter 7, Pg. 125-134. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Demerjian GG, Pooja Goel. “Immunologic and Physiologic Effects of Dental Sleep Appliance Therapy.” Chapter 8, Pg. 135-171. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Balategel T, Demerjian GG, Sims AB, Patel M. “CBCT & MRI of Temporomandibular Joint Disorders and Related Structure.” Chapter 10, Pg. 201-217. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Chiappelli F, Barkhordarian A, Demerjian GG. “Patient-centered outcomes research and collaborative evidence-based medical and dental practice for patients with Temporomandibular Joint Disorders.” Chapter 11, Pg. 219-238. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Chiappelli F, Barkhordarian A, Demerjian GG. “Patient-centered outcomes research and collaborative evidence-based medical and dental practice for patients with Temporomandibular Joint Disorders.” Chapter 12, Pg. 239-249. Temporomandibular Joint and Airway Disorders, A Translational Perspective. Springer Nature 2018. Gewerbestrasse 11, 6330 Cham, Switzerland.

Demerjian GG, Barkhordarian A, and Chiappelli 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.

Abstracts:

Demerjian G, Barkhordarian A, Sims AB, Chiappelli F. Systemic Correlates of TMJ Neuro-Inflammation. Systemic Correlates of TMJ Neuro-Inflammation (#105). World Dental Federation (Fédération dentaire internationale, FDI) Annual Dental Congress, Istanbul, Turkey, August 28-31, 2013.

Demerjian G, Barkhordarian A, Sims AB, Chiappelli F. Temporomandibular Joint Disorders Orthopedics and Joint Disease correlates to systemic conditions. 11th Armenian Medical World Congress, Hollywood, California, July 3-7, 2013.

Demerjian G, Sims AB, Barkhordarian A, Chiappelli F. Dental Arch Expansion and Mandibular Orthopedic Correction in Children: A Treatment for Pediatric Sleep Apnea. 11th Armenian Medical World Congress, Hollywood, California, July 3-7, 2013.

Demerjian G, Sims AB, Barkhordarian A, Chiappelli F. Temporomandibular Joint Disease: Treatment with Dental Orthopedics for Pain Management. 11th Armenian Medical World Congress, Hollywood, California, July 3-7, 2013.

Barkhordarian A, Demerjian G, Chiappelli F. Systemic correlates and local responses to Temporomandibular Joint Disorders. 94th AAAS-PD Annual Meeting, Las Vegas, NV; June 15-19, 2013.

Demerjian G. Patient- Centered Diagnosis and Therapies of Systemic Sequelae of Temporomandibular Joint Disorders. 94th AAAS-PD Annual Meeting, Las Vegas, NV; June 15-19, 2013.

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.