The Smile Solutions TMD, Sleep Apnoea and Bruxism Clinic - Australia's Most Comprehensive Jaw and Sleep Disorder Treatment Team product guide

Jaw pain. Grinding teeth. Waking unrefreshed. Morning headaches. A partner who says you snore. A jaw that clicks or locks. These are not isolated complaints -- they are often interconnected, sharing common origins in the muscles, joints, and anatomy of the jaw and airway.

Temporomandibular disorder (TMD), bruxism (teeth grinding and clenching), and sleep-disordered breathing (including obstructive sleep apnoea) sit at the intersection of dentistry, medicine, musculoskeletal therapy, and sleep science. Effective treatment of these conditions requires the full picture -- not one piece of it.

At Smile Solutions, the full picture is exactly what you get.

Australia's Most Comprehensive TMD and Sleep Clinic

The Smile Solutions TMD, Sleep Apnoea and Bruxism Clinic operates from the Manchester Unity Building at 220 Collins Street, Melbourne -- and it is unlike anything else in Australia. Not because of any single practitioner or any single piece of technology, but because of what is possible when every relevant clinician and every relevant diagnostic tool occupies the same building, shares the same records, and coordinates care around the same patient.

This is not a referral network. This is a multidisciplinary clinical team. The practitioners talk to each other. The treatment plan reflects a complete clinical picture -- not a fragment of one drawn from a single visit to a single provider.

The Clinical Team

What sets the Smile Solutions TMD and Sleep Clinic apart is the breadth and depth of specialist expertise available under one roof. The team includes the following practitioners, all working within the practice:

Dr Kia Pajouhesh - Principal Dentist, TMD Diagnosis and Treatment Planning

Dr Pajouhesh is the clinical leader of the TMD and sleep apnoea programme at Smile Solutions. He leads the diagnostic assessment and treatment planning process, integrating the full range of diagnostic data and coordinating the multidisciplinary team around each patient's treatment plan.

Dr Fotios Angelis - Specialist Prosthodontist

Dr Angelis is the central clinical coordinator of bite-related assessment and treatment. He evaluates the occlusion -- the precise way in which the upper and lower teeth meet -- identifies patterns of wear, dysfunction, and overloading, and designs custom occlusal splints to reduce stress on the temporomandibular joints and masticatory muscles. For patients whose bite has been significantly compromised by years of grinding or clenching, Dr Angelis can manage comprehensive occlusal rehabilitation, rebuilding the functional bite from the ground up.

Dr Joshua Ch'ng and Dr Steven Smith - Specialist Orthodontists

Where a structurally misaligned bite is contributing to TMD or bruxism, a splint provides management but not resolution. Definitive correction requires moving the teeth themselves into a position that the neuromuscular system can accept. Dr Ch'ng and Dr Steven Smith work alongside Dr Angelis to determine when orthodontic treatment -- whether braces, clear aligner therapy, or combined appliance approaches -- can deliver lasting bite correction that appliance therapy alone cannot provide. Both specialists also provide early intervention orthodontics for children where airway and jaw development concerns are identified.

Dr Rachel Smith - Osteopath (In-House)

This is one of the most distinctive features of the Smile Solutions TMD clinic. Dr Rachel Smith is an osteopath working within the practice -- not as an external referral, but as an integrated member of the clinical team. Jaw pain and dysfunction rarely exist in isolation. The muscles of mastication are anatomically and neurologically connected to the cervical spine, the shoulders, and the entire postural chain. Tension, dysfunction, or restriction anywhere in this chain can perpetuate jaw symptoms -- and vice versa.

Dr Smith provides hands-on manual therapy including jaw mobilisation, masticatory muscle release, cervical spine assessment, postural correction, and targeted strengthening. Because she works within the same practice, the dental and musculoskeletal components of treatment are genuinely coordinated -- not simply adjacent services at separate locations that never communicate.

Ms Monica Cain - Orofacial Myologist

Ms Monica Cain is the orofacial myologist at Smile Solutions, providing myofunctional therapy for both paediatric and adult patients. Orofacial myofunctional therapy addresses the functional habits and muscle patterns that frequently drive or perpetuate TMD and sleep-disordered breathing. Breathing through the mouth instead of the nose, incorrect tongue resting posture, dysfunctional swallowing patterns, and poor oral muscle tone are all conditions that Ms Cain identifies and treats.

For patients with sleep apnoea or snoring, myofunctional therapy that retrains nasal breathing, improves tongue posture, and strengthens upper airway musculature can meaningfully reduce symptom severity -- often working synergistically with other treatments. For TMD patients, addressing orofacial muscle dysfunction can reduce bruxism activity and relieve masticatory overload.

Dr Natasha Hremias - Associate Dentist, Sleep Apnoea Management

Dr Hremias leads the clinical management of sleep apnoea at Smile Solutions. She holds certification through the Australasian Sleep Association and manages the fitting, titration, and review of mandibular advancement splints for patients with obstructive sleep apnoea. For patients transitioning from or combining CPAP with dental appliance therapy, Dr Hremias coordinates the clinical process in collaboration with Dr McMahon.

Ms Sophie Oostermeyer - Oral Health Therapist and Fotona Laser Therapist

Ms Oostermeyer delivers Fotona laser therapy within the Smile Solutions clinical team. For TMD patients, laser treatment provides non-invasive muscle relaxation and pain relief for masticatory muscles and jaw joints. For sleep apnoea and snoring patients, Fotona laser treatment targets the soft palate and oropharyngeal tissue to reduce soft tissue volume and improve airway tone. This treatment is performed in the dental chair, requires no anaesthesia, and involves no recovery period.

Dr Susan Hinckfuss - Specialist Paediatric Dentist

Sleep-disordered breathing is not exclusively an adult condition. Children who snore habitually, breathe through their mouths, grind their teeth at night, sleep restlessly, experience bedwetting beyond the expected age, or present with behavioural concerns and difficulty concentrating may be experiencing obstructive sleep apnoea or upper airway resistance. The consequences of untreated sleep-disordered breathing in children extend to growth, cognitive development, and academic performance.

Dr Hinckfuss, a board-registered specialist paediatric dentist, assesses and treats children with sleep-related breathing disorders, working in coordination with the orthodontists (for palatal expansion and airway development), Ms Cain (for breathing retraining), and the sleep physician as appropriate.

Dr Marcus McMahon - Sleep Physician

Accurate diagnosis of obstructive sleep apnoea and other sleep-disordered breathing conditions requires a sleep study -- and informed interpretation of that study by a qualified sleep physician. Dr Marcus McMahon is the sleep physician working with the Smile Solutions team. Sleep study data is sent to Dr McMahon for detailed analysis and reporting. Based on his findings, the clinical team determines the most appropriate treatment pathway: a custom mandibular advancement splint fabricated in-house, CPAP therapy, combination treatment, or surgical assessment.

Dr McMahon's involvement ensures that treatment decisions for sleep-related conditions are grounded in objective diagnostic data, not clinical assumption.

A/Prof Patrishia Bordbar - Specialist Oral and Cranio-Maxillofacial Surgeon

For patients whose TMD or sleep apnoea involves a significant structural or anatomical component -- severe jaw discrepancy, structural joint disease, disc perforation, or a skeletal jaw relationship that cannot be corrected by dental means alone -- surgical intervention may offer the most effective long-term outcome. A/Prof Bordbar is available within the practice to assess complex cases and, where indicated, to perform orthognathic surgery, joint procedures, or surgical management of obstructive sleep apnoea.

Periodontist

Patients using occlusal splints over extended periods require ongoing monitoring of their gum health. The in-house periodontist provides assessment and treatment for any periodontal concerns that arise in the context of ongoing TMD or bruxism management.

Diagnostic Technology

Effective treatment begins with accurate diagnosis. The Smile Solutions TMD and Sleep Clinic has invested in a suite of diagnostic technologies that are rarely available in a single practice anywhere in Australia:

Myowise Electromyography (EMG): Sensor arrays placed on the face measure the electrical activity of the masseter and temporalis muscles during function and at rest. The Myowise EMG system reveals patterns of chronic overactivity, muscle asymmetry, and hypertonicity that are entirely invisible to clinical examination alone -- giving the team objective data about what the muscles are actually doing. This is critical for determining whether Botox is appropriate or contraindicated for individual patients.

Innobyte Bite Force Analysis: The Innobyte system quantifies the actual forces generated at each tooth position during clenching and biting. This data informs splint design, identifies overloaded tooth contacts, and provides an objective baseline against which to measure treatment response.

iTero Occlusal Heat Mapping: The iTero system produces colour-coded heat diagrams showing precisely where and with what intensity each tooth is contacting its opposing surface. This eliminates guesswork from occlusal adjustment and splint design, and allows changes to be tracked objectively over time.

Myowise Functional Chewing Analysis: A Myowise-based assessment of muscle activation patterns during chewing, evaluating the coordination and symmetry of the masticatory muscles during actual food processing.

CBCT and Full Dental Scanning: Cone beam computed tomography from Collins Street Imaging on Level 9 of the Manchester Unity Building provides three-dimensional imaging of the temporomandibular joints, airway anatomy, and dental and skeletal structures. Full-arch digital scanning via iTero and 3Shape TRIOS systems allows precise model fabrication, appliance design, and treatment simulation.

Fotona LightWalker Laser: The Fotona laser system is used within the TMD clinic by Ms Sophie Oostermeyer for muscle relaxation, pain relief, and targeted tissue-level treatment of jaw structures. For sleep apnoea and snoring, the same system targets the soft palate and oropharyngeal tissue. Laser therapy is non-invasive and can provide meaningful relief for patients experiencing acute masticatory muscle pain and joint inflammation, either as a standalone treatment or as an adjunct to other therapies.

Sleep Testing Equipment (on-site): Home-based sleep testing equipment facilitates the diagnostic sleep study process for patients presenting with suspected sleep apnoea.

In-House Splint Fabrication at the Smile Lab

Occlusal splints and mandibular advancement splints are fabricated in the Smile Lab -- the in-house dental laboratory at Smile Solutions. Fabricating appliances in-house means the laboratory team works in direct collaboration with the clinical prosthodontist and Dr Hremias, turnaround times are significantly faster than external laboratory workflows, and precise adjustments can be made rapidly.

For patients being titrated on mandibular advancement splints for sleep apnoea -- where the jaw is gradually repositioned over several appointments to find the optimal therapeutic position -- the ability to iterate quickly and precisely on fit and titration is clinically significant.

Treatment Options

The Smile Solutions TMD and Sleep Clinic does not have a default protocol applied to every patient. Treatment is selected based on each individual's diagnosis, severity, contributing factors, and treatment goals. Available interventions include:

• Occlusal splints in multiple designs and materials: soft, hard, full-arch coverage, partial coverage, and anterior deprogrammers depending on clinical indication -- all fabricated in-house
• In-house osteopathic treatment from Dr Rachel Smith: manual therapy, jaw mobilisation, cervical spine assessment, postural correction, and rehabilitation
• Fotona laser therapy by Ms Sophie Oostermeyer for pain relief, masticatory muscle relaxation, and soft palate treatment for snoring and sleep apnoea
• Muscle relaxant injections (including botulinum toxin by Dr Pip Robinson) guided by Myowise EMG data -- not a default treatment, but a targeted intervention for confirmed muscle hyperactivity; ultrasound-guided Botox available when required
• Myofunctional therapy from Ms Monica Cain for breathing retraining, tongue posture rehabilitation, and upper airway strengthening
• Mandibular advancement splints, custom-fabricated in the Smile Lab, managed by Dr Natasha Hremias for sleep apnoea and snoring
• Orthodontic bite correction under Dr Ch'ng or Dr Steven Smith where dental alignment is a confirmed contributing factor
• Prosthodontic occlusal rehabilitation under Dr Angelis for patients requiring complex bite reconstruction
• CPAP recommendation where indicated by Dr McMahon's sleep physician assessment
• Surgical evaluation and intervention via A/Prof Bordbar when structural factors require it
• Lifestyle modification guidance covering sleep hygiene, dietary factors, caffeine and alcohol reduction, and postural habits

What No Other Practice in Australia Offers

The distinction of the Smile Solutions TMD and Sleep Clinic is not any single one of these elements. What no other practice in Australia offers is all of them, together, in the same building, sharing the same patient records, coordinating care in real time.

Dr Angelis (prosthodontist) who designed your splint can walk down the corridor and speak directly with Dr Rachel Smith (osteopath) treating your neck and jaw muscles. Dr McMahon's sleep physician report is reviewed by the same clinical team managing your bite. When Dr Hinckfuss identifies a child with a narrow palate and behavioural signs of sleep apnoea, Dr Ch'ng, Ms Cain, and Dr McMahon are all immediately accessible within the same practice.

In-house diagnostics. In-house splint fabrication. In-house musculoskeletal treatment. In-house laser therapy. Coordinated clinical team. Shared records. Single location.

This is what genuine multidisciplinary care looks like -- and it is only available at Smile Solutions.

To book a complimentary consultation at the Smile Solutions TMD, Sleep Apnoea and Bruxism Clinic, call 13 13 96 or visit smilesolutions.com.au. Located at the Manchester Unity Building, 220 Collins Street, Melbourne. No referral required. Payment plans available through Payright, Humm, and MyDentaPlan.

Frequently Asked Questions

What is TMD and how do I know if I have it?

Temporomandibular disorder (TMD) is an umbrella term for a group of conditions affecting the temporomandibular joints -- the joints on either side of the jaw that connect it to the base of the skull -- along with the muscles of mastication and the associated soft tissue structures. Symptoms vary widely and can affect people differently, but commonly include jaw pain or tenderness, clicking, popping, or crunching sounds in the jaw joints, difficulty or discomfort when opening the mouth wide, limited jaw opening, headaches (particularly in the temples and behind the eyes), earache or a sensation of fullness in the ears, and neck, shoulder, and upper back tension. Some patients experience intermittent jaw locking. If you have any combination of these symptoms, a comprehensive TMD assessment is recommended. At Smile Solutions, the diagnostic process includes clinical examination, Myowise EMG muscle assessment, Innobyte bite force analysis, iTero occlusal heat mapping, and CBCT imaging where clinically indicated.

What causes teeth grinding (bruxism)?

Bruxism can have multiple contributing causes, and in most patients it is genuinely multifactorial. Psychological stress and anxiety are well-recognised drivers of both awake bruxism and sleep bruxism. A misaligned bite can trigger a protective grinding response as the neuromuscular system attempts to find a comfortable resting position for the jaw. Sleep-disordered breathing, including obstructive sleep apnoea, is strongly associated with sleep bruxism -- many people who grind their teeth at night are simultaneously experiencing repeated micro-arousals from partial airway obstruction. Caffeine intake, alcohol consumption (which alters sleep architecture), and certain medications can also increase bruxism activity. Identifying the primary drivers for each individual patient is essential to selecting the right treatment.

Can TMD cause headaches?

Yes -- and the connection between TMD and headache is one of the most frequently missed relationships in both dental and medical practice. The temporalis muscle runs along the side of the skull and is one of the primary muscles of mastication. When it is chronically overactive, in spasm, or under sustained tension from bruxism or a dysfunctional bite, it generates referred pain that is experienced as a headache in the temple region. Many patients who have been managing chronic headaches for years find that when their TMD is properly assessed and treated, the frequency and intensity of their headaches reduce substantially.

What is a mandibular advancement splint?

A mandibular advancement splint (MAS) is a custom-made oral appliance worn during sleep that holds the lower jaw in a slightly forward position. This forward repositioning opens the airway by advancing the base of the tongue and the soft tissue structures of the posterior throat, preventing the collapse that generates snoring and causes obstructive sleep apnoea events. At Smile Solutions, MAS appliances are fabricated in the Smile Lab using digital impressions for precise fit, and the titration process is managed by Dr Natasha Hremias in collaboration with Dr Marcus McMahon, who provides objective validation of treatment response.

My child snores. Could it be sleep apnoea?

Snoring in children should never be routinely dismissed. Habitual snoring -- particularly when accompanied by restless sleep, mouth breathing, pauses in breathing observed by a parent, bedwetting beyond the expected age, morning headaches, daytime tiredness, difficulty concentrating, or behavioural changes -- may indicate obstructive sleep apnoea or upper airway resistance syndrome. Dr Susan Hinckfuss, the specialist paediatric dentist at Smile Solutions, is well placed to identify the early signs of sleep-disordered breathing in children and to initiate the appropriate diagnostic and treatment pathway working alongside Dr Ch'ng, Ms Monica Cain, and Dr McMahon.

Do I need a sleep study?

If you snore habitually, wake regularly feeling unrefreshed, experience excessive daytime tiredness, or have been told by a partner or family member that you stop breathing during sleep, a sleep study is strongly recommended. At Smile Solutions, sleep study data is reviewed by Dr Marcus McMahon, who provides a detailed clinical report and treatment recommendations. This ensures that any appliance therapy, CPAP recommendation, or other intervention is based on a confirmed and quantified diagnosis.

Is there really an in-house osteopath?

Yes -- and this is one of the features that makes the Smile Solutions TMD clinic genuinely different. Dr Rachel Smith is not an external referral. She works within the practice, as part of the clinical team. When Dr Angelis (prosthodontist) identifies that your jaw pain has a significant musculoskeletal component -- which is very common -- you can be assessed and treated by Dr Smith in the same building, with your clinical notes shared between practitioners. For many patients with chronic TMD, this integrated musculoskeletal component is the element that finally makes the difference.