40 Timber Lane
South Burlington, Vermont 05403
What We Do
This practice is limited to the evaluation, diagnosis and non-surgical treatment of Temporomandibular Disorders, Orofacial Pain and Oral Medicine.
Temporomandibular Disorders (TMD) manifests in a number of different ways including symptoms such as joint, ear and facial pain and clicking and locking of the jaw.
Orofacial Pain (OFP) focuses on pains associated with the teeth, face, head and neck and includes a large variety of headaches.
Oral Medicine (OM) focuses on a variety of conditions that may be caused by such things as systemic, autoimmune and dermatologic diseases, salivary gland and chemo-sensory (taste and smell) dysfunction and adverse reactions to medicines or medical treatments such as radiation and chemotherapy.
There are a number of contributing factors to TMD, OFP and OM. Many people suffer with a combination of pain, anxiety, sleep disorders and systemic diseases. Below is a brief description of how each of these various problems can influence these conditions.
Sleep Disorders: Pain may lead to sleep loss and sleep loss may enhance pain. Insomnia, non-refreshing sleep and excessive daytime fatigue are common complaints in chronic pain patients. Snoring and obstructive sleep apnea are common in our patients and often can be successfully managed with various oral appliances.
Headaches: The prevalence of headache in TMD and OFP is substantial. Musculoskeletal pain from these disorders may contribute to changes in pain pathways to and within the brain that leads to this escalation of headache. Treatment of TMD and OFP often reduces or eliminates headache. Referral to a headache neurologist may be considered.
Neuropathic Pain: This disorder relates to a variety of nerve pains that can affect the head, face and neck. This is nerve pain that often has a burning, tingling, numbing and/or electrical shocking quality. These pains can be the result of dental or surgical treatment, trauma, and systemic conditions or may be spontaneous.
Bruxism: There are a number of oral behaviors that will influence the development and perception of TMD and OFP. Clenching and grinding the teeth; lip, cheek and tongue biting; chewing on foreign objects; tooth tapping; and smoking are all factors that can aggravate and perpetuate pain. Managing these behaviors can be critical in the management of TMD and OFP.
Systemic Disorders and Arthritis: Various forms of systemic disorders and arthritis can influence the development and perpetuation of TMD and OFP. The result can include developmental disorders affecting the face and jaw, dental malocclusions, limited jaw opening, popping and grinding sounds in the jaw and, of course, pain. Referral to a primary care physician or a rheumatologist is sometimes necessary.
Trauma: Trauma can be the consequence of both physical and emotional events. These circumstances can result in Post-Traumatic Stress Disorder (PTSD) which is another, common occurrence in patients suffering with TMD and OFP. Referral for oral surgery or an ear, nose and throat consultation may be necessary.
Stress: PTSD and anxiety are 2 to 3 times more common in patients with TMD and OFP. Acute stress can lead to increased muscle tension, but chronic stress can lead to long-term alterations in immunologic, neural and hormonal functions. Many patients who suffer with TMD and OFP are on medications which can contribute to clenching and grinding the teeth. Consultation with a primary care physician, a psychologist or a psychiatrist may be beneficial in some circumstances.
The doctors and supporting staff at Vermont Orofacial Pain Associates are committed to improving the quality of life for patients who suffer with Temporomandibular Joint Disorders (TMD) and Orofacial Pain (OFP) including headaches, nerve trauma, sleep and orofacial behavioral disorders.
We believe that an evidence-based diagnosis of the root causes of TMD and OFP is central to providing a successful treatment plan to suit the needs of each individual. For this reason, the initial evaluation includes a detailed interview with an experienced, board-certified doctor including a review of each patient’s medical and dental histories, symptoms, and an assessment of relevant behavioral and stress factors. If necessary, the interview is followed with state-of-the art imaging, diagnostic models of the teeth and a physical examination.
We also believe that an important first step to wellness is through engaging each patient’s active participation in their own recovery. Educational and audiovisual support is provided to help patients understand the mechanisms that cause the symptoms peculiar to TMD and OFP. Questions are encouraged.
What our patients say about us…
Meet the Providers
Dr. Crandall completed his dental training at Temple University School of Dentistry in 1974 and the General Practice Dental Residency at the Medical Center Hospital of Vermont in 1975. In 1984 Dr. Crandall received a Certificate for completion of the extended program in the Diagnosis and Treatment of Temporomandibular Disorders (TMD) at the University of Medicine and Dentistry of New Jersey. Dr. Crandall has maintained a referral-based practice limited to TMD and Orofacial Pain since 1984.
Dr. Pinto received his DMD from the University of Pennsylvania, School of Dental Medicine, and residency training in the Division of Oral and Maxillofacial Surgery at Penn Health System (Oral Medicine). He also received advanced training in Orofacial Pain and Dental Sleep Medicine at the University of Kentucky and Tufts University in Boston, and residency training in Dental Public Health at the National Institutes of Health in Bethesda, Maryland.
Phone Number: (802) 862-7185
Phone Hours: Monday: 8am – 4pm
Tuesday: 8am – 4pm
Wednesday: 8am – 4pm
Thursday: 8am – 4pm
Friday: 8am – 2pm
Fax: (802) 658-8036
Email Address: firstname.lastname@example.org
Address: 40 Timber Lane
South Burlington, Vermont 05403
Billing and Insurance
The staff at Vermont Orofacial Pain Associates (VOPA) is committed to making the healthcare services that are provided as affordable as possible. To this end, we provide fee schedules and payment plans when necessary and help our patients understand and navigate the often complicated world of insurance billing.
The Providers at VOPA are contracted with several major medical insurance companies including Medicare and Vermont Medicaid. In 1997, the State of Vermont passed legislation requiring all medical insurance plans located in the state to provide benefits for TMJ and Orofacial Disorders and allow dentists to be paid for these services.
However, despite this law, some medical insurance plans may not offer benefits because the plan is located outside the state of Vermont or is a self-funded plan. If you wish to find out if your plan provides benefits for these services, call the customer or member service phone number on your insurance card.
At this time, the VOPA providers are not contracted with United Healthcare, Tricare, or New York Medicaid.