It is estimated that more than 10 million people in the United States are affected by Temporomandibular Joint (TMJ) disorder (TMD). One researcher estimated that 75% of the US population will, at some time, experience one or more symptoms of this condition. TMD is very complex and includes joint and connective tissue disorders as well as muscle dysfunction (myofascial pain dysfunction, MFPD). The majority of those affected are women of childbearing age, but it can impact most age groups and men as well.
Common TMD and MFPD are poorly understood by many primary care clinicians and commonly misdiagnosed as ear infections, migraine headaches, vertigo, tinnitus, chiropractic disorders, and even as psychological issues. Because TMJ disorders can cause a multitude of other symptoms like neck pain, shoulder pain, back pain, depression, anxiety, and poor sleep, all of which can have other etiological factors, many misdiagnosis are made as well as unnecessary drugs prescribed or unnecessary surgeries performed. The patient who holds the record in my practice had been given a total of 26 prescriptions, none of which were necessary and resulted in many serious side effects, which took years to overcome.
The first step, before treating any symptoms, is to make a proper diagnosis. This requires a dentist or oral surgeon that specializes in TMJ disorders or sometimes an ENT that knows the area well enough to realize the need for a proper referral.
Although most dental schools recommend several medications, I don’t. Relieving pain with a drug is like giving a pain killer to a patient for a painful foot without first removing the thorn. An extensive exam and history should first be performed including dietary and lifestyle habits and stress management. Certain habits, like excessive consumption of inflammatory foods, excessive gum chewing, fingernail biting, opening the mouth too widely or moving the jaw side to side, poor sleep hygiene, chin leaning, excessive stress such as from a long commute in heavy traffic, and many other factors can play major roles. Untreated OSA, obstructive sleep apnea, can cause severe TMJ problems because one can clench so much harder when asleep.
With a proper diagnosis the TMJ specialist can construct a treatment plan that best approaches the special needs of all the contributing factors. The plan may include using other clinicians to administer physical therapy, chiropractic care, acupuncture, oral surgery including changing the fluid within the joint, Botox injections of specific muscles, seeing an ENT, and many more options. In my practice my own personally-designed lower orthotic (splint) is standardly placed, occasionally with immediate relief. The least invasive and least costly approach that results in a happy patient is always my goal.
If you experience any joint sounds when moving your jaw, don’t wait until it hurts. Those sounds mean a malfunction of the disc between the jaw and the skull and can signal that bone loss or arthritis may be happening. It is much more affordable to treat it early and prevent permanent damage rather than allowing it to become serious with a less desirable result. A large percentage of migraines are myofascial pain which can be relieved without drugs. For more information, please visit www.aodtc.com.
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