The acronym TMJ stands for temporomandibular joint, a.k.a. the jawbones. TMD represents the dysfunction of these temporomandibular joints, which describes the dysfunctional symptoms yet has very little to do with the underlying cause. If I wanted to make the abbreviation more precise, I might suggest MFMD—myofascial mandibular dysfunction. Myofascial means facial muscles and most dysfunctions would not exist if the muscles weren’t contributing to the problem. In the past, TMD was considered a “dental” issue, but some medical insurance companies are now considering the dysfunction a medical condition.
In my practice, Advanced Oral Diagnosis and Treatment Center (AODTC), we are astutely aware that your head is part of your body. Therefore, it is important to work holistically to solve the cause, not just treat the symptoms.
Let’s look at some of the symptoms for which we seek the cause: chronic headaches-sometimes diagnosed as migraines, facial muscle pain, joint pain (in front of the ear), joint sounds (gravely, sandy or popping), locking closed-unable to open the mouth normally, or locked open-unable to close the mouth or bite the teeth together normally. Neck and shoulder pain can result as a response to the facial and head pain. Chewing pain can also happen, taking the joy out of eating.
These problems should never be made light of. I have seen lives radically altered due to the never-ending agony. Please DON’T wait until it is really bad before seeking help. The best dentists are aware of the complexity and will refer you to a specialist.
Those sounds of clicking, popping, or a gravel-like noise are all due to the disk inside the joint capsule not being able to move properly with the joint as it rotates, then slides forward as you open. What this means is you are likely having bone to bone contact and irreversible damage may be occurring. In so many of my patients, what should be nice round joints (condyles) have been flattened and possibly lost the cortical plates. These irreversible problems could have been avoided by seeking help when first noticed.
The most severe damage usually happens while sleeping due to our ability to clench and grind with much more force when asleep. I have designed a type of removable, custom-made splint to wear while sleeping that prevents this trauma.
Probably the most common cause of TMD is the habit of keeping the teeth together, along with clenching and grinding. In normal lifestyles, teeth are only designed to come together when we swallow, which has been found to be an average of 16 minutes a day. Research using electrodes that was done over 50 years ago found that the average TMD case has teeth together 16 hours a day. The underlying cause of these painful habits can be stress, hormone imbalance, obstructive sleep apnea, pain in other areas of the body, the need for medications, taking stimulants, nail biting, as well as other illnesses.
Arthritis, especially rheumatoid, can attack the joint, causing a very complex case for specialists. Any trauma to the head or neck can cause severe TMD and general pain problems that can only be handled properly by a team of specialists. Even something as simple as having your mouth open too long for a dental procedure or wisdom tooth extractions can start the dysfunction of the joints.
Leaving the dysfunction untreated and hoping that it will resolve on its own may result in years of issues rather than weeks to months. Common treatments may be suggested by various clinicians, which include soft diet, cold compresses, over-the-counter night guards, drugs, and more. In so many cases I have had patients come to me after years of discomfort, many times having paid for complex, unpleasant, and expensive treatments that did not help.
At AODTC our method is treating the patient not the symptom. Many drugs used to treat the symptom only relieve pain, allowing the underlying dysfunction to do more damage. Never forget that taking pain medication is oftentimes like telling our body to “shut up” when it is crying out for help. The goal of a holistic approach is to discover and treat the disease, resulting in the side effect of better overall health.
Because our office specializes in TMJ treatment and oral appliances for sleep apnea, we will not surprise you with fees for extra dental procedures, crowns, equilibrations, orthodontics, etc. If any additional dental work is needed we can refer you to an appropriate specialist. For more information about AODTC, located in Danville, California, please visit www.aodtc.com.
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