Let’s Talk About Your TMJ

Years of living with jaw pain, frequent headaches, and other symptoms relating to TMJ discomfort can significantly impact your quality of life. If you’re looking for relief, working with a biological dentist to look within and beyond the mouth may be the answer. In this blog post, we'll look at what causes TMJ problems, some common symptoms, and how a biological dentist might approach your situation regarding diagnosis and treatment. You'll gain expert insight into the root cause behind this complex condition and natural ways to provide relief. So if you're ready to learn more about this fascinating field, read on!

Some common signs, symptoms, and treatments (that often don't work, resulting in living with the issue or trying alternatives that tend to act like a bandaid more than a proper fix. Symptoms (patient complaints or concerns): noises, pain, restricted motion, deviations in motion, headaches/migraines, tooth wear/chipping/breakage, avoidance of chewing certain foods, allegations of grinding, clenching, gum recession. Signs and clues we observe, in addition to the above, that suggest a possible TMJ or related issue: scalloped edges of the tongue, wear on front teeth and possibly a ledge behind the upper front incisors, changes in the appearance of the front teeth over the last 5 years (chipping, crowding or shifting of teeth), sensitive gag reflex, tight or well-developed smile muscles, glazed over look in the eyes with some venous pulling/dark shadows beneath; mouth breathing/open-mouthed posture, a tongue thrust, dry lips; a well-pronounced swallow; a "princess and the pea" bite, a heavily restored mouth especially in the back molar region; a history of tooth removal for orthodontic treatment.

What are some causes and contributing factors: Disharmony between muscles and teeth for a variety of reasons (I like to ask why, then ask why again - splints address basic disharmony, taking pressure off the muscles and allowing the teeth to go where the jaw muscles desire, instead of keeping the jaw caged in by the teeth; they can also help to reposition the jaw condyles so that they rest more optimally in their fossae... but this is often a short term/temporary fix). Restrictions of the tongue and other supporting soft tissues -- or poor function of the tongue -- create an added strain on the ligaments, teeth, and jaw, which also increases the collapsibility of the airway—engagement of muscles to develop increased oral volume and allows for less restricted airflow. Inadequate oral volume where the tongue (SUV sized) is parked in a compact car parking space is an invitation for jaw strain and airway issues—use of stimulants - amphetamines, esp - that trigger muscle contractions. Challenges with growth and development create situations that physically put more strain on the jaw joints, potentially causing some degeneration/degradation of the jaw joints and disc; osteoarthritis changes can also be a challenge. Parasites can also trigger grinding. The list goes on.

So, what do we do? Diagnosis is first! We have an in-depth set of screening questions to review with patients before they even enter the door. From there, we take a diagnostic panoramic radiograph (& soon will be able to take some 3D images) to visualize, among other things, the jaw joints, looking for position and asymmetry, and pathology - mostly, this is a screening. 3D imaging will be much more enlightening. Our exam includes an eval of the joints - load testing, measuring the max opening, and looking at noises, deviations, and compensations. I also evaluate the tongue - looking at functions, habits, and restrictions. Our action and care plan differs for patients suffering from acute pain type issues: pain relief is first and can range from moist heat + soft diet to an equalizer type splint to unload the joint to steroids and anti-inflammatories. Some patients find relief via a chiropractic adjustment. I have some other tricks up my sleeve if those don't work. If we encounter problems that need to be addressed during our screening and evaluation, we may put a patient in a deprogrammer - a splint that is worn for about 2 weeks and separates the teeth so that we can deprogram the engrams in the brain, the muscle patterns. It allows the muscles to go where they want to go, and based on that, we can better diagnose jaw issues related to the bite. I begin with a sleep study and airway evaluation for many patients, with a probable referral to a myofunctional therapist to evaluate tongue function.

This gets into concurrent conditions; I see: myofunctional disorders, airway or sleep breathing issues, stress management, and parasites… for those who have myo and airway issues, this can also mean problems with the foundation of their teeth - periodontal challenges that can be seen in the form of pockets and inflammation or recession; acid reflux that causes tooth breakdown, increases the risk of oral cancer; hypertension - a poorly managed airway can be seen in patients struggling to control their blood pressure, and also blood sugar… Many patients with muscle strain benefit from bodywork - physical therapy, craniosacral therapy, chiro.