TMJ (Temporo-Mandibular Joint) syndrome is the term often used to describe a number of variable symptoms affecting the head and neck. CMD (Cranio-Mandibular Disorders) and TMD (Temporo-Mandibular Disorders) are other terms used for the same condition. Although TMJ is probably the most recognized name, it is very limiting by referring only to the two jaw joints. In reality the symptoms most patients experience is much more generalized.
Probably the most important point regarding TMJ is that no one person has the answer. There are many factors which can contribute to a person having TMJ symptoms.
Being a dentist, I can identify and recommend treatment for the dental factor. I can also assist you in finding other methods and techniques to relieve your symptoms. However, in most cases, the percentage of the problem directly related to a dental condition is, in my opinion, usually less than other factors. People with bad “bites” don’t necessarily have TMJ symptoms. Conversely, people with good “bites” aren’t necessarily free of TMJ symptoms. When the bite is incorrect and a person has TMJ problems, then it is important to consider what might be accomplished by improving the bite.
The symptoms, causes, and treatments listed below are all related to what I believe is the central core of TMJ problems; that core is muscle tension. Therefore, treatment is aimed at reducing muscle tension.
Causes / Factors:
Stress – definition is a change (good or bad); stress causes muscle tension (result of stress is muscle contraction to prepare for the “fight or flight” reaction); stress can be physical (injury or exhaustion), emotional, or dietary
Trauma – whiplash, blow to head
Nutrition – caffeine, nicotine, and high levels of sugar increase muscle tension
Inadequate sleep – poor quality or low quantity
Trauma – see http://www.headacheprevention.com/ for information.
Stress reduction – relaxation exercises, dealing with & feeling emotions (E-motions = Energy in motion), biofeedback, Physical therapy, chiropractic, acupuncture / acupressure, Rolfing, massage
Dietary changes – reduce caffeine, nicotine, foods with high sugar content, softer diet
Psychological counseling – probably the most difficult for many and also can be the most rewarding for those committed to improving the quality of life
Stretching – we have some handouts for starting
Myofunctional therapy – to correct improper swallowing patterns
Exercise – ideally should be aerobic (walking, jogging, bicycling, swimming, etc.)
The best results are usually obtained by incorporating as many of the above treatments as are applicable. Each treatment can raise the pain threshold a notch until the sum of the notches results in the symptoms being gone or significantly improved.
Treatment You Probably Don’t Need:
TMJ surgery – last resort, in my opinion. Some “experts” recommend TMJ surgery early in treatment. I believe surgery should be considered only after more conservative attempts have not been successful.
Computerized diagnostic tests of the jaw opening and jaw muscles – I sold my equipment when I realized it wasn’t usually necessary; there are simpler, less expensive tests available for most cases MRI’s, CAT scans, etc. – except when the possibility of tumors needs to be considered
Medications – except limited use for pain relief or to break the pain cycle in the beginning of treatment; muscle relaxants or tranquilizers may be useful to help break the pain cycle
Headaches (usually referred pain from jaw, neck, or shoulder muscles that are tense), neckaches, backaches, tender muscles.
Other stress related problems (ulcers, difficulty sleeping, high blood pressure, emotional disorders, shortness of breath, stomach aches, lethargy, nausea, etc.)
- Limited range of motion
- Ringing in ears or dizziness
- Clenching or grinding the teeth
- Clicking, popping, or locking of the jaw joint
- Limited opening of the jaw and/or difficulty chewing
Much of what I have presented here is based on personal experience and study. There are many opinions, many of them quite strong, among health care providers involved in TMJ treatment. Many of the dental “experts” rely on surgery, technical diagnostic equipment, or other methods which I believe tend to be short-sighted and limiting. If you consult with 10 different providers, you will likely get 10 different opinions. I believe this leaves you with the choice of going with the person you feel most comfortable with. The definition of “doctor” is a teacher. This is especially true with TMJ patients. I don’t believe I can “fix” a TMJ patient.
Since much of what we are dealing with is stress-related, the patient needs to be responsible for their own level of health. My role is to assist, with the help of other health care providers, in this process.
If you or a family member is suffering from TMJ, please get in touch with the office of Crater Lake Dental to learn about treatments for TMJ in Medford, Oregon. You may call 541-779-4344 for an appointment.