TMJ braces migraines The Case of The Concept of a Commodity Gone Wrong

The other evening, my wife asked me to meet up with her and the kids at the mall for dinner. My daughter had a bunch of her friends doing the shopping thing and they all had dinner afterward. The other kids were to be picked up by their parents. One of the parents showed up very early to say hello and just catch up. She was concerned her daughter might not be doing so well since she had been hospitalized two days prior with a severe and debilitating migraine. She started getting migraines a few years ago- around the time she started getting braces. You already know where this is going, don’t you, dear readers?

The mother told me and my wife that her daughter had just finished braces phase one, and now was ready for phase two and another two years and thousands of dollars worth of treatment. I looked at her daughter and could not figure out from a cosmetic view point why she needed more time in braces. Then the mom told us she went to a ‘cheaper’ orthodontist who also could not figure out why the girl needed more braces. The mom just wanted to save money, thinking all orthodontists are basically the same. This is where they went wrong- mom thought buying braces was like buying soap or a toothbrush- basically it’s all the same- just a commodity in other words. WRONG!

I have tried for years and years to explain to parents that orthodontic work must be done three dimensionally. It really does a patient no good if you are just making their teeth straight and you ignore the vertical height of the teeth, which are critical to support the TM joints. You ALL know this, don’t you? For all the years I have blogged onward and upward, I have once again encountered a parent who ‘just doesn’t get it’. So as I sat at this restaurant, I looked across at my wife and asked “Should I tell your friend the truth or just shut up while I’m ahead?”. Her friend then piped up and said “Give it to me”, thinking she could handle the truth. So, as you all know dear readers, I told the truth. I explained that when the vertical height of the teeth is ignored, the jaw bones (condyles) jam the sockets and impinge on those little discs that cover the condyles and the discs get pushed out of place and can pinch blood vessels and nerves- VOILA!: Migraines.

And so as I did my thing and explained to the mother that all orthodontic work is simply not the same. Basically, I let her know that she was not buying a product, she was buying a service and with that service comes either very basic knowledge, or a very high level of understanding of the various systems in the human body. I explained that if the cranial bones are distorted, then this is contributory to headaches as well, and most likely we would need an MRI of the TM joints to check for disc displacement. The mother was basically dumbfounded at this point, saying no one told her any of this, and she had no idea all of this was connected. At this point, I told my wife and her friend that I was glad to talk more but we should probably continue this at my office with a real and proper exam for her daughter.

I guess the motto of the story should be you get what you pay for. But that’s not fair since neither the mom nor the orthodontist is trained in this field. I have the same problem with other doctors as well- little to no understanding of TMJ disorders or cranial bone or cervical spine distortions. As time goes by, I am sure the knowledge will spread and I am trying to make it happen one patient at a time.