TMD (Temporomandibular Disorder) | Sleep & TMJ Therapy https://www.sleepandtmjtherapy.com Wed, 29 May 2024 14:50:58 +0000 en-US hourly 1 https://wordpress.org/?v=6.7.1 TMJ Disorder: Breaking Down Its Links to Being So Prevalent https://www.sleepandtmjtherapy.com/tmj-disorder-breaking-down-its-links-to-being-so-prevalent/ Wed, 29 May 2024 06:37:31 +0000 https://www.sleepandtmjtherapy.com/?p=854 Almost every day I am asked the question: “What caused this?” or “Why did this happen?” Many individuals experience the debilitating effects of TMJ disorder without fully understanding its underlying causes. In almost all cases, the warning signs were there: crunching and clicking or popping in the jaw joints, grinding, headaches, neck pain, heavy eye [...]

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Almost every day I am asked the question: “What caused this?” or “Why did this happen?” Many individuals experience the debilitating effects of TMJ disorder without fully understanding its underlying causes. In almost all cases, the warning signs were there: crunching and clicking or popping in the jaw joints, grinding, headaches, neck pain, heavy eye blinking, migraines or even sleep-disordered breathing.

Unfortunately, most of the time these symptoms are often overlooked, leading to prolonged suffering and a lack of effective treatment options. In this blog post, we will delve into the connections between TMJ disorder and these common symptoms, shedding light on why this condition is so prevalent and how it can impact various aspects of daily life.

Unveiling TMJ Disorder and Its Common Symptoms

TMJ disorder stands as a complex and often misunderstood condition, affecting the mechanics and comfort of the jaw joint and its associated structures. This disorder can manifest through a variety of symptoms that, while seemingly unrelated at first glance, share a common origin in TMJ dysfunction. Among these symptoms, as noted above, jaw joint noises are notable indicators, often dismissed as mere nuisances rather than signs of underlying issues.

Facial pain, presenting itself in various intensities and patterns, further complicates the daily lives of those affected. A noticeable asymmetry in facial structure can also emerge, subtly altering one’s appearance and potentially affecting self-esteem. Additionally, increased eye blinking, an involuntary response to discomfort or strain, may be observed, linking neurological responses to physical dysfunction. Beyond these, headaches and neck pain stand out, acting as significant disruptors to one’s well-being and productivity.

These symptoms collectively paint a picture of a condition that extends its influence far beyond the confines of the jaw, impacting broader aspects of health and quality of life. The interconnected nature of these symptoms underscores the necessity for keen and informed observation, ensuring that TMJ disorder is recognized and addressed with the urgency and comprehensiveness it warrants. In most cases of TMD (Temporomandibular disorder), the root cause often goes back to childbirth. That’s right, birth caused all the problems! As someone who sees these cases every day, it becomes pretty darn obvious that the problems were there from day one. By simply looking at the person and looking for any facial asymmetry, it becomes very clear that this person has deformities and imbalances in the skull–granted, it’s nothing major, but it’s enough to cause all sorts of health issues.

Navigating the Diagnostic Maze: Understanding TMJ MRI Findings

MRI imaging emerges as a pivotal tool, shedding light on the complexities of the condition with remarkable clarity. This advanced diagnostic method goes beyond the surface, offering a window into the internal mechanics of the jaw that other evaluations might miss. Here we can see the soft tissue and the big reveal of where that little disc may be displaced. Through MRI scans, the visualization of condylar damage, bony erosions, displaced discs, and even the subtlety of chronic arthrosis (breaking down of the joint) becomes possible, each finding painting a part of the broader picture of TMJ health.

These insights are invaluable, as in our practice, this aids in treatment strategies tailored to the individual’s specific condition. In addition, the CBCT x-ray allows for a view of the cranium with the jawbone. Between the two, this deep dive into the anatomical and functional details not only aids in a more accurate diagnosis but also provides a way for treatment to target the disorder’s root causes. As we navigate this diagnostic maze, the goal remains clear: to move towards effective management and relief for those enduring the symptoms.

The analogy I like to use is if the front-end alignment is ‘off’ on your car, it will run very rough and feel like it’s falling apart. Well, that’s how the human body feels. If the body is not in alignment, it runs rough and feels like you’re falling apart. In other words, most of the time you can just look at a person to know if they are asymmetrical, and if so, most of the time they are not feeling very good. As it turns out, if you really took the time to look at people very meticulously, you would agree that most of them are asymmetrical and most likely suffer some degree of malady because of this.

Now, just imagine a lifetime of little aches and pains and you wonder why years later your whole body just hurts all the time. Because of all those little warning signs, for so many years now there is a much bigger problem that will take more time to handle. This is why when I meet a new patient, I explain that I cannot simply fix the problem overnight. These things take time and patience.

Towards a Solution: Addressing TMJ Disorder Holistically

The best solution is addressing TMJ disorder holistically, without surgery. This demands a comprehensive strategy that goes beyond surface-level symptoms to unravel the complex web of contributing factors: angulation of the jaw, where the disc is displaced, and any evidence of damage around the jaw.  Personalized treatment plans can emerge as the cornerstone of this holistic strategy, tailored to meet the unique needs and circumstances of each individual. Such plans might incorporate a blend of physical therapy, stress management techniques, massage therapies,  and within our practice an oral appliance (an ALF or Modified Gelb appliance).

This all aims at restoring balance and function to the TMJs and related structures. A critical aspect of this multidisciplinary approach is the ongoing dialogue between the patient and the healthcare team, ensuring adjustments to the orthotics can be made as progress is evaluated. This dynamic and responsive model of care not only seeks to alleviate immediate symptoms but also aims to establish a foundation for long-term health and well-being. By addressing TMJ disorder through this holistic lens, individuals are empowered to reclaim control over their health, navigating toward a future free from the constraints of TMJ-related discomfort.

The Silent Progression: Why TMJ Disorder Often Goes Unnoticed

As you can see, birth could contribute. As later in life we wonder: what could have caused this pain and other ailments? As you see, this disorder often evolves quietly, masquerading under symptoms that do not always appear related to the jaw. The general lack of widespread knowledge and understanding about the disorder contributes to its silent advancement as well. People experiencing a constellation of seemingly disparate symptoms like increased eye blinking or facial asymmetry might not recognize these as potential indicators of TMJ disorder.

This gap in awareness and association delays the pursuit of diagnostic clarity and intervention, allowing the disorder to manifest more complex challenges. This scenario underscores the critical need for enhancing public and professional understanding of TMJ disorder. In our practice, this is one of our goals to create awareness and understanding. Hopefully, this blog has given you a bit more to think about and understand why identifying this in younger people before bigger problems can happen is optimal. Identifying these signs early can often allow for early intervention — I am not talking about orthodontics, but I am talking about ALFs and proper bodywork to help the body grow and develop in a normal fashion for our younger population. For the older population, this allows for a gentle correction providing a relief of symptoms.  That’s what it is all about folks! That little disc.

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Oral Cancer and TMD- Coincidence or Correlation? https://www.sleepandtmjtherapy.com/oral-cancer-and-tmd-coincidence-or-correlation/ Wed, 23 Nov 2022 07:49:31 +0000 https://www.sleepandtmjtherapy.com/?p=619 There are so many factors involved with TMD (temporomandibular disorder) that it can make one’s head spin. When it comes to analyzing TMJ disorders, there are many factors that need to be examined. One of the first pieces to the puzzle is actually a palpation exam where the dentist presses on the various muscle groups [...]

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There are so many factors involved with TMD (temporomandibular disorder) that it can make one’s head spin. When it comes to analyzing TMJ disorders, there are many factors that need to be examined. One of the first pieces to the puzzle is actually a palpation exam where the dentist presses on the various muscle groups to determine if any are irritated from the TMJ discs. The way it works is that when the discs in the jaw joints are displaced, this causes a pull on the muscles in that area, causing discomfort. Then, when the muscles are palpated, they basically hurt. This helps in understanding how serious the problem is. The other diagnostic tool needed is to have a really good MRI of the potentially displaced discs and how badly they are displaced. If the discs are slipped forward (anterior displacement), then this is much easier to work with than if they are laterally or medially slipped. These displacements are by far more difficult to fix because the discs can get jammed down into the tissue and it now becomes very difficult for them to get back into proper position. The problem with displaced discs is that they will quite literally ‘pinch’ blood vessels and nerves in and around the joints. This can, and will, lead to lots of pain that will reduce your ability to sleep well.

Why is sleep important? When the body does not sleep well, it is far more likely that disease processes can begin. As anyone knows, when your body is just tired all the time, it is far more likely you will catch the flu and infections are far more likely to set in. This is the case with cancer as well. When your body is debilitated from lack of sleep it is easier for cancer to set in.  There is now plenty of research to support this. If you simply Google ‘cancer from sleep apnea’ you will find that with moderate to severe sleep apnea, you are two and a half times more likely to develop cancer and three times more likely to die from cancer. This is a serious statement. What this means is that if you are not sleeping well, you are far more likely to contract kidney cancer, melanoma, breast cancer, and uterine cancer. Even though the risk of lung or colorectal cancers is less, it is just not worth the risk when you do not sleep well. TMJ disorder affects not only your joints but impacts the quality of sleep. A confirmation from UVA hospital’s research is that good sleep has been confirmed to be key to good health. With good sleep, the lymphatic system is regulated, and in turn, helps regulates many immune systems.

So, what is the message of this little blog? The message is to pay attention to your body. If the jaw joints are causing pain – headaches, neck or back pain, or even dizziness and tremors – then pay attention and have it looked at by someone who understands the situation. And this has now opened up another proverbial can of worms: Who do I see? TMJ disorder is so poorly understood that there is no consistency in diagnosis or treatment. So please stay tuned as the next blog will delve into the devious world of diagnosis and treatment.

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Considerations When You Have TMD https://www.sleepandtmjtherapy.com/considerations-when-you-have-tmd/ Wed, 09 Nov 2022 19:59:20 +0000 https://www.sleepandtmjtherapy.com/?p=608 Most of us who have TMD (Temporomandibular Disorder) ask our doctors what restrictions we have to endure when wearing appliances in our mouths. One of the first things to consider is what to eat. There is actually a recipe book dedicated to just that purpose! Basically, if you are wearing ALF appliances, then you have [...]

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Most of us who have TMD (Temporomandibular Disorder) ask our doctors what restrictions we have to endure when wearing appliances in our mouths. One of the first things to consider is what to eat. There is actually a recipe book dedicated to just that purpose! Basically, if you are wearing ALF appliances, then you have the usual turbos on the lower teeth. When eating, the ALFs must be removed and therefore all that really touches will be the teeth with turbos. This is why you need to eat soft food – that is until the back teeth erupt. Remember: the purpose of those turbos is to allow the other teeth to erupt which will protect the integrity of the joint space for the articular discs.

Many people will find that the turbos do not really slow them down too much when eating, but they do need to eat softer foods than they normally might. In general, if your food is fork tender, then it should be easy enough to eat and swallow. Mastication (chewing) is good for your digestive system and muscles, yet when you have a TMJ problem, it is better to go softer for a while so the joints can heal.

Another frequent topic that arises is what exercise can be done when a person has a TMJ problem. The issue when a person has a slipped articular disc is the disc needs time to heal and try to recapture its proper position in the socket. If you work out too hard at the gym, this oftentimes causes a pull on the neck muscles (sternocleidomastoids). These muscles will pull on the slipped discs and make them worse. This is why a more carefully crafted exercise program for TMD cases has been developed.

One of the most important aspects of exercise for the TMJ patient is to make sure you do not lift above the height of the shoulder. A guide would be to not lift above the arm when it is stretched out horizontally. The reason for this is that the body will tend to ‘detach’ from this motion, and you will lose strength. Example: If you swam the ‘crawl’ as it is called, your arms would go above the shoulders, and you would pull the water toward you. In this action, you will stress the muscles in the neck and inadvertently pull on and potentially damage the discs in the joints. This is why over-the-shoulder lifting must be avoided.

There is a nicely modified program for TMD patients that involves being careful to protect the joints while still getting in a good workout. Some of these exercises involve using the elliptical machine. As an example, the Peloton is a quality elliptical type of workout. It is not recommended to use the treadmill because it is so much like running that the neck gets pounded. This can hurt the discs as well. There are several other modifications of exercise programs, but they need individual attention and modification per patient.

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