As 2024 wraps up, we take a moment to reflect on the significant progress made in understanding and treating Temporomandibular Joint (TMJ) disorders. Throughout the year, our efforts have focused on enhancing patient care and exploring innovative treatments. This journey would not have been possible without the dedication of our team and the tremendous support of our patients. THANK YOU!

We have witnessed firsthand the remarkable resilience and determination of individuals facing TMJ challenges. Their stories have not only inspired us but have also driven us to push the boundaries of what is possible in TMJ therapy. The advancements made this year have provided new hope for those dealing with chronic pain and dysfunction associated with TMJ disorders.

One of the highlights of 2024 has been the introduction of new treatment methods that show great promise in managing TMJ symptoms. From manual therapy techniques (Neubie, Laser or Massage) to minimally invasive procedures like arthrocentesis and arthroscopy. The field has seen a range of developments aimed at improving patient outcomes. These treatments have offered many patients significant relief and have contributed to a better understanding of the complexities involved in TMJ disorders.

We have seen a rise in collaborative efforts among healthcare providers, researchers and patients, which has led to more personalized treatment plans and improved patient education. These partnerships have been instrumental in advancing our understanding of TMJ disorders and tailoring therapies to meet individual needs.

Community involvement has played a crucial role in our mission this year. Through workshops, informational sessions and support groups, we have fostered a sense of community among patients, enabling them to share their experiences and support one another. These initiatives have been invaluable in raising awareness about TMJ disorders and in offering practical strategies for coping with the conditions. Looking back, it is clear that 2024 has been a year of significant progress and growth in the field of TMJ disorders. The dedication of our patients and the tireless efforts of our team have paved the way for a brighter future in TMJ care.

Breakthroughs in TMJ Therapy

This past year has brought about some new ideas in appliance therapy for TMJ disorders. I have been noticing an increase in allergies these past few years–and mostly to metals like nickel–so my lab and I have developed some new appliances that work better than anything we have had in the past.

Our office recently acquired the fantastic Fotona laser. This deep-tissue laser treatment reduces inflammation and stimulates the cells in your body to heal. It feels wonderful–soothing, calming and just plain ‘delicious’ as some of our patients have told us. For patients with obstructive sleep apnea, I can use the Fotona laser to reduce the size of a thick tongue and tighten the palate for better breathing. This is in lieu of PPP (Palatal Pharyngeal Plasty) surgery that has to be repeated every few years. I think it is infinitely easier, less expensive, far less painful (little to no pain with our laser) and therefore makes more sense than having surgery.

We also have the Biolase which is used in conjunction with massage therapy. My assistant Ruth is now here more days than ever due to the increased demand for laser and massage at the same time. If you need a break from day-to-day stress, see Ruth and experience what laser massage can do.  This treatment calms the tension in the muscles around the jaw, face, neck and shoulder. This procedure of identifying trigger points helps relieve the symptoms associated with TMD. As Ruth massages the masseter (jaw), sternocleidomastoid (front of the neck) or temporal muscles, relief comes to the patient experiencing symptoms like headaches, earaches, neck or facial pain or simply relieving pressure on the TM joints.

This year brought other developments in TMJ therapy. One of the more noteworthy breakthroughs is manual therapy. This approach involves physical therapists using their hands to stretch the soft tissues and muscles around the joint, effectively improving function and relieving pain.

Another promising technique is arthrocentesis, a procedure where fluid is injected into the TMJ to remove scar-like tissue and inflammatory substances. This method has shown positive effects in pain relief and improving mouth opening, although these benefits might be short-lived.

Arthroscopy continues to be a valuable tool for TMJ treatment It involves inserting an instrument with a tiny video camera into the jaw joint to visualize the area and remove adhesions or reposition the joint’s disc. This procedure has been moderately successful in improving pain and function.

Another innovative option explored this year is prolotherapy. This involves injecting a solution into the TMJ area to stimulate the body’s natural repair mechanisms. Prolotherapy shows promise, particularly in cases where the joint is dislocated or exhibits hypermobility. However, more research is needed due to the limited number of studies available.

Although we can offer both arthroscopy and arthrocentesis, neither of these techniques will actually fix the underlying problem; a displaced disc. The oral surgeon who performs this procedure is always very clear that these techniques are used to help alleviate discomfort and attempt to improve the situation. These techniques basically help a patient buy time and see if they can put off a full TMJ surgical procedure.

Emerging therapies like platelet-rich plasma (PRP) injections are also gaining attention. PRP involves using a patient’s own blood components to promote healing in the TMJ area. This treatment aims to reduce inflammation and encourage tissue regeneration, offering a potential new avenue for those who have not found relief through other methods. Again, the surgeon would explain that this will not likely fix the displaced articular disc, but if it helps to heal some of the joints, it might be worthwhile and easier than surgery.

Of course, the someday-to-be-famous ALF appliance is helping both adults and children. For each patient, this lightweight wire helps with realigning the cranium avoiding unnecessary strains. For the patient in need of arch development, this is a great alternative to a palatal expander and for pre-orthodontic needs, reducing their time in braces. By re-aligning the jaws in a very natural and careful fashion, many children need far less time in orthodontics. The additional benefit goes along myofunctional habits like a tongue thrust or resting with lips apart.

And speaking of orthodontics, we have come a long long way since the time of ugly metal braces. In almost every case, I can use clear aligners to erupt the teeth gently, slowly and carefully to the proper height to support the jaw joints after we determine the correct height needed. It took quite a while for the Spark company to understand what I needed to have done, but they finally understand and can produce aligners that do what is needed!

Another area of interest is the application of botulinum toxin (BOTOX®) injections. Botox is traditionally known for cosmetic uses, but it has been found to alleviate TMJ symptoms by relaxing overactive muscles around the joint. I am a certified provider of Botox injections. I have found that using this treatment provides good relief to tense muscles. Again, it is only temporary for most lasting up to six to eight months.

Stories and Experiences from Our Patients

Throughout 2024, we have had the privilege of witnessing the incredible journeys of many of our patients. Their stories reflect not only the progress in TMJ treatment but also the unwavering spirit and determination they exhibit in their recovery process.

One such story is of Cynthia, who had been grappling with chronic TMJ pain for several years. She finally found relief through a combination of manual therapy and lifestyle modifications. Sarah’s commitment to adhering to her treatment plan and maintaining a positive outlook was key to her progress. Her journey serves as an inspiring example of how patient involvement can significantly influence outcomes.

Another remarkable case is John, who underwent a plication surgery procedure to address his TMJ dysfunction. Despite initial challenges and setbacks, John’s perseverance and dedication to his recovery routine led to significant improvements in his functionality and overall quality of life. His story underscores the importance of patient resilience in the face of adversity.

We also had the honor of supporting Maria, who explored prolotherapy as a treatment option. Initially skeptical, Maria decided to give it a try after discussing the potential benefits and limited research with her healthcare team. Her willingness to explore new avenues of treatment resulted in noticeable pain relief and improved joint stability, showcasing the potential of emerging therapies in TMJ management. The prolotherapy provided some degree of relief without needing TMJ surgery

I like to explain to each of our patients that THEY need to be their own advocate for their course of treatment. Sure, this treatment addresses the damaged disc/joint system but in so many cases there is already nerve and muscular damage. You need to try things like acupuncture, massage, physical therapy, osteopathy and many other treatments to provide a long-term approach to managing your health.

Each patient’s journey is unique, and their experiences highlight the varied approaches to managing TMJ disorders. For example, Emily, a young professional, found that a combination of platelet-rich plasma (PRP) injections and stress management techniques significantly reduced her symptoms. Her proactive approach to integrating different treatments demonstrated the value of personalized care plans.

The resilience and determination of our patients continue to inspire us. Their willingness to engage in their treatment plans and try new methods has been crucial in their journey towards better health. We are grateful for their trust and partnership, which drive us to continually improve and innovate in the field of TMJ disorders.

Innovations and Research

Research conducted in 2024 has illuminated the intricate nature of TMJ disorders. Studies indicate that a combination of genetic factors, psychological stressors and pain perception can influence the onset and persistence of TMJ disorders. This comprehensive approach has helped in better understanding the multifactorial aspects of the condition, paving the way for more effective treatment plans.

Additionally, research has dispelled several myths surrounding TMJ disorders. The small amount of research, and the teaching in dental schools, tell us that a bad bite or orthodontics does not cause TMJ disorders. Here is the reference to such thinking.

For those of us who actually treat TMJ disorders, we are well aware that if the bite is not correct and does not support the TM joints, this will indeed cause the articular discs to be displaced, and then pain will happen. As part of the treatment protocol, the patient will wear an orthotic to ‘open’ the bite taller, and then later on do three-dimensional orthodontics to erupt the teeth to better support the condyle/disc system within the jaw bone socket. Therefore, a bad bite and/or regular orthodontics can indeed lead to TMJ disorder.

Innovative technologies have also emerged, providing new avenues for treatment and management. Virtual reality tools are being developed to assist in pain management and rehabilitation exercises. These tools offer patients immersive environments where they can perform guided exercises designed to improve TMJ function. The use of virtual reality in TMJ care promises to make therapy more engaging and effective for patients.

AI-driven diagnostic methods are another area of significant progress. These advanced systems can analyze a multitude of patient data, including imaging and clinical history, to provide more precise diagnoses. The integration of AI into diagnostic processes helps in identifying subtle patterns that might be missed by traditional methods, ensuring a more accurate assessment of TMJ disorders.

In addition to technological advancements, there has been an increased focus on integrative approaches to treatment. This involves combining traditional medical treatments with alternative therapies such as acupuncture, yoga and mindfulness. Such integrative care approaches aim to address the physical, psychological and emotional aspects of TMJ disorders, offering a more holistic treatment plan tailored to individual patient needs.

The strides made in 2024 have been possible due to collaborative efforts between researchers, clinicians and patients. Continuous research and innovation are essential for discovering new insights and developing more effective treatments for TMJ disorders.

Looking Forward to 2025

In 2025, we foresee promising advancements in the field of TMJ disorders that will enhance both diagnostic and therapeutic approaches. The integration of artificial intelligence (AI) in diagnostic processes is expected to refine the accuracy and speed of TMJ disorder diagnoses. AI can analyze patient data more comprehensively, offering personalized insights that aid in creating tailored treatment plans.

Additionally, virtual reality (VR) tools are likely to become more prevalent in TMJ therapy. These tools provide immersive environments for patients to engage in rehabilitation exercises, making the treatment process more interactive and effective. By incorporating VR, we can offer patients a unique way to manage their symptoms and improve joint function.

The focus on integrative care will likely intensify, with a blend of traditional and alternative therapies becoming a standard approach. This holistic method addresses not only the physical symptoms but also the psychological and emotional aspects of TMJ disorders. Techniques such as acupuncture, yoga and mindfulness will be integrated with conventional treatments, providing a well-rounded care plan that caters to individual needs.

Research into emerging therapies, such as platelet-rich plasma (PRP) injections and prolotherapy, is expected to yield more definitive results. These treatments show potential to promote healing and reduce inflammation in the TMJ area. As more studies are conducted, we anticipate clearer guidelines on their efficacy and broader adoption in clinical practice.

Community engagement will become part of our efforts in the near future. We plan to create outreach programs, workshops, support groups, informational sessions and other events to increase awareness of TMJ disorder–will continue to be a cornerstone of our efforts. We plan to expand our outreach programs, offering more workshops, informational sessions and support groups. These initiatives will aim to educate, support and empower patients and their families

Our collaborations with local organizations will be strengthened to raise public awareness about TMJ disorders. By hosting more public events and awareness campaigns, we aim to reach a larger audience and reduce the stigma associated with these conditions.

In essence, 2025 holds the promise of significant progress in TMJ care, driven by technological innovations, integrative therapies and community involvement. Our commitment to advancing the quality of care and supporting our patients remains steadfast, and we look forward to another great year of helping people navigate and overcome TMJ disorders.

At Sleep & TMJ Therapy,  Dr. Jeffrey Brown and our team are here to help you get the relief you need from TMJ issues in Falls Church, Virginia. Please call our office at 703-821-1103 to learn more or schedule a visit.

The post Year-End Summary of TMJ Disorders: Thank You to All Our Patients first appeared on Sleep & TMJ Therapy.

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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