What is the TMJ or TMD?
What are the Signs and Symptoms of TMD?
What causes TMD?
What is Dental Distress Syndrome?
How is TMD Diagnosed?
What is Neuromuscular Dentistry?
What can I do to treat TMD?
What is TMJ or TMD?
TMJ, although it has become almost a household word, is a non- specific, catch-all term for a variety of pain/dysfunction conditions of the head and neck. It was originally derived from “Temporomandibular Joint”, a jaw to skull joint that is located in front of the ear. Most doctors use the term TMD, Temporomandibular disorder, to more accurately describe a variety of conditions that affect jaw muscles, TMJ, and nerves associated with chronic facial pain. Back
What are some of the Signs and Symptoms of TMD?
• Headaches
• Sensitive and sore teeth
• Facial pain
• Neck and shoulder aches
• Ringing in the ears
• Jaw pain
• Ear congestion
• Clicking/ popping in the joints
• Worn down teeth
• Clenching/ Bruxing
• Limited opening of the mouth
• Cervical/ neck problems
• Loose teeth
• Tingling in the fingertips
• Forward head posturing
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What causes TMD?
Medical-Dental researchers and clinicians all agree that there are multiple causes for TMJ disorders. Some known causes are: malocclusion (a bad bite), bruxism (grinding teeth), para-functional habit (chewing gum, fingernail bite, pencil bite, habitual clenching, habitual jaw support on one side, using one side for a prolonged period of time etc.), post major surgery, scar tissue, automobile accident, whiplash, falls/injury, trauma (macro and micro) to the jaw, underdeveloped dental arch, structural imbalance (short leg, short arm), mal-alignment of spine, chronic stress related clenching/grinding, degenerative arthritis, emotional/psychological related stress, internal organ dysfunction, nutritional imbalance, toxic deposit, viral/bacterial infection, poor posture, and more unidentified factors. In other words, "Anything can cause TMJ disorders". Back
The fact is, "TMJ is an inert object". It is not capable of initiating any movement on its own until attached muscles are contracted and pull it to move. If TMD symptoms begin to develop, it must be a result of unusual muscular activities beyond their adaptable capacity. Muscles or ligaments do not have an intelligence of their own; they can only do what they are told to do by the nerves which control them. Therefore, with the exception of cases that have seen some type of severe blow to the jaw or accident, a muscular imbalance, with consequential joint distortion, must be caused by a neurological disturbance, which results in spasmodic muscles. Back
What is Dental Distress Syndrome?
Teeth are inserted into the jaw bone and at the end of the jaw is the TMJ. The ligaments, tendons and muscles of TMJ which hold the jaw to the skull are small and very delicately balanced. If chronic distress is placed upon them and distract the adaptive limit to the muscles and joint, it goes into a protective spasm (cramp). This continuous spasm can become part of a cycle: muscle tenderness, pain, and more spasm, that results in tissue damage. Any dental distress, which disturbs the harmony of this complex "neuro-musculo-skeletal system" (nerves, muscles, bones and joints working together in harmony), can result in TMJ Disorder. Back
The number one cause of dental distress syndrome is malocclusion (Bad Bite). TMJ position is established by the upper and lower arch relationship. This relationship is dictated by the bite of the teeth. If you have a physiologically and functionally well balanced bite, you may not notice any discomfort, dysfunction or pain while joint is in move. However, if you have a bad bite, this can cause dental distress and forces TMJs to move to a non-physiologic position. Back
Every time we chew, swallow, move head around, walk, work, drive, exercise, play, lift things up, and even during breathing and fall asleep, the upper and lower teeth constantly meet together lightly or clench hard. If there is a bad bite, this not only distresses to the trigeminal nervous system, but also forces the TMJ to move away from its balanced physiologic position. Back
How is TMD Diagnosed?
Dr. Nehawandian will consider all the information gathered by taking your history and doing a physical examination of your teeth, head and neck. When indicated, she will conduct a series of tests using non-invasive electronic instruments such as the K-7 Evaluation System. Data from these tests will indicate whether your bite is a major contributing factor to your problem. If your habitual bite is a probable cause of your condition or pain, Dr. Nehawandian will identify a jaw position determined by the relaxed state of the muscles. This jaw position and the corresponding new bite, called Neuromuscular occlusion, will harmonize the TMJ, muscles, and teeth. Back
What is Neuromuscular Dentistry?
Neuromuscular Dentistry (NMD) is the science of dentistry that embodies accepted scientific principles of patho-physiology, anatomy, form and function. NMD objectively evaluates the complex relationship between teeth, temporomandibular joints and the masticatory muscles in order to achieve a bite that is based on the optimal relationship between the mandible and the skull — Neuromuscular Occlusion. The goal of Neuromuscular Dentistry is to relax the muscles controlling jaw position and to establish a true physiological rest position upon which treatment considerations are based. Back
NMD is the science of occlusion encompassing not only the teeth, but the objective evaluation of the status and function of the jaw muscles and joints — before, during and after treatment — to achieve the optimal result. Back
What can I do to treat TMD?
The immediate concern is to provide relief of your symptoms. The best way to do this is by using a technology called ULF-TENS. The second step will be to stabilize your bite. An orthosis is a custom made appliance fabricated of plastic that can be worn over the teeth to maintain the neuromusculary derived bite position. At this point, nothing is done to permanently alter your bite. You typically wear this plastic appliance for a prescribed period of time to verify that this new jaw position solves or reduces the problem. After having worn the appliance for some time, Dr. Nehawandian will discuss several options open to you for long term treatment. Back
