Temporal mandibular joint dysfunction (TMJ-D) exists in the gap between medicine and dentistry. It is a joint disorder that can cause a myriad of acute and chronic jaw, face, neck, shoulder, head and ear pain presentations. Along with pain, it can present with:
- Inability to fully open the mouth or move it side to side
- Face pain
- Buzzing or ringing in the ears
- Sudden inability to find a comfortable jaw position.
- Clicking, popping or locking of the jaw.
There are many causes of this complex and often debilitating condition, malocclusion from a variety of sources such as direct or indirect trauma to the head, intubation following surgery or recitation procedures, inflammatory arthritic medical conditions such as rheumatoid arthritis, lupus, osteoarthritis, gout, scleroderma, fibromyalgia, previous poorly done dental work, bruxism or grinding the teeth at night, substances such as excessive caffeine or other stimulants or poor diet in general and poor postural neuromuscular biomechanical balance.
The jaw joint hangs on the temporal bones of the skull. The suchers of the skull are the joints in between the bony plates that create the rounded enclosed shape of the skull that provides the bony protective covering of the brain. Over one hundred years ago Osteopaths palpated and described motion in the cranium and now today we have laboratory evidence to prove that the skull not only moves but is often found to be “misshapen” limiting fluid flow in the brains arterial and venous circulatory systems. But perhaps even more importantly, the flow (or lack of flow) of the cerebral spinal fluid that can be associated with several symptoms including those contributing to TMJ-D.
Other influences from below the jaw joint can also contribute to balance and proper function of the jaw joint such as myofascial tension in the muscles of the neck, shoulder girdle and spine as they attach to the skull. Influences from as far away as the bottom of the feet affect how the stress and strain patterns are influenced as they project through the jaw joint and skull. For example, if someone has an asymmetrically fallen arch on one foot, that essentially drops that lower extremity further to the floor and influences the pelvis to sidebend to that side. All motion in the body is coupled meaning if it sidebends it also rotates. So, when the pelvis sidebends to the side of the essentially short leg it also rotates taking all the muscles and their fascial strain patterns with it. This sidebending and rotating influence travels up the system ending in the fascial attachments in the scalp that covers the skull. This fascial asymmetry and its effects had to pass right through the neck muscles and thus effect the balance of the jaw joint as it hangs on the temporal bones of the skull.
Dr. Talty has teamed up with Dr. Paul Henny, DDS who specializes in the dental aspects of diagnosis and treatment of complex TMJ disorders. Dr. Henny addresses the occlusive surfaces, first by resting the joints by having the patient switch to a soft diet and then creates custom adjusted hard acrylic orthotic appliances (bite splints) that redistributes the stresses on the TMJ that turn off the excessive muscle drive. He then may equilibrate the bite by performing a series of treatments with different custom bite splints that balance the occlusive surfaces of the joint. Please visit his website www.drpaulhennydds.com for further information regarding his treatment protocol.