dysfunction (TMD) or disorder of the temporomandibular joint (TMJ) are
common terms for Craniomandibular Dysfunction, a collection of symptoms
which result when the chewing muscles and jaw joints do not work together
correctly. Many chronic suffers are misdiagnosed with neuritis, neuralgia,
stress, or tension headache, even labeled as neurotics or hypochondriacs!
The simple fact is that your teeth must come together in a bite that
supports a healthy normal jaw joint relationship with the joint discs in
place between the condyles of the jaw and the fossae of the skull in
order that the muscles of the jaw, head and neck work properly.
How do you know if you
have TMD? It's not always obvious! TMD can generate referred pain,
manifesting in areas other than the jaw but still intricately related to an
unstable bite. Do you suffer from migraines or headaches, pain behind the
eyes, earaches, ringing or buzzing in the ears, loss of hearing, dizziness,
clicking, locking of your jaw, grinding, clenching, unusual wearing or
cracking of your teeth, jaw soreness upon awakening, difficulty swallowing,
facial pain, neck pain, shoulder pain, or numbness/tingling in the fingers?
You may have a compromised bite!
Maybe you've tolerated
symptoms for years. Your malocclusion (bad bite) might be inherited –
crowded or overlapped teeth, poorly aligned teeth, extra or missing teeth,
irregularities of jaws or face – or it might have resulted from habits like
thumb/finger sucking, mouth breathing and poor tongue functioning. Your bad
bite may be the consequence of a single missing tooth, an improper
restoration, or ground down or broken back teeth. The onset of symptoms may
have been sudden and intense, as in after an accident, whiplash, or a blow
to the face. Regardless of cause, jaw joint disorders tend to worsen over
time if left untreated.
How is TMD treated in
our office? Your initial appointment will be a visual temporomandibular
joint dysfunction examination and consultation. This appointment will take
about 45 minutes to one hour and at the completion of this initial visit a
tentative diagnosis will be established. You will find the doctor to be
conscientious and thorough in his examination. You will have an opportunity
to have your questions and concerns answered and proposed treatment and
costs will be discussed with you at this time.
If you wish to proceed,
the second appointment will involve diagnostic records and consultation,
confirming the initial examination and diagnosis. The records appointment
involves panoramic and transcranial digital radiography and digital
photographs to document where you are before treatment begins. If
appropriate, and you wish to proceed with treatment, impressions will be
taken to have an orthotic appliance constructed and programmed by the doctor
as a first step toward symptom relief and jaw joint disc recapture. This
will help your jaw joints to realign and then the muscles to relax.
Treatment length will
vary from individual to individual and severity of the case but on average
you will return to our office on a monthly basis for 6 - 12 months. Each
month adjustments will be made to the splint in order to realign the jaw
joint into a normal relationship with the discs interposed between the
condyles of the mandible and the fossae of the skull. Some conditions will
benefit most from multidisciplinary treatment, and in those cases the doctor
will work closely with a craniosacral massage therapist, chiropractor,
physical therapist or other practioners to help in your healing.
During the initial
treatment phase, the lower jaw is repositioned, thus creating a
space between the back teeth when the splint is not in place. Phase II
treatment will be necessary following the splint phase, with the purpose of
aligning the teeth to support the jaw in its new and comfortable position. Phase II treatment may include – orthodontics, crown and bridge,
restorations, new complete or partial dentures, implants or a combination -
to reposition your teeth to maintain the newly created and healthy jaw joint
relationship established with the Phase l splint.
As your joints begin to
heal and your initial symptoms improve, the Phase II treatment plan will be
determined by the doctor and discussed with you at that time with regards to
an estimated cost and time line. If any questions or concerns arise during
treatment, please do not hesitate to contact our office. Ultimately you
deserve to live free from chronic pain!
For more information on
CMD, visit the website of the American Academy of Craniofacial Pain at