What Is TMJ?
TMJ refers to the temporomandibular joint, the ball-and-socket joint where the lower jaw meets with the head. TMD is a term for temporomandibular dysfunction, which refers to a constellation of disorders within the joint and a range of conditions causing pain and dysfunction in the head and neck areas including headaches, ear pain, neck pain, eye pain, facial pain, joint noises such as clicking and popping, ringing of the ears, and even visual disturbances and dizziness.
The TMJ is considered the most complex joint in the human body. It is not a hinge joint as some used to believe, but a gliding-hinge joint. It is not the center of lower jaw rotation as it is suspended in “space” by ligaments and muscles much like a puppet on strings. This suspension allows the lower jaw to move up and back as well as down and forward and side to side. It is considered one of the most complicated joints in the body for a number of reasons:
- It is the only sliding-hinge joint in the body
- You cannot move one side and leave the other stationary
- It is a load or weight bearing joint, but considerably smaller than the knee for example; yet we can generate many pounds per square inch upon clenching, much more than what most people weigh
- Dislocation of one or both jaw joints is one of the primary contributors to chronic head and neck pain including those headaches of “migraine-like” intensity
- The integrity of the TM joints is determined and maintained by a person’s dental and facial skeletal relationships early in life
- The structural position or relationships with the TM joints are primarily determined by the position of one’s teeth
Treatment for TMJ
Treatment for TMJ will vary by patient and be customized to address the specific problems you are experiencing. Upon consultation, Dr. Dierkes will address your concerns and develop a TMJ treatment plan for you. We use a conservative, non-surgical approach to treatment, using a naturopathic and holistic avenue to care for the patient while recognizing that the body has an innate ability to heal itself.
We offer the following treatments for patients with TMJ:
- Splint therapy
- Assessment of predisposing factors contributing to the onset of TMD
- Nutritional and hormonal assessments to assist in establishing normal muscle physiology
- Trigger point injections for referred pain
- Prolozone to reduce pain, improve vascularity, dissolve restrictive adhesions or scar tissue within the TM joints, and to regenerate cartilage.
- Botox to reduce the intensity of muscle contraction
- Regenerative medicine (PRP – platelet rich plasma) to assist in the repair of a damaged joint
Treatment often involves the use of an orthopedic device worn on the lower teeth to reposition a dislocated jaw joint. Even a 1.0 mm discrepancy can mean trouble. This involves:
- Initial placement of a “soft” device to assist in a subsequent bite registration to accurately record an
optimal jaw position for fabrication of the acrylic appliance or orthotic.
- Use of TENS to relax the muscles and to allow the jaw joint to move into a relaxed muscle dictated
position to be maintained by the appliance
- Physical therapy or cold laser
- Trigger point injections for areas of referred pain
- Prolozone injections to eliminate pain related to muscle spasm
- Mineral and hormone assessments
- Ozone sauna
The Condyle/Disc Relationship:
So often, we have referred to internal derangement as if the disc just fell off the condyle. Rather than considering that the disc has just fallen off the top of the condyle, I think it better to consider what comes first. In other words, what causes the disc to become displaced. In my opinion, the condyles or mandible becomes misaligned or displaced relative to the disc.
Once this happens, there may be years of muscular and bodily compensation altering one’s overall posture resulting in the loss of the normal cervical (neck) curvature with attenuation along the entire spine ultimately. So what causes this misalignment in the first place? Well, there is general agreement that TMD is multi-factorial, meaning there is no one identifiable cause.
Unfortunately, most surgical intervention or orthodontics for that matter do not even consider condylar head position. This is tragic as the original underlying problem has not been identified or adequately managed.
Dr. J. Michael Dierkes, DDS, MS, NMD is a nationally recognized orthodontic specialist who has been creating beautiful smiles for over 30 years. His services have improved the lives of people from Roswell and the surrounding areas, including residents of Sandy Springs, Alpharetta, Marietta, and Atlanta. Whether you are an adult, a child, or a teenager, our knowledgeable staff is committed to helping you achieve the radiant, beautiful smile you deserve. Please call us today to schedule your initial consultation!