TMJ & TMD
Temporomandibular joint syndrome (often called TMD, temporomandibular joint dysfunction) can be a tricky condition to treat. You or someone you know, may have suffered for years or even decades with minimal answers. Just like any other condition, I believe a holistic full body treatment plan that considers multiple potential root causes provides the best short and long term solution to jaw pain.
Given how complex the TMJ is, finding the right doctor or group of doctors to help you may be the most difficult part in achieving long-lasting results.
Symptoms of TMD
Some of the most commonly known symptoms of TMJ syndrome are:
- Jaw pain
- Decreased mouth opening (should be at least 3 knuckles wide)
- Neck pain
- Tinnitus (ringing in the ears)
Some of the less common symptoms that can be related to TMD include brain inflammation, digestive disturbances, emotional instability, hormonal imbalance and immune disorders.
Chicken or the Egg
The question with any health condition is whether the condition is the primary problem or whether it is the result of another root level condition causing a TMJ problem. In the case of the TMJ, very few practitioners are searching for deeper causes of TMJ dysfunction, but I have found clinically that the deeper you search the better results you can get.
Part of the reason more doctors aren’t searching deeper is because we have become very specialized in traditional medicine and it becomes near impossible to arrive at some of the conclusions I will share in this article, because the TMJ is probably one of the most common clinical problems that is associated with multiple systems that crosses a variety of specialties.
What I mean is that a TMJ problem almost always appears muscular or mechanical when in fact 80% of the time (or more) it is the immune system, insulin dysregulation, chemical intolerance or a previous distant injury in the body that is altering its function.
The details of the TMJ get quite complex, but the most important takeaway from the anatomy is that the TMJ is controlled by muscles. Not rocket science, but understanding what alters muscular balance related to the TMJ is critical if you want the best results possible. The major muscles controlling the TMJ are the masseters, lateral pterygoids, medial pterygoids, buccinators and temporalis.
If we only looked at the immediate muscles surrounding the TMJ then we would not be very holistic. Even if we include the remaining muscles in the neck and upper back, it’s still only “muscle-centric”.
What exactly is happening in TMD?
The temporomandibular joint (jaw joint) is a hinge joint that connects the lower jaw to the temporal bone of the skull. The joint is flexible, which allows it to smoothly move up and down as well as side to side. Normally this allows you to talk, chew and yawn without pain. The muscles surrounding the jaw control the position and the movement of the jaw.
Some of the most common problems with TMD are synovitis, capsulitis, tendonitis, arthritis and disc derangement. If you look at that list, almost all TMJ dysfunctions are related to inflammation. Clinically, I don’t find inflammation to be directly associated with jaw pain very often, so what is the story.
The jaw is connected on both sides to the skull, just like a bucket handle is connected on both sides to a bucket. When either side is even slightly off, due to muscular imbalances you end up with TMJ dysfunction. What most often causes the joint to be slightly off to the font/back or left/right is the muscles that attach to it.
Standard treatment for TMD is looking mostly at symptom remedy not root causes. At home treatments for TMD suggested by WebMD, are limited to not using your jaw, eating only soft foods or simply using it less. This is what I call avoidance of the problem. Dentists will focus on alignment of the teeth and at times will refer out to specialists for night splints or as a last result surgery. There are more conservative dentists and less conservative dentists, so finding the right one for you or getting multiple opinions may be best. I recommend finding a biological dentist that believes in a holistic approach. A good place to start would be www.iabdm.org
For a little more on TMJ dysfunctions, I found these two videos to be very easy to understand and they cover the two major TMJ dysfunctions that I see in practice.
Doesn’t a dentist treat TMD?
First, let us not negate the fact that dentists can help you with some of the contributing factors to developing TMD. If you have damage to occlusal surfaces, supporting structures, dental neglect, periodontal disease or a recent traumatic injury affecting your TMJ they can definitely help restore proper occlusion.
Other than the rare scenario and the above mentioned problems, I mostly view TMJ disorders as a musculo-skeletal condition caused by physiology gone awry.
Many chiropractors have had success treating TMD for years, even without a holistic view, utilizing only the chiropractic adjustment. Things like ultrasound therapy, cold laser and joint manipulation provide much benefit as they alter the surrounding musculature of the jaw.
What affects the Muscles?
For each and every condition there is a group of muscles and conditions that directly affect how well the muscles function in that area. For the TMJ some of the major considerations are head trauma, blood sugar imbalances, immune conditions and chemical intolerance/heavy metals.
Head trauma can cause injury to the intricate muscles that balance the TMJ. Actually, trauma or injuries to anywhere in the body can cause the TMJ to dysfunction. The TMJ acts as one of the body’s many “gyroscopes” that helps to maintain balance and keep the head level. If something from a knee to a shoulder makes you “off balance” then the TMJ is often going to try and compensate.
Some dental work including braces can also alter the mechanics of the TMJ and can often show up as injuries or compensations in the treatment process.
Blood Sugar Imbalances
Dysglycemia is a disorder of blood sugar metabolism or blood sugar balancing. The majority of this balancing occurs between the pancreas and the adrenal glands. The pancreas releases insulin when blood sugar is high sugar and the adrenal glands release adrenalin and noradrenalin when blood sugar is low. This push and pull balancing act can easily go wrong when someone eats too many refined and processed foods or has high levels of stress in their lives. You may have a blood sugar imbalance affecting your TMJ if you experience headaches, shakiness, brain fog, and either fatigue or energy after eating.
Dr. James Ooye, D.D.S. he states, “Hypoglycaemia is directly related with temporomandibular joint (jaw joint) disturbances through the electromagnetic system. Experience has shown that practically all TMJ syndromes involve hypoglycaemia (low blood sugar). Correcting TMJ problems often results in improvement of or correction of the symptoms just listed.”
Dr. David Eggleston, D.D.S. when talking about the TMJ reports, ““Abnormal function of the nervous and endocrine system (including the immune system) with no underlying structural deformity of these systems, is considered a functional disorder. When the patient is under distress the nervous system and the endocrine system send out their distress signals. When the person is under distress, the signals from these two systems are not normal and functional disorders occur.”
Applied Kinesiologists have long been considered the geeks of the TMJ. The reason why is because we realize that the TMJ can cause pain and dysfunction throughout the entire body. One of the discoveries found through applied kinesiology is the link between the TMJ and the immune system. The thymus and spleen are the major immune organs that can affect the TMJ.
In addition to the thymus and spleen, heavy metals and chemicals sensitivities can also alter the immune system and thus be reflected in TMJ function. If you are someone that can’t walk into a perfume store without getting a headache, you may have chemical intolerance.
All common scents including perfumes and the smell of food like bananas, strawberries and almonds, all get their smell from a chemical group called aldehydes. This sensitivity to smells can be a metabolic problem often associated with candida infections and molybdenum deficiency or it can be a problem with free radicals and the depletion of antioxidants.
TMJ problems can be difficult to treat when only taking single-faceted approach. If you have tried some of the basic traditional methods of treating TMJ without success, looking deeper to systemic type conditions is often necessary. Things like night guards and splints, avoidance and most diagnosis often don’t give you as a patient a way to dig deeper. Finding the proper dentist or doctor that looks into deeper root causes is important in the resolution of difficult, long-standing TMD cases.
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