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Temporal Mandibular Joint or TMJ is actually the jaw joint(s) which are on each side of the head near the ear. TMJ generally refers to pain or problems in this area. This is a common problem that is caused my any number of factors including stress, grinding or clenching of the teeth, poor alignment of teeth as well as poor neck and spinal alignment. Symptoms generally involve pain in the joint itself, headaches, jaw muscle pain and even teeth pain.

 

TMJ

The most common cause of the pain is a trigger point or spasm in one or more of the chewing muscles.  Many dentists who treat TMJ overlook the fact that skull bones move as proven by many osteopathic physicians the past 60-70 years. The skull bones tend to become restricted leading to many health problems including TMJ. Think about it–if the temporal bone of the TMJ is not in its normal position then the mandible that articulates with this bone would be off. This in turn would throw the teeth slightly out of alignment triggering grinding and clenching. Please refer to my publication on BIOCRANIAL. This release is what doctors term Cranial Sacral treatment.  There are about 4-5 different ways to bring about this release, Biocranial  is one that I have been trained in for the past 8-9 years. It has many health benefits, yet I use this treatment primarily for TMJ and related muscles.

 

My early training of TMJ involved the use of a hard plastic splint or “nightguard”, then grinding teeth or rebuilding teeth to fit the jaw alignment. When muscles are tense or the joint is misaligned, then grinding the teeth to match a jaw in an abnormal position is not the best answer in my opinion. Of course, each patient is evaluated on a case by case basis, but in general if the skull bones are able to move freely and the muscles are relaxed, the proper bite or occlusion can be established. In my experience once the above is resolved, bite adjustments are minimal or not needed.

 

Here is a brief story I wish to share with you that changed my thinking. I was at a seminar some 40 years ago and the lecturer was a TMJ specialist of some sort. His patient was a female in her 50’s with symptoms of pain and headaches. The first photo showed a beautiful set of teeth with not a single cavity. The very next slide was a picture of all those teeth cut down into little pegs!

He crowned every tooth in her head. After witnessing this drastic approach I decided there must be a better, less intrusive way to correct a TMJ problem. He said her problem was resolved; I hope it was too for what she sacrificed.

 

It’s difficult to discuss a complex subject on one page. However, the treatment can be simple and inexpensive in many cases. We use a resilient appliance (for nearly 25 years) that is very effective at protecting the teeth and relaxing the chewing muscles. It was developed by Dr. Lawrence Funt, an orthodontist from Maryland, who mentored me back in the 90’s. He had one of the largest pain centers in the country back in the 70’s.  He stated that he trained under Dr. Janet Travell–the doctor who authored “The Trigger Point Manual” which is the basic guide in sports medicine today.

 

Yours for better dentistry,

 

Paul V. Gallo, DDS