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TMJ Dysfunction: Holistic Dentistry

TMJ stands for Temporo Mandibular Joint. This fancy name means it is connected to the lower jaw and touches temples of the head. TMD stands for Temporo Mandibular Disease.

Treatment of TMD (jaw joint disease) has two phases. Phase one is pain relief. Phase two is changing the structure so that pain does not return. Sometimes surgical intervention is necessary. Unless you ask a surgeon, surgery is the last resort.

Defining What is Normal

A normal tm joint does not make sounds. It has never made sounds. If your jaw joint ever made clicking, popping, sand grating sounds - you have a problem. It can also be that sound was present but not now. Odds are there is a problem. Due to our body's amazing capacity to repair and accommodate, oftentimes structural change is not felt.

Normal opening of your mouth is at least 52mm from edge of lower front tooth to the edge of the upper front tooth. Another way to measure is to be able to fit four fingers in your mouth. Normal joints go together with teeth that don't look worn out. However, it is possible to have teeth that look “brand new” and still have TMD.

Self Diagnosis: A Check List

The symptoms listed below can be used to indicate candidacy for TMJ treatment:
  • Do you have clicking, popping or grating noises in one or both of your jaw joints when you open and/or close?
  • Do you ever have a sensation of ear “stuffiness”, pressure or blockage of your ears? Is there excessive ear wax production?
  • Do you ever get ringing, whooshing, roaring, hissing or buzzing noises in your ears?
  • Do you ever feel dizzy when you turn around?
  • Are there imprints of your teeth in the sides of your tongue?
  • Are your teeth excessively worn?
  • Does your jaw deviate to one side when you open slowly and fully?
  • Do you have missing back teeth?
  • Does your “bite” feel wrong?
  • Do you have pain or soreness in any of the following areas: jaw joints, upper jaw or teeth, side of neck, back of head, forehead, and sides of head (temples), tongue, chewing muscles and/or behind the eyes, lower back?
  • Does your jaw ever lock or get stuck (lockjaw - trismus)?

The Holistic Perspective

Holistic means all inclusive. When any disorder is addressed, the entire person should be considered — body and mind. If a person has a kidney problem, it is not necessarily their kidneys that are malfunctioning. The problem literally can be coming from anywhere and its manifestation could be through the kidneys.

TMJ problems and others in dentistry should be addressed in the similar fashion. Problems can arise as a result of body's compensation to maintain an optimal level of function. To remove the need to compensate is to treat holistically. Remove the proverbial pebble from the shoe and you will stop limping.

TMJ Dysfunction - Airway Passage Relationship

To treat a TMJ problem, for some patients, is to address a breathing problem.

The lower jaw has a unique joint in that its position is controlled entirely by muscles. If there is a pebble in the shoe than muscles of the leg and foot will pull to avoid pain in the foot. Hence the limping. While limping can be tolerated indefinitely choking cannot be.

Suboptimal breathing is registered instantly and muscles of throat, mouth, and chest move respective structures around to allow for unobstructed breathing. One example of compensation for choking is an open mouth. Here a jaw is pulled down for air to get in. A body has to work constantly and use energy to keep pulling the jaw. This will result in sore muscles in neck, back and inside of mouth. To ease pain of neck, back, and jaw is to remove the need to compensate for choking.

How does one remove the need to compensate for choking? Get the thing out of the throat that chokes you in the first place.

What could be sitting in your throat that's not food? A piece of meat we call tongue. Its normal home is a mouth, but for many people their mouths are too small. The tongue then has to compensate for the lack of space. Options are limited. It cannot shrink.

The tongue can either go forward and hang out of the mouth or go back into the throat. Once your tongue is partially obstructing your airway, an alarm in the brain goes off. A neurological stimulus is sent to the muscles of the throat and jaw to keep the airway open as best as possible.

Since the tongue will be sitting not where it should be all the time, this alarm function can occur continuously. Muscles of the jaw and throat will be working overtime continuously as well. Jaw joint muscles are therefore never relaxed.

This type of TMJ dysfunction is commonly treated, and oftentimes remedied, with a dental appliance that repositions the jaw to make more room in the mouth and throat.

Dr. L. Kundel

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