According to the National Institute of Dental and Craniofacial Research, temporomandibular joint and muscle disorders, commonly referred to by the umbrella term TMJ, affect over 10 million Americans. Because TMJ causes so many people pain and discomfort, researchers have been spending more time trying to establish the exact causes and treatments. But the best treatment for TMJ is occlusal correction, one of the most underutilized procedures in dentistry today.
TMJ is a potentially debilitating disorder whose underlying causes and cure are poorly understood by mainstream dentistry. TMJ is acute or chronic inflammation of the temporomandibular joint, the joint where the mandible (lower jaw) connects to the bone at the side of the head. This is one of the most important joints in our bodies because the motion allows us to talk, chew, yawn, etc. Sometimes trauma, such as whiplash as in a "rear-ended" automobile accident can cause the disorder. Burt Reynolds nearly lost his career when he was hit in the face with a chair that was wrought iron instead of balsa wood. This incident was the inciting cause of his TMJ.
Another cause is a bad bite-when the jaw can't find a definite location to bite there is a subconscious urge to grind or clench, to try to find a stable position, and this can cause stress on the joint. The literature says that the bite does not have any causal relation with TMJ, but the scientific literature predominately contradicts what I, and most dentists, believe.
Part of the problem with diagnosing TMJ is the many varied symptoms that can occur. Dizzy spells, ringing in the ears, headaches, pains, and strange noises in the head may all be attributable to TMJ. Headaches are probably one of the most common symptoms of TMJ. Other symptoms include pain in the face and neck, stiffness in the jaw (with limited movement or locking), and clicking. Even chewing can be painful. One case I encountered was so severe that the patient considered suicide. He was referred to me by his physician after more than ten years of suffering.
Because this joint disorder is often caused by a bad bite, the most effective treatment is organic occlusion, or the ideal fit of jaws and teeth. This bite correction procedure should always be done prior to any TMJ work, any periodontal work, and any major reconstruction work. This is an irreversible solution, but it is the long-term solution. When the torque produced by missing teeth, misplaced teeth, or dental work not in harmony with the existing bite is corrected, the joint has the best chance to heal.
There are other, short-term, solutions to this problem that actually just relieve the pain symptoms. These include pain medications, eating soft food, ice packs, and stabilization splints. Splints can provide immediate relief and hope for the patient, but the reason for the relief is really a testimony as to what is wrong-the habitual bite or the fit of the natural teeth is wrong. After doing it wrong for almost thirty years, I made the radical change that I now recommend to all dentists: occlusal correction.
Since occlusal correction is the latest concept of occlusion, most dentists have not been trained to use it, do not want to use it, or are oblivious to it. Like brain surgery in medicine, only very skilled dentists should be doing occlusal correction. They are called gnathologists. The procedure involves grinding small spots on the tops of the teeth to allow the mandible to sit in the rearmost hinge posture. This posture relieves the strain on the TM joint and allows it to heal, but has been avoided because of the disasters caused by inadequate training.
The goal of this procedure is to achieve what is known as organic occlusion, in which the jaw is seated properly and the teeth fit together in a stable, even bite while harmonizing with the jaw's position. If the jaw, for whatever reason, can't find a stable position, a person may experience clenching and grinding. In such cases correcting the tops of the teeth according to precise engineering principles will fix the problem and may also alleviate related issues such as headaches, muscle pain, joint sounds, and in some cases even problems with eyesight and digestion.
Although occlusion is controversial, the fact remains that the procedure that works most often for the largest number of people is occlusal correction. It is by far the most useful procedure in dentistry today. Most often, after the major three-hour correction appointment, a patient goes home with the first hope he or she has had in years. The person's pain is gone, the face is relaxed, and all the teeth hit at the same time. Dentists need to know there is a superior approach to many of the problems they face, and patients suffering from TMJ need to understand the treatment alternatives that will work best for them.
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