TMJ Therapy Explained

The outdated dental model for treating TMJ was based on theories such as malocclusions (“mal” – bad; “occlusion” – bite) causing jaw muscle pain, or missing teeth causing jaw dysfunction, or some kind of jaw mal-alignment causing disks to slip out of place and produce pain in the joints. These concepts inevitably led to a “need” for mechanical corrections to be made, which would be accomplished by orthodontics (braces), crowning teeth, or making bite adjustments by grinding (reshaping) the teeth. These procedures are irreversible, and so in many ways they are similar to surgical treatments. However, research from around the world in the last 25-30 years has shown that these mechanistic concepts about TMD treatment are largely unfounded, and therefore these kinds of irreversible treatments are generally not necessary.

The current medical model is based on the proposition that the TMJ is a joint, and has much in common with any other joint. Therefore, it can be subject to all sorts of typical orthopedic problems — sore muscles, inflamed joints, strained tendons and ligaments, and of course disk problems. Almost all of these problems are capable of being treated without permanently changing or altering the joint structure/s. Obviously, in this model the “alignment” of teeth and jaws is neither analyzed nor changed because those factors have been proven to be mostly irrelevant to what is causing the TMD symptoms. Thus, the medical model is also more conservative, and patients treated within this framework can be spared the more invasive and expensive dental procedures of the past. Additionally, TMDs are now known to be influenced by genes, gender, and age, as well as a host of environmental and behavioral triggers such as stress and anxiety. For many patients, jaw pain may be a manifestation of a larger medical malady, including other widespread pain-inducing conditions such as fibromyalgia (“fibro” – connective tissues; “myo” – muscle; “algia” – pain). These new discoveries make it even more important to deal with TMDs within a medical framework.

The American Association of Dental Research (AADR) regarding Temporomandibular Disorders (TMDs) concludes: “It is strongly recommended that, unless there are specific and justifiable indications to the contrary, treatment of TMD patients initially should be based on the use of conservative, reversible and evidence-based therapeutic modalities. Studies of the natural history of many TMDs suggest that they tend to improve or resolve over time. While no specific therapies have been proven to be uniformly effective, many of the conservative modalities have proven to be at least as effective in providing symptomatic relief as most forms of invasive treatment. Because those modalities do not produce irreversible changes, they present much less risk of being harmful.  Professional treatment should be augmented with a home care program, in which patients are taught about their disorder and how to manage their symptoms.”

We hope this information about temporomandibular disorders will prove to be helpful to you or somebody you care about.

The treatments we use (not all at the same time) include:

• Orthotics (Splints)
• Ultrasound therapy
• Trigger point injections
• Inotophoresis
• Electro acupuncture
• Message therapy
• Spray and stretch
• Supporting medications

Importantly, for individuals who continue to have TMJ problems even after good conservative treatment has been provided for at least several weeks, or if the symptoms are progressively getting worse, further diagnosis and treatment should be sought.  Ask Dr. Markman for a complete diagnosis and treatment plan for your TMJ problems.