The TMJ is a very sensitive system of bones, muscles, nerves and tendons that must function in unison. The joint bones move with a complex concert of muscles and tendons. Disturbances in this highly sensitive system can result in debilitating pain. TMJ pain symptoms can include headaches, clicking, ringing in the ears, neck pain, shoulder pain and tooth pain. TMJ treatments range from specially designed night guards to dental restorations, orthodontics or surgery in certain cases. A rebalancing the TMJ complex can result in alleviation of pain and a return to normal function.
About TMJ: What Is It?
Curious about TMJ? TMJ is the general term used in reference to jaw and or facial pain. It can also be referred to as TMD or Tempromandibular Dysfunction. This is pain that arises due to dysfunction in the Tempromandibular joint. This pain is usually associated with a causative reason; trauma, misbalanced occlusion, crowded teeth, orthodontic treatment, a misplaced dental restoration, tooth grinding, arthritic or rheumatic changes.
The TMJ is a very sensitive system of bones, muscles, nerves and tendons that must function in “neuromuscular harmony”. If one of the components of this system is disturbed it may elevate the normal pain thresholds and reduce pain tolerance. Onset of pain can have a clear connection with the causative event or may have a subtle combination of multiple dysfunctions. Underlying causes may exist for years without pain. After the onset of pain it may require precise correction of the resting position of the jaw. The level of correction may have to exceed the harmony which was tolerated prior in order to bring healing to the TMJ and curing pain.
The correction of TMJ conditions vary, and require diagnostics which involve muscle relaxation and measurements of proper jaw function.
When TMJ is treated or rather corrected the system returns to a pain free state. This means when the joint is in a harmonious and balanced position the triggers causing pain diminish (unless there is another cause of the pain).
Diagnostic methods begin with relaxation of the muscles with electrical stimulus. This is called TENS (trans epithelial nerve stimulation).This allows the bones to rotate without “outside” interference. When the joint is controlled with an objective method it removes the ability of the muscles to influence improper motions. It allows the dentist to find the root source of pain.
Each patient’s joint is different and the same TMJ treatment may produce different and varying depth of effects. There are various forms and combinations of treatments; each has its own focus of healing.
The most common issues of clenching, grinding tooth and jaw discrepancies fall into less complex treatments and may include a TMJ night guard (mouthguard) or splint therapy, restorations, orthodontic tooth movements, medications or even botox injections.
Less common issues may or may not require further intervention. Trauma may require medication, relaxation, support or surgery. Capsule or ligament damages due to trauma may require surgery if medications and other methods fail. Arthritis type changes may require anti-inflammatory medications. Severe jaw and tooth discrepancies may require jaw surgery.
Treatment may involve stages (just as a broken bone would need to be set then heal and finally return to use). Below is a photograph of our initial phase of treatment. It is called TENS. TENS or Trans Epithelial Nerve Stimulation is a small electrical current that triggers regular movements of the muscles involved in TMJ. With those regular movements bring blood flow and oxygen. They bring relaxation. With a relaxed system we can find the “correct” position of your TMJ. We can find the harmonious position of the joint, the muscles and the teeth.
Below you will notice someone who has spent time on the TENS unit. They have a blue “bite registration” that was created with a K7 Jaw tracking system. Once we understand the relaxed and repeatable position of your jaw a stable bite can be established. With stability comes healing and alleviation of pain. This photograph is a patient who had severe pain on biting. His pain was constant and after seeking many doctors and physicians found a Neuromuscular dentist.
We found that his pain was rooted in teeth that would hit harder on one side of the mouth. The twisting of the jaw that followed caused pain in the left side of his face and head. At times this would trigger migranes. Medicines would not help. If we can view it another way, it was as if his hips were hurting because his shoes were not the same height.The mis-balance was causing muscle pain and real pain at that. After establishing this proper dimention, a temporary splint was made for him to wear 24 hours and 7 days a week.
He would take this splint out only to clean it and his teeth. In just a few days his pain was gone. After months of wearing this splint he and we were ready to make these changes permanent. He wanted us to not only correct the shorter left side but to repair all his damaged and worn teeth. As you can see his results were quite esthetic and have been pain free from the day we have cemented them until this moment.
TMJ Symptoms: Do You Have It?
When a TMJ disfunction exists symptoms may radiate in any direction from the TMJ itself. These include the surrounding bony and muscular structures.
TMJ symptoms may include:
- Headaches / migraines (visual disturbances)
- Muscle tension and pain on single or both sides of face
- Clicking or popping of the jaw
- Deviation of the jaw on opening
- Ringing in the ears / hearing loss
- Neck pain (throat / swallowing)
- Shoulder pain
- Difficulty opening or closing the jaw
- Tooth pain / tooth damage (sensitive or loose tooth)
New York TMJ Specialist: Dentist Fred Stange
Dr. Frederick Stange, DDS, FICOI, ICCMO received his Doctor of Dental Surgery from Stony Brook School of Dental Medicine in 2002.
At graduation he was presented with numerous awards including those in Oral Medicine and Cosmetic Dentistry. He was accepted into Stony Brook’s first two year residency AEGD/PhD program (Advanced Education in General Dentistry). Here he worked with advanced cases involving reconstructions and dental implants. For 3 years he lectured as an associate professor and clinical instructor of Oral Biology, Operative Dentistry and Dental Anatomy.
Dr. Stange trained additionally for an entire year in placement of Dental Implants and advanced bone grafting. He thus earned and maintains a prestigious Fellowship with the ICOI (International Congress of Oral Implantologists.
Dr. Stange has specialized training in TMJ disorders. He is a member of ICCMO (The International College of Cranio-Mandibular Orthopedics) this college is an international dental organization devoted to the science of neuromuscular occlusion and application of objective electronic measurement for the treatment of dental malocclusions, temporomandibular disorders, and skeletal misalignment.
- TMJ Training completed with B. Cooper DDS
- Member ICCMO (The International College of Cranio-Mandibular Orthopedics)
- Neuromuscular Dentistry training based Seattle Washington
Dr. Stange is also a restorative dentist as well as a TMJ specialist. This allows him to diagnose and fabricate the appropriate corrective appliances / restorations to aid in correction and improvement of TMJ symptoms.
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