Headache/TMJ Therapy

"If you can't measure it, then it's just an opinion."
~Dr. Robert Jankelson

People who suffer from migraines, chronic earaches, or any of the symptoms listed below may have temporomandibular joint dysfunction, called TMJ or TMD. This condition occurs when the jaw joints are improperly aligned. Stress on the joint, muscles, and nerves leads to a host of nagging, sometimes debilitating, symptoms.

• Headaches and Migraines
• Undiagnosed Head, Facial or Neck Pain
• Tingling Fingers
• Stuffy or Ringing Ears
• Shoulder Pain
• Tooth Wear and Bone Loss
• Arm, Hand, or Shoulder Weakness
• Poor Posture
• Hormone Imbalance
• Disturbed Vision
• Difficulty Swallowing

Dr. Davis is the only dentist in the area who works with a team of neurologists, A/O chiropractors, and physical therapists, which has given him a 95% of TMJ/TMD cases successfully and non-surgically. In most cases, medical insurance benefits will apply to TMJ/TMD therapy.

What is a typical “TMJ”?

It is common for a patient to come to our office who has had various pain or dysfunction symptoms for years. Often, the patient has spent time and money unsuccessfully pursuing alternate therapies. At times, it is because the patient had been told that she does not have “TMJ” since it is not “typical”. 

So it begs the question what is a “typical TMJ”? 

What were we taught in dental school? 

1. Clicking joints are fairly common and do not need any intervention.
2. “TMJ” is self limiting and “settles” down with time.
3. “TMJ” is primarily a “psycho social disorder” that is stress-induced.
4. Pain or discomfort in the TM joints or the joints locking open or closed constituted typical “TMJ” symptoms. 

The conservative therapy would be occlusal splints or bite guards along with soft diet and perhaps some muscle relaxing medications. That would help many patients to get some symptom relief. If that does not help, then the next step is referral to a maxillo-facial surgeon for joint or jaw surgery.

If we look at this as a “joint” problem, then when joint symptoms (such as pain or strain in the TM Joints, clicking, popping or grinding of the TM joints) appear, it is “typical TMJ”. Our dental education placed the emphasis on joint position when it comes to occlusion (bite). 

Let me use an analogy to illustrate another way to look at this:
I am sure you can think of a door that does not quite shut right, where the door runs into the door jamb first? How do you shut the door to keep the cold air out? Some would answer, “slam it”, or “lift the door and push it” or some other answer. If that is done thousands of times, what would happen to the door and jamb where they meet first? Would there be damage to the paint or wood at this place? 

What would happen to the hinges over time? Would there be some strain at the hinges? They may creak, wear out or fall apart. If that happens, would the solution be to just put a new hinge in? If so, how long would it last, before the new hinges wear out as well? Unless the underlying cause of the problem is addressed, it may not last.

The way the door swings freely before running into the jamb is analogous to the neuromuscular trajectory (path of closure) of the mandible. The wear in the door (the teeth bumping together and chipping or grinding) is something all of us commonly see. Correcting the door and jamb so they align readily without straining the hinges, is analogous to a Neuromuscular bite correction. 

What are missing in this analogy are muscles and nerves. The mandible (lower jaw) is much more complex than a hinged door. It is controlled by the muscles of mastication (chewing) which includes neck muscles. 

Nerves send the commands to the muscles and also sense their position or strain. This could result in a number of symptoms including headaches, neck aches, tingling down the arms, ear pain, ear congestion, tinnitus, pain referred to teeth etc. 90% of ALL pain is muscular in origin. But it still may not be “typical TMJ”.

One way to reduce the tension on the hinges is to put a door prop and not allow the door to close. This is similar to a bite guard or an NTI device than many dentists use. But doors are meant to close and teeth need to occlude - fit together - for chewing function. 

As with the door analogy, all TMJ disorders are a complete or partial result of a bad bite (malocclusion). Just as the bending of the hinges and chipping of the door jamb is a result of the door not closing properly, the most effective way to relieve TMJ symptoms is by correcting the bite. This is accomplished by the patient wearing a Neuromuscular orthotic. As opposed to most night guards or splints, Neuromuscular orthotics are created using specialized equipment and imaging to ensure that the joint, jaw, and muscle position will be the best for the patient. 

After a few months, once the joint has healed, posture corrected, and pain and headaches are alleviated, the patient can opt for a permanent bite correction by permanently restoring their new bite with porcelain restorations, or braces. In rare cases, mild adjustments to the chewing surfaces of the natural teeth are all that is needed to permanently correct the bite.   

It is, of course, the patient that chooses whether to correct the jaw alignment or just lessen the strain on the masticatory system, or take medications to mask the symptoms or do nothing at all. 

I feel as long as I have educated the patient about the consequences of each option including ‘doing nothing’, I can absolutely support any of the informed choices they make. Ultimately the decision is theirs.
~Dr. Prabu Raman - author of "What is a Typical TMJ?"

Neuromuscular dentistry is the philosophy that the entire oral system must function in harmony for optimal oral health. With K7 and a TENS unit, Dr. Davis can find the optimal position for your jaw. To realign the jaw joints and bite (occlusion) and provide relief from TMJ symptoms, Dr. Davis may use orthodontic therapy (braces), an oral splint, or he may build up back teeth with restorations. In some cases, we may advise you on stress-relieving exercises and habit changes, as well.

Call to reserve your TMJ and neuromuscular dentistry consultation with Dr. Davis. Our Pocatello dental office serves patients from surrounding communities, including Sun Valley, Pocatello, Boise, and Elko Nevada area, as well as those from out of town.

The following patients shown below not only look beautiful, but have had their TMJ symptoms and disease restored. Therefore, what appears to be a cosmetic make-over, is in reality the body’s ability to heal itself and give a much more pleasant appearance when things are healthy and in their natural order. Granted, these patients chose to have their teeth permanently restored to a correct color and shape due to years of TMJ problems causing tooth destruction. However, the facial balance, relaxed correct muscle tone, and a symptom-free healthy and happy facial profile are evident in these before and after photos. We see a fundamental law repeated in nature: “Form Follows Function,” and if something “IS” good then it "LOOKS" good.

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