Understanding TMJ Problems

Our dental education placed the emphasis on joint position when it comes to occlusion (bite). Let's look at it this way. Think of a door that doesn't quite shut right, where the door runs into the jamb. How do you shut the door to keep the cold air out? Common answers include "slam it," or "lift the door and then shove it closed," or something similar. Ok, but what happens to the door and the jamb if that procedure is employed over and over again, hundreds, maybe thousands of times? Would the wood or paint be damaged? What about the hinges; how long would they last at this rate? Unless the underlying cause is addressed, the problem will just keep cropping up, no matter how many cosmetic or temporary repairs are done.

Why are we discussing home repair? Well, the way a door swings freely before running into the jamb is similar to the neuromuscular trajectory (path of closure) of the mandible. The wear in the door (the teeth bumping together, chipping or grinding) is something we commonly see in our own mouths. Correcting your bite is like aligning your door and jamb so they fit together smoothly, without straining the hinges.

All TMJ disorders are a complete or partial result of a bad bite (malocclusion).

Though the door analogy is a good illustration of TMJ issues, in reality, your mouth is a much more complex entity. Muscles and nerves are interconnected and interdependent on a larger scale than a door and its frame and hinges. Your mandible is controlled by the muscles of mastication (chewing), which includes neck muscles. Nerves send commands to the muscles and they also sense the muscles' position and strain. This is why many people suffering from TMJ problems have symptoms like headaches, neck aches, tingling down the arms, ear pain, tinnitus, pain referred to their teeth, and the list goes on. Ninety percent (that's right, 90%!) of ALL pain is muscular in origin.

One way to reduce the tension on those hinges is to prop up the door and just prevent it from closing. This approach is similar to a bite guard or an NTI device than many dentists use. But doors are meant to close, and teeth need to fit together so you can chew. The most effective way to relieve TMJ symptoms is by correcting the bite. Dr. Satchwell accomplishes this by prescribing a custom 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.

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