Are you suffering from jaw pain, headaches, neck pain, and ear symptoms like pain, ringing in the ears, and dizziness? If so, then you might have a temporomandibular joint disorder (TMJ or sometimes TMD). TMJ is a jaw disorder, but its effects can be far-reaching and variable. So variable, in fact, that it’s common for doctors to misdiagnose TMJ as many things, and people don’t get relief from their symptoms.
If you suffer from symptoms in your head and neck that your doctor hasn’t been able to treat effectively, TMJ treatment might be the answer for you. To learn if it’s right for you, please call (619) 727-6633 or email Strober Dental for an appointment with a San Diego TMJ dentist.
TMJ CAUSES AND EFFECTS
In TMJ, the temporomandibular joints, may become inflamed from bite misalignment, teeth grinding (bruxism), external injury, arthritis, or other causes. The inflammation can set up a chain reaction of strained muscles in the face, neck, and head, sending pain signals through the associated nerves. We’re not always sure exactly which is the cause and which is the effect in TMJ, which is why it can be hard to treat.
The pain can be intense, but Dr. Strober takes a proactive approach to TMJ treatment with neuromuscular dentistry. The goal is to provide as immediate relief as possible, then figure out the cause so relief can be made permanent.
Although about 30% of all Americans will experience TMJ at some point in their lives, most cases are mild and transitory and don’t require professional care. Thousands of patients nationwide suffer from chronic TMD / TMJ, whose symptoms can be disruptive, even disabling. Unfortunately, many people remain unaware that they are afflicted with TMD, as its symptoms are easily and frequently misdiagnosed by doctors.
COMMON SYMPTOMS OF TMD / TMJ
Neuromuscular dentists are specially-trained to test for the presence of TMD in patients. If your jaw joint is misaligned, it can affect the muscles, tendons, and nerves in your neck, back, and shoulders, resulting in a wide range of symptoms throughout your body.
Some of the most common symptoms are:
- Tension headaches and migraines
- Jaw sounds like popping, clicking, or grinding
- Back, neck, and shoulder pain
- Numbness and tingling in fingers
- Itching, stuffiness, or pain in the ears
- Ringing in the ears (Tinnitus)
- Poor posture
- Grinding and clenching of the teeth
- Worn, chipped, or broken teeth
Headaches – The headaches that are caused by TMJ are usually tension headaches: the result of muscle stress in your face and neck. TMJ can also act as migraine trigger.
Jaw pain – Pain at the misaligned joint is very common, as the muscles strain to bring the joint back into alignment and as other tissues are compressed or stretched. Jaw pain can also result from tense, sore muscles, and from pinched nerves.
Popping and clicking of the jaw – When your jaw is properly aligned, a disc of cartilage acts as a cushion for your joints. When joints are misaligned, the disc can be out of place much of the time, only popping or clicking into place occasionally.
Limited jaw movement – Some patients’ bites are so far out of alignment that their jaw joint catches on itself and becomes stuck.
Back, neck, and shoulder pain – The muscles in your jaw, neck, and back all work together. Any tension that is occurring in one muscle will radiate to another, often causing bad posture, which can throw your neck and back out of alignment.
Numbness and/or tingling – Muscle tension can also place pressure on the bundle of nerves that is located between your shoulder and neck. This nerve bundle, called the brachial plexus, controls your arms and hands. Too much pressure on your brachial plexus can cause tingling and numbness in your hand and fingers.
Ear pain – Your ears are complex organs with small, delicate parts. Since your jaw joint and its corresponding muscles are located so close to your ears, misalignment and tension can all too easily cause ear problems, including ringing, pain, stuffiness, and even infections.
Teeth grinding (bruxism) – Your jaw’s tension can cause you to unconsciously grind and clench your teeth at night, which often leads to headaches and tooth damage.
The first step in successful TMJ treatment is a positive diagnosis. TMJ can often be confused with other conditions, and misdiagnosis is responsible for many cases of unsuccessful TMJ treatment. Dr. Strober performs a careful diagnosis.
First, Dr. Strober will listen to your description of your TMJ symptoms. Next, he will perform a thorough exam of your teeth, jaw, head, and neck. This will likely include touching your joints and muscles while asking you to move your jaw joint in certain ways. It may also include imaging of your jaw joint using panoramic x-rays, MRI, or CT scans.
To relax your jaw muscles, we will use TENS (transcutaneous electric nerve stimulation), a kind of electric massage that can relieve tension and allow us to better analyze the state of your jaw system.
We will also analyze your jaw joint system using the scientific K-7 diagnostic system, which includes three detailed instruments that tell us about the state of your jaw joint. Computerized jaw tracking will help us analyze irregularities in the motion of your jaw. Sonography will analyze the sound of your jaw joint so we can determine whether there is any friction or displacement of joint elements. Finally, electromyography will analyze the activity level of your muscles and tell us whether they are working harmoniously together or in conflict. It will also tell us if you jaw can ever find a position of maximum rest, or if it remains in constant tension.
NEUROMUSCULAR DENTISTRY AND TMJ TREATMENT
When it comes to TMJ, minimal interventions are best, so we will start with the most noninvasive TMJ treatment we believe is likely to get good results for you.
For some people, periodic TENS treatments are all that is necessary. The increased blood flow flushes toxins from the area, and in less than an hour, the muscles relax into their natural position.
For some people, though, the jaw can’t find a good relaxed position on its own. Once Dr. Strober can see the natural position of your jaws, he creates a custom orthotic appliance, similar to a sports mouthguard, for you to wear. Depending on the type and severity of your TMJ, you may wear the orthotic while you sleep or sometimes during the day as well. The appliance will hold your jaws in place and keep you from grinding your teeth.
If the orthotic is getting good results, but you want relief from TMJ without the oral appliance, we can talk about permanent TMJ treatments using cosmetic or reconstructive dentistry. If a misaligned bite causes your TMJ dysfunction, Dr. Strober may recommend orthodontics, like Invisalign, to move your teeth into the correct position. If your teeth are worn down and unable to hold your bite in the right place, we can use dental crowns to build up your teeth so they can hold your jaw in the right place.
In rare cases, your jaw joint damage may be so extensive that we may refer you to an oral surgeon for surgery on the jaw joint. We try to prevent the need for surgery by detecting and treating TMJ early.
NEUROMUSCULAR DENTISTS, GNEUROMUSCULAR DENTISTS, AND OTHERS
The most recognized and common background of a TMJ dentist is as a neuromuscular dentist. Neuromuscular dentists look at your mouth as an entire system and focus on the way the different parts of that system work together, or, as the case may be, don’t work together. The name is intended to refer to the role that both nerves and muscles play in the complex system, as well as the reference to teeth in the name dentist.
Gneuromuscular dentists are actually quite similar in their approach. The “G” at the front of their name comes from gnathology, which is the study of the jaw system. It has a slightly different emphasis, but takes a very similar approach to the treatment of TMJ.
Other dentists may treat TMJ but do not necessarily identify with either of these two schools. They may have studied “functional occlusion,” or other disciplines that describe the relationship between the teeth and jaw function.
Dr. Strober has trained as a neuromuscular dentist at LVI and a a gneuromuscular dentist at Occlusal Connections. This cross-training gives him a comprehensive perspective on the complex, multifactorial condition.
HOW TO CHOOSE A TMJ DENTIST IN SAN DIEGO
If you are looking for a TMJ dentist in San Diego, a great place to start is with referrals. Many people with TMJ problems are already working with medical professionals related to their symptoms. If you are working with a doctor, chiropractor, physical therapist, or a specialist such as a neurologist, talk to them about what dentists they might recommend for TMJ. You can also talk to your general dentist to see if he knows any dentists that he might recommend.
Talk to friends and family that may have seen a TMJ dentist for chronic pain. They may recommend their dentist.
Take your recommendations and referrals online. Research all the dentists you have heard mentioned and compare them to other dentists in the area. Read dentists’ websites about the treatments they provide, read about their training background and treatment history, and look for testimonials on the website.
Read online reviews of the dentists. Actually reading the reviews is more important than just looking at the star rating. You want to know if someone is praising or criticizing a dentist for things that matter to you or if they are irrelevant.
Schedule appointments with three dentists. Talk to them about your symptoms and ask for treatment recommendations. Also ask them about their training. This is very important. A TMJ dentist isn’t like an orthodontist or other specialist whose license is a guarantee of certain training. TMJ dentists vary widely in their training and experience, so the personal narrative of a dentist’s experience is vital in finding the right TMJ dentist for you. Always make sure to check their credentials to make sure they match what they tell you or put on their website.
Once you have interviewed several dentists, select the one that makes you feel most confident about their training, experience, and ability to treat your TMJ.
Dr. Rod Strober is a highly experienced TMJ dentist who has trained at the Las Vegas Institute for Advanced Dental Studies, the most highly recognized and recommended training center for neuromuscular dentistry in the world.
To learn whether Dr. Strober is the right TMJ dentist for you, please call 619-727-6633 or email Strober Dentaltoday for an appointment at our office in San Diego and learn more about TMJ Treatment.