Most patients cite headaches as their principal reason for seeking help with a
potential TMJ problem. They are the most frequently reported side effect. Tension
headaches are the most common type of headache - the TMJ headache is a tension type
of headache. It is often described as a migraine headache. In some cases, people
report having a headache at a recurring time on a near daily basis - in the morning,
afternoon or evening.
Tension headaches attributed to TMJ are due to constant contraction of
muscle fibers within a muscle, which creates tension, pressure or a tight feeling
in the face and head. This constant contraction prevents or reduces blood flow to the
muscle fibers and surrounding area. In response to this deprivation, the body sends
more blood to the area(s), which can result in an increase in general blood pressure to
the muscles and head. Headaches due to increases in blood pressure in this scenario are
sometimes referred to as vascular headaches. Clenching and grinding the teeth,
also symptoms of TMJ, produce pain (headaches) from the muscles in the head.
Unfortunately, these TMJ headaches can be so frequent or severe that they are
frequently misdiagnosed and treated as migraine headaches.
The pain from muscle headaches (TMJ) can be blocked with medications, or nerves cut
with brain surgery or muscles somewhat relaxed with muscle and psychological
therapy, but the cause of the disease and damage from the bad bite, malocclusion,
will persist. Side effects from medications, complications from brain surgery, and
limited results with muscle or psychological therapy do not correct the source of
the problem. The practice of TMJ treatment that Dr. Miller practices is referred to
as neuromuscular dentistry. It ensures that muscles are happy because the muscles do
not have to work hard at positioning the teeth to a strained bite any longer.
By putting the temporomandibular joint back into alignment and placing the jaw
into its optimal position, neuromuscular dentistry alleviates most headache
problems related to TMJ, muscle, nerve and joint disorders.
A "bad bite" (malocclusion) causes an imbalance in the jaw-to-skull relationship,
which in turn twists the jaw into a strained position that refers pain to the
muscles in the neck, shoulders, and back.
Muscles work as a team. Seldom does a single muscle work without other muscles in
the team joining in. The bones in the neck, especially the atlas and axis, are
intimately involved with the muscles of chewing, biting, talking, breathing, and
head posture. Sore, tight, contracted muscles of the jaw will tilt the head and
shoulders causing compensation from neck, shoulder and back muscles. Although
neuromuscular dentists like Dr. Miller do not claim to treat neck, back, shoulder, or
arm pain, patients are pleased how frequently these problems can be relieved.
It is vital to understand that the bones, joints, muscles, and nerves in the
face and neck have a complex relationship. They work in concert to correct the bite,
and strain radiates to these other areas. With this knowledge, Dr. Miller can work
to relieve strain on the jaw and the surrounding muscles. Once the bite has been
aligned, pain in the neck, shoulder, back or other areas of the body resulting from
the malocclusion disappear.
Because TMJ is a dysfunction of the jaw joint, jaw pain is a very common symptom. A "bad bite" in which
your upper and lower teeth do not come together in proper alignment also disrupts the placement of the jaw
and the surrounding muscles. This imbalance in the bite-jaw-muscle relationship is what causes the pain
in the jaw. Pressure and forces on the teeth can cause bone to dissolve or extra boney projections to be
built up. Jaw pain can also result from movement or tearing of the cartilage disc that cushions the
jaw joint.
Oddly, not everyone suffering from TMJ disorder complains of jaw pain. This contributes greatly to the
confusion surrounding TMJ. But once the relationship between the muscles, joints and bones are understood -
how the body will favor attempting to correct a bad bite to other system's detriment - then understanding
how pain and discomfort is radiated or distributed to other areas is now logical. If the jaw's strained
position puts the jaw joint in an awkward position for a sustained period of time, then TMJ sufferers will
experience jaw pain directly.
Neuromuscular dentists relieve jaw pain related to TMJ by going to the source of the
problem - the "bad bite" and misaligned jaw. In most cases, correction of the bite
can be accomplished without the use of surgery, and patients report long-lasting pain relief.
When a patient's bite is not properly aligned, TMJ (temporomandibular joint)
dysfunctions and a number of related symptoms can arise. One of these symptoms is
facial pain.
The jaw area of the face is a complex network of bones, joints, muscles, and
nerves. When the jaw becomes misaligned, the surrounding bones, muscles, and nerves
are also affected. This includes the muscles of the face, which experience strain or
spasm because the muscles are working extra hard to compensate for the unstable bite.
A neuromuscular dentist can help facial pain problems by working with the source
of the problem, the bite. Your neuromuscular dentist will stabilize and realign your
bite so that the teeth, muscles, and joints all work together without strain.
Ringing in the ears, or tinnitus, is another symptom of TMJ that is commonly
misdiagnosed and often goes untreated or is treated ineffectively or invasively.
In many cases, ringing in the ears is one of the results of having a strained
bite in which the jaw is not aligned. The jaw area of the face is a complex
network of muscles and nerves, and when the bite is misaligned muscles and
nerves throughout the head, including the ears, can be affected.
If you are experiencing tinnitus, the first step is always a thorough diagnosis.
This first step allows you to eliminate or determine if a misaligned bite is the cause
of the ringing, and save time and money handling misdiagnosis and/or ineffective or
invasive procedures used to correct the problem.
If the cause of your tinnitus is determined to be due to an unstable or
misaligned bite, Dr. Miller can work with the source of the problem by stabilizing
and realigning the bite to eliminate the ringing. Aligning the bite starts by using
a non-invasive orthotic, which is worn and slightly modified to ensure that ringing
and pain are eliminated before any more permanent solution is attempted or proposed.
The nerves and muscles in the jaw area of the face are very complex, so when your bite is off,
these nerves and muscles are also affected. A misaligned bite can cause the muscles throughout the jaw,
face, neck and shoulders to go into spasm. When these muscles (scalenes) are in spasm they can pinch the
nerves leading down the arms (the brachial plexis) and into the hands, which in turn results in
feelings of numbness or tingling.
TMJ dentists like Dr. Miller can help you with numbness or tingling in your hands or arms by helping to
determine if your bite is the source of the problem. If it turns out to be the source, then having your
bite corrected to its proper alignment will effectively relieve these symptoms. With your bite aligned,
the muscles affected by the jaw joint will be able to go back to their normal function and position,
relieving the spasm and the subsequent numbness and tingling felt as a result.
Clicking, popping, or snapping in the jaw joint is the most common symptom of TMJ.
There may or may not be pain in the jaw when the clicking or popping sound is heard.
The clicking sound may even be so loud that others can hear it when you chew or
speak.
Usually the cause of the popping jaw is a displaced disc in the jaw. The jaw joints are "ball and
socket" joints, similar to the shoulder joint. When ball and socket joints are functioning properly, the
ball and socket do not touch. A thin disc made of cartilage separates the ball from direct contact with
its socket. This disc of cartilage is, in turn, held in place and guided by a muscle.
If your bite is misaligned or trauma tears the surrounding muscle tissues, the jaw joint is pulled
out of alignment, and the disc pulled forward or even torn. Now that the cartilage disc is not serving as
a cushion between the ball and socket, these bones subsequently rub against one another and press on nerves,
causing clicking or popping sounds in the jaw joint, sometimes accompanied by pain in the jaw, joint
or teeth. The muscles holding the disc in place are now strained as well, potentially leading to additional
pain in the jaw and face, in turn radiating to other areas: the head, neck, back and shoulders.
Neuromuscular Dentistry, Dr. Miller's approach to TMJ treatment, works to realign the bite, which
realigns the displaced disc. Once the jaw is back in alignment and the cartilage disc returned to its
original, natural position, the clicking and popping sounds in the jaw stop and the muscles holding the
disc in place can relax, alleviating the jaw, face, head, neck, back, and shoulder pain that resulted.
Severe cases of TMJ can partially or totally immobilize the jaw. Muscles in the jaw constantly straining
to bring a "bad bite" into an alternative position, given enough time, can seize. This can last for
varying periods of time - from several moments to several minutes to permanent. Most frequently, limited
jaw mobility is reported as being permanent, and in certain cases, patients continue in this debilitated state
without seeking help.
Variations include cases where movement of the jaw outside of a limited range is possible, but results
in pain or discomfort. Any limitation of jaw mobility or locking is not considered normal. Men and women with this serious condition, even
if only experienced on a temporary basis, should immediately
contact Dr. Miller or another qualified TMJ dentist to receive an accurate diagnosis - your initial
consultation is always complimentary with us. This is a condition where patients are advised
not to simply 'wait and see'.
Tooth pain and sensitivity are common symptoms of TMJ disorder. If the teeth
are the cause of TMJ then any or all of the teeth may be sore. The teeth may also
become sensitive because of clenching or grinding the teeth, a common action in many
people, particularly when the disc of the TMJ is displaced.
Unfortunately, when seeking relief from this tooth pain, many patients are
misdiagnosed and may even go as far as having the nerve from the tooth removed with
a root canal or even having the tooth extracted. The worst part is that these
measures may not relieve the pain, and can actually make it worse! Not to mention
that there is no better substitute for your natural tooth - losing a tooth should
always be the last solution proposed when no other option is left available.
TMJ dentists like Dr. Miller relieve sensitive and sore teeth related to TMJ
by going to the source of the problem - the "bad bite" and misaligned jaw. In
most cases, correction of the bite can be accomplished without the use of surgery,
and patients report long-lasting pain relief.
Because the body will attempt to accommodate the "bad bite" or malocclusion in a number of ways,
sometimes the constant act of the bite coming together at an incorrect angle, over time, can lead to
a vast array of seemingly unrelated symptoms, including worn, cracking or chipped teeth or restorations
or even teeth becoming loose. If you have any of these symptoms, it is strongly advised to visit a
qualified TMJ dentist like Dr. Miller to ascertain or rule out malocclusion as a possible cause.
Unfortunately, many people are misdiagnosed and either have teeth replaced or, worse, removed, only to
find that the same or surrounding teeth or restorations start to have similar or recurring problems.
Tooth loss always has an underlying cause - it is never an isolated event (except in the case of
trauma). Without understanding and correcting the actual underlying cause of tooth loss, it is very
likely that other teeth (or the replaced teeth's restorations) will follow the same destiny. Getting an
accurate and thorough diagnosis of the TMJ is the first step to understanding the root causes of tooth loss -
thereby reducing the amount of dentistry patients will experience over their lifetime, while increasing
overall dental health and keeping more of their natural teeth.
If you have tooth loss that you don't understand how to prevent future loss, or are looking at
more restorative work, be sure to have a qualified TMJ dentist like Dr. Miller give you a thorough
diagnosis to be sure that malocclusion is not the cause of the issue. Restoring a mouth without
first correcting malocclusion can make things worse! Including the onset of other TMJ symptoms not
previously reported.
While not a physical symptom, the majority of people suffering from TMJ may also suffer from depression,
usually as a result of their condition being misdiagnosed or dismissed as having no physical cause. Having
pain dismissed by an authority figure (such as a physician, psychologist, or dentist) creates
a dichotomy between a patient's perceived and expressed reality - the definition of mental illness - and a
cause of depression. This lack of effective communication is one that Dr. Miller has worked hard to
overcome in his practice and 'bedside manner'.
Patients of our practice are always listened to and their concerns fully addressed prior to
any treatment being presented or engaged - this is a basic tenet of comprehensive, quality
dental care delivered in a respectful, professional and ethical manner.
One condition that nearly all TMJ patients seeking help can claim is pain. Scientific evidence has
shown that patients with chronic pain experience chemical changes in the brain. These chemical
changes can lead to depression.
Because TMJ is a multifaceted disorder, some patients need to work with more than one specialist to
return to optimal health. Such patients might work with Dr. Miller as well as a psychological
counselor, chiropractor or physician. However, other patients experience complete pain
relief solely from the treatment Dr. Miller provides and the peace of mind that comes
from having their condition diagnosed and treated. Speak with your neuromuscular dentist about your
personal needs.
C. Edward Miller, DDS
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