TMJD

Temporomandibular joint dysfunction (TMD, TMJD) is conventionally described as an umbrella term covering pain and dysfunction of the muscles of mastication (the muscles that move the jaw) and the temporomandibular joints (the joints which connect the mandible to the skull).

This however is a confusing term. The muscles do not dysfunction but are hyperactive. The joint itself has ended up in a more confined space than it should and hence cannot function correctly and starts getting damaged including the disc. The muscles attached to the joint also become hyperactive and sore from constantly being stimulated to correct the situation which the jaw is unable to do because of occlusal irregularities.

Our foreface, the maxilla and the mandible, can be considered as a balancing chunk of material to precisely balance the head over the neck so that the neck vertebrae can function correctly. If there is any deficiency due to tooth loss or lack of proper forward development of the jaws the weight bearing of the head changes. It must tip forward or compensatory changes must be made in the neck. This starts propagating pain in the neck and shoulder muscles and onto the rest of the body often causing multiple symptoms as shown in the graph below.

JAw sleep graph
Trying to treat the TMJ is a futile exercise. The dental and all other asymmetries must be dealt with as extensively explained in this website.

When patients seek treatment, they mention jaw pain, often they do not say anything about the teeth. They will mention neck pain, fatigue and sleeping difficulties etc but hardly ever teeth. Often the teeth are gleaming Class I relationship but the jaw joint is not happy. The only treatment we can provide safely has to be focussed on the teeth and nowhere else ensuring that we are giving the jaw joint more room to operate.

Providing splints initially gives more room for the jaw joint area but soon the splint ends up depressing the teeth deeper into the bone and when not wearing the splint the jaw joint has even less room than when the patient started the treatment. Keeping adding more acrylic to the biting surface starts causing huge open bites in the posterior region hence this concept is dangerous It is obvious to see that the TMJ is not causing the problem but the quality, position of the dentition and jaws.
So, trying to treat the jaw is a futile exercise. The asymmetries must be dealt with as extensively explained in this website.

Here are some reports from the expeiences of some other patients:

"I have been visiting NHS maxillofacial surgeons for 2.5 years and none of them could help me or give me the correct treatment even after they confirmed it was TMJ dysfunction. The first thing they did was to give me a hard splint to wear. After one year in pain and no positive results from splint, they washed my jaw joints surgically! That did not work either.
Moreover, they got me to remove my wisdom teeth. I did that but that did not help at all. My pain got worse and out of control and at the end they gave me many different kinds of painkillers and antidepressants and said if that won't help they do not have any more treatment for me."
N.D.

"The chiropractor said essentially it was my jaw and I should look into some form of dental help. He advised someone I did not like and I decided to get a referral from my GP to see an NHS consultant. A maxillofacial specialist however told me there was nothing wrong with my jaw/TMJD and I should eat mushy food and do less exercise. It is hard to express how frustrated and upset I felt." S.P.

"Before coming to Dr Amir I was referred to an NHS dental hospital and medicated with amitriptyline which made it difficult to even function at work and nothing was offered to address the cause of my problems. I struggled with debilitating jaw and facial pain which left me exhausted at the end of each day and also suffered with neck and shoulder pain, poor concentration, blurred vision and balance problems" W.T.

"Due to having 4 wisdom teeth removed back in 1998 my health suffered.I developed frozen shoulder,numbness,dizziness and felt awful.Many dentist treated me with splints which just made my symptoms worse.When I arrived at Dr Amir's my teeth no longer even fitted together!I was in a desperate state,severely dizzy and very frightened" M.G.

"For 10 years I had headaches, migraines, tinnitus and a weird undiagnosed but debilitating " face pain" which I was told by the nhs and private specialist was a range of things from a type of migraine, sinus infections (with sinus surgery!) and "just one of those things" D.L.

"I was referred to a maxillofacial department of a hospital, where I was prescribed with amitriptyline. The dugs helped only by dulling the pain, but came with lots of unwanted side effects." A.W.

Experience over some 30 years of practice and seeing very many patients suffering from all kinds of illnesses it is my calculated conclusion that a majority of illnesses like ME/CFS, MS, FM have a lot to do with jaw asymmetries rather than any other cause.. Please read all the information on this website.

A majority of patients coming for treatment have previously been diagnosed into many illnesses and syndromes.

A TMJ and a dento-mandibular symmetry check up at the outset of any illness is imperative for an optimal outcome and before your problem becomes chronic.

TMJ pain and tooth grinding occur because the patients’ jaw does not sit happily in the joint which articulates with the skull. It is the consequence of a physical asymmetry in the jaws and teeth and the mismatch of the upper and lower jaw relationships. It is neither caused by “stress” nor is it due to some other “mental” cause.

In fact, experience shows that most pains, organic disturbances and mental symptoms are a consequence of this asymmetry.

The diagnosis of a jaw problem is generally based on the presence of some characteristic clinical signs and symptoms:

  • Clicking of the joints. Often no clicking is discernible. There are electronic devices available which can accurately depict any jaw joint disturbances.
  • Deviation upon opening and closing the mouth. Here again, often no deviation is seen.
  • Limitation in opening the mouth and again often it is not apparent.
  • Tooth clenching or grinding during sleep. Many patients show wear on their lower incisors but are totally unaware of any tooth grinding.

In many patients the problem is present without the patient realising that there is any problem with the joint. It can however, be ascertained by the presence of many other factors:

Pain on the palpation of certain muscles: alsteral Pterygoid muscle

  • The lateral pterygoid muscle: This muscle can be palpated using your index finger and running it inside your mouth along the upper molar teeth deep upwards and backwards. Usually one side will be found to be much more painful than the other.
  • The sternomastoid muscle: This muscle is painful at its insertion point under the mastoid process just behind the ear. Again one side will be more painful than the other.
  • The trapezius and other suboccipital muscles:
  • Often a patient will complain of shoulder or arm pain and these muscle will be found to be very stiff and painful especially at the base of the skull and over the shoulder. Other muscles like the Masseter are often puffed out giving the patient a very square or a moon face appearance.

Trigeminal

The Trigeminal nerve: The simplest way to look at the ramifications of an asymmetry around the jaw joints is to consider the trigeminal nerve which is the main nerve around the teeth and jaws and supplies 60% of the afferent input to the brain and upon this afferentation the output of our brain is determined. Imagine all the signals going to the brain saying that something is wrong with the mouth, teeth and jaws.

Tooth grinding is often the consequence - not the cause of TMJ dysfunction.

The ramifications of jaw asymmetry spiral down the body affecting organ function and skeletal function with pain and symptoms arising anywhere and everywhere.

These are mostly resolvable illnesses as long as one concentrates on the correction of the Jaw and body asymmetries.

Illnesses resulting from Jaw asymmmetries are not "Overlapping Conditions" as often described in the literature.

These supposed co-morbid conditions are a consequence of jaw asymmetry.

These signs and symptoms including the absence of patient discernible symptoms are a key to realising that the Temporomandibular asymmetry is behind the ailment of the patient. The symptoms, as you study this Web site, could be as remote as pain in a foot and yet the jaw and the Atlas are usually at the centre of the origin of these remote symptoms.

To find out how your jaw asymmetries may be causing your symptoms please:

  • Call us for an appointment.
  • Register to complete our copyrighted online Questionnaire. (Cost £29.00) Learn more