TMJ Disorder and Chronic Pain
by R.L. Bubenzer, D.D.S., F.A.G.D. Greenfield, Indiana

TMJ disorders and their associated pain consequences are being recognized more and more by the prevention-oriented health care providers. These disorders are fre­ quently discussed in popular magazines and in health columns of daily newspapers.

TMJ stands for Iemporo Mandibular J.oint which is the jaw joint in front of the ear. If you, or someone you know, are suf­fering from the following symptoms in various combinations and intensities such as:

frequent headaches

in the temples, behind the eyes
in the back of the head,
and "like a band around the head",

migraine headaches;
sinus headaches;
popping jaw joints when eating and/or yawning;
stiff neck and shoulders;
tingly fingers; low back pain;
frequent dizzy spells; light-headedness;

then you might have consulted your family physician, and through him the otologist (ear-specialist), radiologist, neurologist and psychiatrist, usually in that order. When, after many tests, nothing was found (and when after attempted drug therapy your pain really did not go away), it might have been suggested that you "learn to live with your pain" or that you would do well to take tranquilizers regularly.

Some well-informed health care provider may also have suggested that the pain might be related to a "bad bite" and may have suggested that you see your dentist. However, not every general dentist recognizes and treats TMJ dysfunction. On­ly specially-trained and qualified dentists can help you with your TMJ-related pro­blems.

To test whether your TMJ's are function­ing properly or are showing signs of dysfunction, place your index finger tip in front of your ear onto the side of the "knob" (condyle) in each joint and then open and close your mouth. If it hurts - or pops or creaks in the joints - they are not function­ing properly. The same is true if these symptoms appear when you place the little fingers into the ear canals, (pad of the fingertip forward, nails to the back, elbows up and out), pressing forward while open­ing and closing the mouth. This self-test for TMJ disorders may give you new insight as to the cause of your chronic pain.

There is hope for relief.

What causes TMJ dysfunction?

We are all exposed to stresses in our environment.

Let us call these external stresses. A typical reaction to these stresses is muscle contraction: tight shoulders and neck, bail­ed fists, and clenched jaws. If the jaws are habitually clenched, due to a lot of stress, anxiety, and/or frustrations, and if the teeth do not support the jaws properly, then the jaw joints become jammed and overclosed, causing damage to the joints. This may oc­cur with totally natural teeth, (even in teenagers), with partially natural plus some false teeth; with full dentures.

External jaw muscles

Usually the disc in the joint is pushed forward, the back ligament of the disc becomes stretched and inflamed, and the knobs (condyles) in the joint make the displaced disc pop or crunch when the jaw is opened and closed. After many years of this, there may be arthritic changes in the joint, a one-way degenerative process. This damage to the TMJs, and the associated muscle spasm, causes pain, not only in the joints themselves, but through muscle spasms in other parts of the body, resulting in many of the symp­toms listed above. The pain syndromes then cause, in addition to the external stress, internal stress which further saps the body and spirit of energy.

If the suffering patient could permanent­ly relax and not clench his/her jaws, the symptoms related to TMJ dysfunction would disappear.

The Real Answer, however, is to find that position of the lower jaw, using the Myomonitor, or other suitable procedures, where all jaw muscles can clench and con­tract in balanced harmony without jamm­ing, overloading and damaging the jaw joints, and pressing adversely on bones of the skull.

A specially-trained and experienced dentist can help to diagnose and measure the muscle spasm and joint damage. He can begin the treatment of TMJ disorder by repositioning the lower jaw with a carefully­fitted plastic bite splint to allow the damaged joints to heal.

Improper nutrition, as well as excessive consumption of "junk food", and lack of adequate vitamins and minerals can cause considerable additional internal stress and thus contribute to TMJ disorders. A nutri­tional analysis to establish the individual's nutritional profiles and needs goes a long way toward relieving stress of TMJ origin.

Only after orthopedic repositioning of the lower jaw and relieving over-loaded jaw joints, and after eliminating stressful eating habits, should we consider Biofeed­back training and relaxation methods. Unless structural changes are made, as soon as a stressful experience re­occurs, the still unbalanced and unsup­ported jaws will be clenched and the TMJs will be overloaded again.

The cooperation of various health-care providers in achieving a balance between mind, body structure and body chemistry may lead to a healthier, happier and more productive life.

Elimination of TMJ dysfunction plays a key role in achieving this goal.

Copyright 1982 by Johns Dental P. O. Box 606, Terre Haute, IN 47808