Tempomandibular Joint Disorder

 TMJ is an abbreviation of Tempomandibular Joint.  Because this joint is so close to the neck, shoulders, skull and teeth, it is often labeled as Musculoskeletal Dysfunction of the head and neck (MSD).  Symptoms that appear totally unrelated such as pain in the back or ear disorders are often alleviated along with acute and chronic diseases of the ear, nose, throat, neck, shoulders, back, vertigo and migraines.  The Syndrome is medical and dental related.

Misdiagnosis is common.  Patients often wander from physician and specialists depending on the location of the symptoms without finding relief. 

The cause of these vastly different symptoms is often the result of a "bad bite" or misalignment of the bite.  This initiates a complex array of actions that result in the symptoms mentioned above. 

Airway obstruction may be a complicating or initiating factor in the "bad bite" and will need to be addressed in any successful treatment.

Diagnosis is both from Symptoms, X-rays and EMG (electromyography).  A definite diagnosis is essential in the approach to treatment.  

4 Approaches or combinations thereof may be recommended as initial therapy:

1. Coronoplasty (occlusal equilibration) to remove interferences that cause the "bad bite".
2. Construction of a neuromuscular orthotic to align the lower jaw
3. Neuromuscular therapy and treatment
4. Chiropractic (Atlas Orthoganists) therapy
5. Surgery (rarely) when irreversible damage has occurred in the joint.

Finally, treatment and resolution of symptoms is the result of a good diagnosis, proper treatment, patient co-operation and the care, skill, judgment and education of the doctor.  All these facets are necessary for a good outcome. 

Don H. Lowrance, MS, DDS

Fellow Las Vegas Institute

Serving Patients in Corpus Christi, McAllen, Brownsville, the Valley, Kingsville, Victoria and the Coastal Bend