TMJ Analysis and Diagnosis

T.M.J. stands for Temporo Mandibular Joint (the jaw joint in front of the ear) which is arguably the most important joint in the body.

We need it working properly for eating, talking, and laughing!

When it’s not functioning properly several symptoms present such as:

• Clicking or locking jaws
• Grinding and clenching the teeth
• Headaches – including Migraines
• Limited jaw opening
• Tinnitus (ringing in the ear)
• Eye pain and light sensitivity
• Pain around the head and face
• Balance problems
• Neck and shoulder problems, and many more

These symptoms are often referred to as:

• T.M.J. Syndrome
• Cranio-Mandibular
• Cervical pain
• T.M.D. Dysfunction.

It is my experience that a lot of people suffer with one of more of the above symptoms, and frequently, for many years. They may, in desperation have sought out a cure from a variety of Health professionals – Doctors, Physiotherapists, Osteopaths, Chiropractors, Acupuncturists, and Massage Therapists to name a few!

Despite the well intended treatment by such professionals, it must be understood that if the jaw joints are out of harmony with the dental bite, no matter what drugs or manipulation techniques are tried, the moment the teeth begin to bite together the therapy becomes undone, thus perpetuating the problem and the need to see the practitioner!

So, the best Health professional to treat T.M.J. problems is a general Dentist trained in the diagnosis and treatment of T.M.J. problems.

You can avoid being misdiagnosed by learning more about T.M.J. below, and your own symptoms. (see previous list)

Lets take a closer look at our anatomy to understand what is happening.

Only the lower jaw (Mandible) is able to move. The upper jaw (Maxilla) is part of the skull.

The teeth determine the position of the Mandible, and without them, the Mandible would be free floating, only having contact to the skull through the jaw joints themselves.

The teeth close only where they fit together the best. This may not be where the muscles and ligaments suspending and moving the jaw actually want to be.

The muscles will therefore assume whatever position is dictated to them by the teeth, or lack of them!

Muscles are composed of bundles of muscle fibres and these fibres have a certain length at which they operate the best – their ‘physiological rest position’.

In this position the muscles are at their most relaxed and strongest. If the muscles are elongated, or foreshortened instead of in their relaxed resting length they will become tense.

This tense contraction impedes blood circulation, resulting in spasm and cramping of the muscle tissue.

We have all experienced muscle cramp. It is very painful, but goes away when the muscle relaxes again.

So now I have a T.M.J. problem – how do I get rid of it?

First of all the shorter the time frame you have this problem the easier it is to fix it!

As a rule of thumb, the longer you have a T.M.J. problem and the older you are the harder it is to treat.

Before treating a TMJ problem a detailed analysis is required which includes:

• X-Rays
• Study models
• Photographs
• Measurements of Jaw Opening/Closing
• Muscle tenderness and Tongue mobility (Tongue-tie?)
• Other diagnostic tools such as MRI scan and CT scan may also be required.

It is not unusual to find that a patient with Jaw Joint problems may also have a Sleep Disordered breathing problem (see section on Sleep Apnoea).

Treatment may involve:

1. Short term “neuro-muscular splint”, this is a simple plastic splint that covers the teeth.
2. Correcting a Bad Bite, this may involve the use of ALF appliances and Orthodontics.
3. Myofunctional Therapy
4. Cranio-osteopathy to help with cranial and body alignment.
5. Breathing Re-training
6. Use of Low Dose Physiological Regulating Medicine (PRM) to help steer the body back to health.

As you can see the TMJ Treatment in our practice involves a Multi-disciplinary approach involving several healthcare practitioners such as:

• Functional Dentist
• Medical Doctors involved in Airway such as ENT and Respiratory Physicians
• Myofunctional Therapist
• Cranio-osteopath
• Buteyko Breathing Practitioner