“My jaw hurts! Doc, I have TMJ!”. I hear this frequently from my patients here in NYC. TMJ refers to the Temporo-Mandibular Joint, so to say you have TMJ is the equivalent of going to a chiropractor and saying you have a “bad back”.
In most cases, what people really mean by this is that they have pain, dislocation or clicking in their TMJs, or jaw joints. Happily, 95% or so of patients really have little dysfunction in their TMJs, they just have muscular discomfort in the associated muscles that move the jaws and neck. This (along with TMJ derangements) is referred to as Myo-fascial Pain Dysfunction Syndrome, or MPD.
MPD really includes any discomfort or reduced function in the head and neck, including muscular pain, clicking, joint dislocation, locking out of the jaw, dizziness, sensitive teeth, migraines, headaches, and a panoply of other symptoms. So, what is this muscular pain? Where does it come from? And most importantly, what can I do about it in NYC?
The TMJ is the most complicated joint in the body; it has two compartments, an upper and a lower, and can accommodate a variety of jaw positions. It has to, because it must accommodate the other joint on the other side of the head, as well as 28 -32 teeth that must fit together just perfectly for it to be in optimal function. In most people those teeth don’t in fact come together perfectly, and they cause a slide or accommodation of the jaw as you close, which pulls the TMJ out of its’ most ideal position into one of the positions it is able to adjust to. There is a price to be paid for this, however, and strains are induced in the TMJ and the muscles associated with it. Most people can adjust to this strain and function just fine, but every once in a while resistance is lowered and your jaw or neck is sore for no apparent reason, even though your TMJ is healthy. This is one form of MPD.
First, there a lot of home remedies. Massage, relaxation, meditation, warm and cold compresses all help in mild cases. Do you hold your teeth together during the day, or do you clench or grind? Many people don’t realize they hold their teeth together during the day – this can have serious long-term consequences, as it keeps your muscles straining all day as they fight gravity to hold your jaws together. Here in NYC, I have been recommending the “puff technique” to my patients for years – just gently blow out your cheeks and let go a puff of air. This instantly separates your teeth and relaxes your muscles. You can do it a thousand times a day, and best of all, it’s free!
If home remedies aren’t enough, a great solution is an orthotic mouthpiece made by your dentist. The most commonly fabricated type is flat on one side and allows your teeth to slide around like skating on ice, allowing your jaws to find their own most comfortable position without involvement from the teeth. When your jaws are not being pulled out of their most comfortable position by the teeth, they have an opportunity to relax and start healing. Most orthotics are worn at night, which is often when most of the damage is done.
You can see my Youtube video below where I detail what you can do at home to alleviate a variety of dental problems until you get into the office here in NYC. Next month, I’ll talk about TMJ dysfunction and its’ relationship to pain and other MPD maladies.
Spiro Condos has practiced dentistry for 35 years and is an Associate Clinical Professor at NYU Dental School, where he is a director of the 2-year post-graduate implant program.
To learn more about TMJ in NYC or MPD solution options, or to book an appointment for a TMJ NYC treatment plan, we welcome you to contact the Dental Implant Center NYC at 212-799-6900.
“To read Part 2 of this article, please click here.”
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