TMJ vs. MPD (Part 2 of 2)
We will look at some alternatives now when treating TMJ or MPD in NYC.
It’s important to note that co-treatment with a physiatrist or physical therapist is often required for additional muscular release for MPD symptoms and evaluation of the rest of your body’s joints and your general posture. Your overall posture absolutely affects your neck and TMJ position and can’t be taken out of this equation.
What a removable orthotic appliance does when it is worn is it allows the jaw to find its’ own place without the teeth getting in the way; the muscles and ligaments in the TMJ are allowed to position the lower jaw in its’ most ideal, or at least pain free place in the joint. Remember, in most orthotics, one side is flat; designed to allow for free movement.
Once the jaw has been relaxed by wearing an appliance and MPD has been reduced or eliminated, we can turn to a more permanent solution by carefully adjusting the teeth to the comfortable jaw position. This can be done by simple shaving down of the teeth, by restorations such as crowns or onlays, by orthodontics or sometimes even by maxillo-facial jaw surgery in NYC.
The advantage these techniques have is that they keep your TMJ in its’ comfortable position all the time, not just at night, when most appliances are worn. The severity of MPD is often greatly reduced by this.
But what if your TMJ isn’t healthy? Just like a knee that doesn’t have cartilage and is chronically painful or arthritic, so can a TMJ wear down its’ cartilage or develop arthritis. This is a more serious problem, and a more frequent contributor to MPD in NYC.
How do you know? It’s really a dentist’s job to diagnose an unhealthy TMJ or MPD case. Here are some clues:
The pain is generally localized in the joint; it feels like it’s just in front of your ear. You may hear a clicking or popping sound when you open and close your jaw. You may not be able to slide your jaw all the way to the right or left, or you may not be able to open wide anymore. Your jaw may “lock out”, as the cartilage in the TMJ balls up in front of your mandible and prevents you from closing (this is generally only temporary!).
Now removable orthotic appliances are more important than ever. They are often used to test a new joint position; your jaw is actually positioned to a new place and held there by the orthotic. These are “directed” orthotics and are different than the ones described earlier. They do not let the jaw wherever it wants, they position it in a particular spot and are generally worn all day and night. These require frequent follow up and adjustment as your jaw and TMJ heal and reform themselves.
In certain cases, TMJ surgery is necessary here in NYC to properly correct abnormalities, just the way orthopedic surgery on knees, hips and shoulders are frequently necessary.
Referral to a neurologist, ENT, or other medical professional in NYC may be necessary in very difficult cases, as your MPD may be part of a wider syndrome such as fibromyalgia, osteoporosis, arthritis or other metabolic issue.
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.