TMJ Disorders

It’s estimated that tens of millions of men, women, and children suffer from TMJ and TMD many of whom have no knowledge of their TMJ condition or how to seek TMJ treatments from a TMJ Doctor or Dentist. Headaches and pain are the most common complaints from those afflicted with TMJ. Around 80% of patients with a TMJ disorder complain of a debilitating headache, and over 40% report some kind of facial pain. Your TMJ condition may unfortunately only worsen with time if you do not seek treatment from a TMJ specialist doctor or dentist. Without proper TMJ treatment you will experience increasing joint damage or inflammation, and further wear and breakdown of your teeth, which typically leads to increases in muscle contraction and consequently increased head, neck and facial pain. If your jaw is not correctly aligned, you’ll add wear and tear every time you speak, chew, swallow, and yawn: even while you sleep.

TMJ Symptoms

Below are a few symptoms that can help determine whether or not you suffer from TMJ: Headaches: sometimes of migraine proportions. Ear pain symptoms: ringing in the ears, hearing loss, “plugged” ears, ear pain, a feeling of “under water” Clicking: There is a pad or disc which ideally sits between the temporal bone and mandible in the TM Joint. This cushion, like a magic carpet, can slip out of place causing clicking when opening and closing. Clicking can lead to locking and grating or crepitus. Locking: When a disc is chronically displaced, it does not always click back into place. This leads to locking of the jaw joint with deflection of the jaw and limited range of motion. Popping: Some clicking can be staccato or popping by nature. Jaw Pain: Although it can originate from many sources, the most common reason for jaw pain is dental, then musculoskeletal. Most dentists can rule out dental decay, periodontal disease or root canal as the offending dental pathology. Muscles, tendons, ligaments and the temporomandibular joint can all cause jaw pain. Jaw pain can radiate from the neck.

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TMJ Treatments

Below are a few possible treatment option sour TMJ specialist doctors and dentist offer; please note all TMJ Treatments offered by The Gelb Center of NYC and White Plains, New York are customized to your specific condition: TMJ Oral Appliances / Bite Guards: The Gelb™ TMJ appliance, Farrar™ TMJ appliance, Gelb TMJ NYU™ and MORA™ TMJ appliances all reposition the jaw to decrease clicking and decompress the auriculotemporal nerve. Stabilization appliances are also used for myofascial pain and cognitive behavioral habit control. Orthodontic appliances can also be used in the course of treatment. BOTOX™ Injections / Trigger Point Injections: Trigger point injection therapy involves the injection of a local anesthetic into tender points to eliminate pain and re-educate the muscles. BOTOX takes relief to a new level with 3-8 months of relief from TMJ. Sleep Appliances for TMJ: Breathing related sleep disorders are often diagnosed in conjunction with TMJ disorders. Oral sleep appliances can be prescribed in these cases. Dr. Gelb uses and offers 8 different sleep appliances. Physical Therapy for TMJ: Manual physical therapy can be used in myofascial release, mobilization of the TMJs, and deep muscle therapy. Postural correction, Feldenkrais, the Alexander technique, cold laser, ultrasound, stim, heat and cold are also used. Some therapists also find craniosacral therapy to be helpful. Chiropractic TMJ Treatments: Applied kinesiology, ART, SOT, atlas orthogonist, and cranial therapy are all used. Foot orthotics are prescribed when needed. Medications: Together with other nonsurgical treatments, medications that may help relieve the pain associated with TMJ disorders may include: muscle relaxants, Medrol, or Neuropathic medications. If nighttime teeth clenching is aggravating your pain, the doctor may prescribe a sedative.

Possible Causes of TMJ

Bruxism: A stereotyped movement disorder which occurs during sleep can overload the TMJ as a repetitive strain type injury and also exacerbate muscle pain. Estrogen : Adolescent girls can experience idiopathic or internal condylar resorption. Perimenopausal women also frequently complain of TMJ sensitivity and bite changes secondary to the presence of estrogen receptors in the TMJ. Autoimmune: Rheumatoid arthritis, psoriatic arthritis, Lupus, Sjogrens, Reiters syndrome, and seronegative arthritis can be responsible for jaw pain and bite changes Joint laxity: Elongated ligaments allow the disc to easily slip out of position. Trauma: Macrotrauma, bad falls, blows to the chin, intubation and wisdom tooth extraction can all lead to joint strain or sprain. Sleep: Lack of stage 3 and 4 NREM sleep can lead to overall or widespread pain and fatigue. Healing occurs with 7-8 hours of deep restorative sleep. Arthritis: Arthritis can be localized as an osteo or traumatic arthritis, or systemic as an auto immune disease. With this, you can also experience inflammation. Inflammation may be localized.

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