TMJ Treatment (Neuromuscular)

TMJ refers to the TemporoMandibular Joints on either side of the jaw. Chronic pain in the face, jaw, head or neck is referred to as TMJ/TMD or Temporomandibular joint disorder.

The most common cause of TMJ is a bad bite or “malocclusion”. When the teeth do not fit together properly, the alignment of the jaw changes and the muscles are forced into a strained position causing pain.

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With a bad jaw alignment, the position and alignment of the head is also affected causing misalignment and pain in the face, neck, arms, shoulders and back. With orthodontic treatment you may correct crowded teeth, but the muscles still may be uncomfortable and the patient may still have jaw pain, headaches, neck aches, shoulder aches and back pain.

Some of the most common symptoms experienced by TMJ patients are:

  • Jaw sounds (clicking and popping) - caused by a lack of cartilage at the rear of the jaw joint, or dislocation of the joint
  • Earache/tinnitus (ringing in the ears) - occurs when pressure is put on the ear canal by the jaw joint
  • Headache - occurs when the ball of the jaw joint puts pressure on the jaw bone
  • Grinding sound – occurs as a result of an uneven bone surface at the rear of the jaw joint
  • Head/neck pain - caused by pinched nerves that are impacted by the ball of the jaw joint
  • Grinding/enamel damage - a manifestation of a subconscious desire to correct jaw misalignment, leads to grinding motion

TMJ symptoms occur when stress is placed on the jaw joint. This causes the jaw joint to be overextended and fatigued. TMJ can be treated using oral appliances, medication or surgery to correct the bite by returning it to a well-balanced position. A well-balanced position relieves the joint of unnecessary stress and allows it to function in a healthy and efficient manner.

Most often, patients find relief with minor solutions. Removable appliances can be used to gently edge the lower jaw forward into a more strategic location. Another option is using a custom-made appliance that ensures the ball-and-socket relationship is operating harmoniously.

If you are experiences any of the symptoms commonly associated with TMJ listed above, contact Dr. Kremer and his neuromuscular team to schedule a complimentary consultation.

Other TMJ symptoms include:

  • Difficulty opening or closing the mouth
  • Neck soreness
  • "Traveling" ear, head and jaw pain
  • Uncomfortable bite (where the teeth meet)
  • Difficulty chewing tough foods
  • Dizziness
  • Shoulder or back pain
  • Locking of the jaws
  • Unexplained tooth loss
  • Pain intensification during chewing, speaking or yawning
  • Vision problems
  • Light sensitivity

Advances in the Health of the Mouth

Chico ER, August 30, 2011

If you’ve never visited a Neuromuscular Dentist, you may want to make an appointment.
The Tempro-Mandibular Joint complex is a unique system in the body for three reasons. First, it is the only joint in the body which is made up of two distinct joints on opposite sides of the body. These are connected by a bone called the mandible. Next, these joints are the only ones in the body which have a hard stop- the teeth, as opposed to other joints such as the hip or shoulder. Thirdly, the Tempro-Mandibular Joint Complex not only rotates but also translates or slides. As you open your jaw, the joints rotate until your mouth is approximately half-way open. At that point, the motion is then changed to a slide.
Because this complex has the teeth as a hard stop, any change in the teeth will then conversely affect the joints. Gravity would cause your mandible to rest on your chest if it wasn’t held in place by a myriad of muscles and ligaments. These muscles and ligaments attach to your maxilla which also helps to hold your mandible in place. Nerves infiltrate these muscles and ligaments, adding sensation and motion to the complex. Altogether, the teeth, joints, muscles and sensory and motor nerves work together to surround the oral cavity.
Traditional dentistry focuses primarily on the teeth and gums. Dentists can help to alleviate cavities and gum disease as well as create beautiful smiles to last a lifetime using the latest and greatest technological advancements.
Advances in the health of the mouth have developed over the past several decades called which serve to address not only the teeth and gums, but also the muscles, ligaments and nerves which surround the oral cavity. Neuromuscular Dentistry focuses on finding the optimal position of the bite by using technology to assess the muscles, ligaments and nerves. If your bite isn’t in its optimal position, then aggravating symptoms can result.

If you’re walking around with a pebble in your shoe all day for years, you’re going to sense that something’s not right, and your hips will eventually realign to compensate for the interference. The same thing happens with your bite. When the bite is out of alignment the muscles became tense and overactive. The muscles then cause the teeth to grind and wear down. The pressure on the teeth is equivalent to five to nine times the force as compared to normal wear and tear, therefore causing your teeth to only last 1/9 as long.

Typically dentists have treated Tempro-Mandibular Joint patients with splints. Splints are a hard piece of plastic which interrupt the bite and relieve the pressure in the joint to a certain level. This treatment has helped many patients and alleviated their symptoms. Neuromuscular Dentistry excels by using scientific equipment that measures the degree of muscle tension as well as giving dentists the ability to precisely detect to a .1 of one millimeter any dislocation of the joint. Like an EKG for a heart test, an EMG machine is used assess the jaw’s muscle and joint health. The new technology allows Neuromuscular Dentists to assess the Tempo-Mandibular Joint just as a cardiologist would assess your heart. Next, the muscles are relaxed and further measurements are taken. The patient’s ideal position is recorded and an orthotic is fabricated. The orthotic, unlike the traditional splint, is anatomical- an extension of your teeth- and balances your bite with the opposing teeth. The orthotic not only stabilizes the tempo-mandibular joint but also the cervical spine because of the strong relationship between the atlanto-occipital, cervical vertebrae and the jaw. This causes the muscles to relax and deconstruct and thereby can alleviate a myriad of symptoms.
Many patients come into the dental office complaining of headaches. It is estimated that approximately 45 million Americans have chronic headaches and that as much as 95% of these headaches are caused by a poorly aligned bite. So what is it that hurts when you have a headache? A number of parts of the head can experience pain. There are a large group of nerves over the scalp, which can cause pain. Specific nerves in the face, mouth and throat can also cause headache pain. Probably the most significant part of the head that is sensitive to pain are the muscles and blood vessels along the surface and base of the brain. These muscles and vessels contain very delicate nerve fibers which can be irritated by changes in the muscles and blood flow to and around the brain. Neuromuscular Dentistry seeks to address the cause of these symptoms—a poorly aligned bite. Most people treat these symptoms with pain medications. These drugs never address the root of the problem. It’s like putting a band-aid on an exposed artery. If you are suffering from severe headaches, Neuromuscular Dentistry is an effective way to alleviate your pain because it serves to readjust the cause of the problem and not simply alleviate the symptoms.
 
What Patients are Saying:
“Consider yourself lucky if you have never experienced vertigo, because it is unbelievably debilitating. When I would lie flat, I would get a 36 hour dizzy spell. During these dizzy spells, I would spend a day and a half sitting upright without moving my head. My lifelong sport of swimming competition was out of the question and so was skiing. I was prescribed 2 medications, which provided only minimal relief. After the dental treatment, my vertigo is gone, I am absolutely comfortable for the first time in my life, and my teeth are beautiful. In fact, I am swimming competitively again and skiing to my heart’s delight! Thank you for helping me overcome this debilitating vertigo and allowing me to do the things I love to do.”
Josh B., Berkeley, CA
“THANK YOU, THANK YOU, THANK YOU!!! It has been 4 months since my neuromuscular treatment and I have not had one single migraine…in fact, I have not had any kind of headache at all!!! It is amazing. I think back to my "headache history"…all the days I spent in the darkest room of my house (usually my closet), curled up in a fetal position, nauseous, touch and light intolerant…and just praying for the pain to go away…it's hard for me to express the gratitude I have to you for solving my problem. You have no idea how you have changed my life.”
Heidi P., Philadelphia, PA
“During my initial exam we discussed my symptoms and how my bite had closed down over the years. My facial muscles always felt so tense. I lived for at least ten years with this facial muscle and TMJ area soreness. Recently, the pain started to worsen. I have also had neck, back, and headache pain for as long as I could remember. I usually took 4-6 Tylenol or Motrin per day to alleviate the pain. You used your neuromuscular techniques to find the precise jaw position for me. I really did not understand the full significance of what was happening, but the results were unbelievable. All of my facial muscle pain, headaches, and other symptoms I had lived with for the past ten years went away.”
Michael F., Hoffmann Estates, IL
Using state-of-the-art neuromuscular dentistry, Dr. Kremer and his dedicated team work hard to  determine if the symptoms you are experiencing are the result of a bad bite. They then go through a series of steps to not only relieve your symptoms, but to also correct the cause of your symptoms.