The temporomandibular joint (TMJ) is one of the most complex and mysterious joints in the human body. Complex because of its unique movements and functions, mysterious because of how poorly understood and downright confusing this complex joint can be; especially when it is sick.
A number of years ago I was explaining TMJ Dysfunction (TMD), including causes and treatment, to a patient in the office. After we finished our discussion and made arrangements to have this patient’s joint evaluated and treated I went to do an exam on a new patient to our practice who was seeing our hygienist. As I sat down to examine the patient she said, “I overheard you talking to your patient about TMJ and I think I have that.”
She went on to describe how she had been suffering from virtually daily headaches for years. She told me how she would often get dizzy and her sinuses always felt “full” and her neck and back were chronically in pain. She then went on to describe how recently she had begun losing her hearing. In fact, she was wearing a hearing aid. This girl was 29 years old and the doctors had no plausible explanation for why she was losing her hearing.
We began treating her TMD immediately. I will never forget the day after we delivered her TMJ splint when we saw her for a follow-up exam. I was standing near the front desk when she came through the front door. She literally ran to me, threw her arms around me and said, “It’s a miracle! A few hours after wearing the splint my ears started popping, like I was coming down from an airplane flight.” She went on to describe how she no longer felt like she was under water and that morning she woke up for the first time since she could remember without a headache.
Part of the mystery of the TMJ also relates to how to treat a sick or dysfunctional TMJ. Most patients experiencing the symptoms of TMD (headaches, neck aches, back aches, ringing or buzzing in the ears, dizziness, sinusitis “fullness”, chronic fatigue and even depression) will go to their medical doctor for diagnosis and treatment. Unfortunately, because proper treatment of the diseased joint REQUIRES manipulation of the teeth, a medical doctor can not treat the cause of the symptoms but can only address the symptoms themselves.
Therefore, a patient suffering from TMD often has a story similar to this: “I went to my medical doctor to figure out what was causing me to have so many headaches, including migraines. I was told it was due to stress and I was given medication to take. The medication was somewhat effective for my regular headaches but didn’t do much for the migraine headaches that I seem to be getting more and more frequent. I went back and explained this to my doctor so they gave me a stronger medication. I pretty much can’t function at all when a migraine headache comes on.” They go on to tell how they have tried the chiropractor with limited success, they’ve tried yoga and hypnosis and even diet and exercise. Basically, they have tried everything and nothing seems to work. Many of these patients are referred by their physicians for a psychiatric evaluation. THEY KNOW THEY ARE NOT CRAZY but many of the people around them think they are because of the chronic pain and other myriad symptoms.
Treating TMD is one of the most professionally satisfying things I do as a dentist. I love hearing people tell me that the pain they have suffered with (oftentimes for many years) is gone. It’s always a good day when I can relieve my patients’ pain rather than cause it.