TMJ Solutions

TMJ / Myofascial Pain . . . What is it?

Usually, a multifaceted disorder which includes both medical and dental conditions.  Many laypersons this it is solely a joint problem as the acronym TMJ (Temporomandibular Joint Disorder) seems to suggest.  In fact, the more appropriate term, TMD (Tempro Mandibular Disorder) involves the joints, the muscles of mastication, the teeth bite, and the central nervous system.  In short, TMD is a disorder of CNS muscles, joints and bite/teeth. When these components are out of sync, problems arise.

Some of these problems can occur when there are joint disc derangement’s, dislocations, a disc of ligament tearings due to traumatic injuries and or inflammatory disorders, i.e., arthritis, fibrosis, ankylosis, etc.

Muscle pain from hyper or hypomobility and growth disorder contribute to the TMD problem.  Common misdiagnosis’ are fibromyalgia, migraine head pain, neuralgias of the masticatory system as well as neck/shoulder and back pain.

No matter what name experts or laypersons give this disorder the problem exists because the C.N.S.(central nervous system), muscles, joints and teeth(meaning the bite) are at war with each other.

Symptom Awareness of TMJ

Dr. Holderbaum’s continued training helps him look beyond the usual dental caring and defective marginal breakdown of fillings and crowns, root cavities, fractured teeth and gum problems.   These problems, many times, are indicators of the more hidden TMJ issue that often goes undetected by the medical and dental professions.

Some of The Possible 120 Signs and Symptoms Include:

  • jaw joint clicking, popping and grating
  • sore muscles of the head and neck; temporal, behind the head and neck, upper shoulders and the chewing muscles
  • limited mouth opening, earaches and congestion feelings & pain behind eyes
  • dizziness, a ringing in the ears
  • crowded lower front teeth
  • sever wear of lower front teeth, high vaulted palates, over-closed bite
  • receding gums,  loose teeth, loss of molars, habits of tongue thrust and mid-line of teeth not centered

If you are experiencing any or some of these and not getting better, you are not alone. About 1 in 27 (70%) of USA population share your pain.

Many TMJ patients receive numerous listed medical and dental treatments with little or no effective relief from pain.  The SYMPTOMS, not the CAUSES are being treated. 

Some treatments tried are invasive, irreversible, and even made patients worse resulting in disappointment, depression and financial loss.

Most Common Symptoms Cited:

  • Facial Pain – muscles
  • Jaw Joint Pain
  • Back, Neck, Cervical Pain – muscles
  • Face Pain
  • Limited Opening of Mouth
  • Pain in Muscles of TMJ, back, side, front and below eyes of head
  • The bite has no home base – multiple bite positions
  • Clenching / Bruxing – grinding
  • Cold Sensitive Teeth
  • Deviation of Jaw to One Side
  • Jaw Locks Open or Closed
  • Ringing in Ears – Tinnitus, and feeling of Congestion
  • Dizziness – vertigo
  • Tingling in Fingers and Hands
  • Insomnia – difficulty sleeping

Treatment Overview

The TMJ Consult

  • One can expect about 1-hour long visit with the following being evaluated and discussed with the Doctor and a PowerPoint Presentation
  • Meeting with Dr. Holderbaum and discussing the problem
  • Brief screening muscle palpation
  • Some measurements are taken and compared to a golden proportion
  • Answer any and all of your questions as complete as possible
  • Discuss treatment plan for y our treatment i.e., visits and fees

Comprehensive Evaluation

  • Review your history of the problem and previous treatments of other doctors
  • Medical and dental history
  • Posture: head and neck evaluation
  • Record degree of pain on muscle palpitation
  • Habitual bite evaluation
  • Periodontal evaluation
  • Review and evaluate all x-rays (previously taken and brought to the office)
  • Treatment options discussed
  • All necessary photographs
  • And all impressions for necessary diagnosis costs

Phase I Therapy

  • Average time – 3 hours
  • A low-frequency TENS unit is used to find the physiologic resting position of the muscles and mandible.  The old habitual bite is stabilized with an orthotic to the new neuromuscular (physiologic) bite.
  • Making and seating an office fabricated neuromuscular (physiologic) orthotic which is custom fitted to the exact muscles zone of neutrality.  This is a preliminary orthotic to keep the new bit position until a laboratory one is made and inserted in about 2 weeks.
  • The new physiologic position is refined even more when the laboratory orthotic replaces the office made orthotic.
  • Very little doubt is left as to the accuracy of the physiologic resting position when the jaw muscles are in their neutral zone.

Phase II Therapy

This phase includes permanent stabilization of the mandible to the skull.  The teeth are the stabilizing factor.  There are various modalities or combinations of treatment to achieve the Comprehensive Oral Rehabilitation.  The permanent restoration procedures are designed to match the patient’s new neuromuscular position of the muscles, mandibular posture and neutral joint position.  The patient does not have to get used to the new restorative work, because our method is predictable, accurate and stable.  This is Neuromuscular Dentistry

Please Feel Free To Call Our Office 719-528-8282