Have you ever heard anyone say, “I have TMJ?” Did you feel empathy for their plight? I’ve got a secret for you: you do too, and you have two of them.
The “TMJ” which is the temporomandibular joint (the joint between the temporal bone of the skull and the mandible or jaw), is sometimes mistakenly used for the disorder which is more accurately “TMD” or “temporomandibular disorder or dysfunction”, is a problem for many of my Patients and their parents. You may find it surprising, but I see it more commonly in people with teeth that are less crowded instead of severely crowded and much of the research has found this to be true as well. There are some aspects to misaligned teeth that I feel are more associated with TMD, but this is anecdotal evidence based on my experience and not fully supported by research. This is one of the reasons why we very rarely begin orthodontic treatment for TMD alone, as it’s possible to get the teeth perfectly straight and the symptoms are still there. However, although we may not begin treatment primarily for TMD relief, many of our Patients experience it as a result of treatment and this could be due to a number of different possibilities ranging from physical changes making the bite more comfortable to the psychological boost that orthodontic transformations provide.
Why all these “possibilities”? TMD is an enigmatic problem for medicine and dentistry because the symptoms can be multifactorial. Lets “face” it, the head is a physically complicated structure, and physical symptoms can be compounded by the psychological symptoms that can be much harder to pinpoint. Not only are the causes multifactorial, but where exactly the relief came from can be difficult too, many times it’s a combination of reasons.
“I was clenching and grinding so bad the last week, but I think it was because my mother-in-law was in town” was just the latest description of TMD symptoms by a Patient yesterday. The world is full of stressors and just this week I’ve heard about stress from nursing school, stress during final exams, stress about a move, and stress about relationships all being contributory to one’s jaw pain. We all have stress, but we all manage it differently so its effects are different for each of us.
What to do about it? Talk to your dentist, physician, naturopath, functional medicine practitioner, chiropractor or orthodontist. Do your own research and see what makes the most sense to you. I have been following the work of Chris Kresser recently and have learned a lot myself about integrative medicine (as opposed to conventional medicine). I came across a guest blog post this week that would definitely benefit you to read even if you don’t have any TMD symptoms. Here is the link.
After over a decade of treating orthodontic Patients and hearing stories of TMD and how debilitating it can be, I’m happy to see this conservative research and therapy discussed. Sometimes more invasive therapies like surgery are needed but hopefully only after the conservative approach has been exhausted. Many of these less invasive ideas are much easier to try and can have other positive side effects as well. For example, nearly 100% of the people I see with TMD report higher than average levels of stress and who can’t benefit from some stress reduction in our fast paced, iThis, iThat and iThere world? (Hint: Chris Kresser’s website has some great info on that as well.)
It’s not just stress that the article discusses; hormone balance and inflammation rank up there as well for contributory factors to TMD and can be helped with dietary and lifestyle changes. If there is any dis-ease in the body at all, from stress to a poor diet, the body doesn’t have the building materials it needs to heal itself in any of the thousands (millions?) of ways it is able to.
Hopefully you find this helpful and are inspired to look at whatever ails you in a different light, TMD or not. I’ve been known often to say “it’s more than about the teeth” and this information is right in line with my mission.
– Dr. John
