Back when I was the guy who stood at Gold’s Gym at 05:00 hours.  That’s 5 am for anyone who is not familiar with the 24-hour time clock. Then one day I was driving home, and it was a dark and rainy night (sounds like a good beginning to a horror story, and as it turns out, it was). There was a jaywalker in the middle of the road, so I hit the brakes hard and stopped, but so did the bus to my right. Unfortunately, the guy behind me did not stop and slammed hard into the back of my car, doing around 40 mph. My neck snapped pretty hard, and my beautiful car was crunched up quite badly. (Sure, it was already 15 years old, but it was my baby :)). I took down the name of the guy who nailed me, went home and went to bed. The next morning my neck hurt so bad I could not move, could not get out of bed and could only call for help.

This was the beginning of a 20-year nightmare of neck pain and back pain that would never cease. I felt like I was living on Advil. My neck, traps, back, shoulders, everything had been in pain for so long that it felt like there was no solution. And then, I slowly began to notice that I was having difficulty swallowing my vitamins and eventually even food was tough to get down my throat. It was like I had to really ‘work it’ to force down my food and people were noticing that I had lots of issues, they actually asked if I was choking. Well, it turns out that I was indeed having swallowing problems sounding like choking!

As the years progressed, I sought countless physical therapy appointments, osteopath visits and any other doctor to help with the pain.  Some of them were really good, others not so much. The problem with all this treatment was that nothing would really alleviate the pain or swallowing problems for any length of time. It was all ‘palliative’ treatment, as they call it.

So, I already knew that I had a severely deviated nasal septum that would greatly affect breathing and healing, obviously. As a member of the ALF Academy, I learned more about my own problems. I learned that when the body incurs trauma, like I did, the ligaments that exist from the mastoid bone behind the ear and go to the hyoid in the throat will often calcify into bone. This calcification is our body’s way to help open up the airway and reduce spinal compression, both of which I had going for me. If you can imagine having long pieces of bone stuck in your throat on both sides and these darned things are blocking both your airway and your ability to swallow, then you can understand what I have been through, and many of my patients have experienced. Was this diagnosed as Eagle’s Syndrome? No, not really, but some of my doctors did suggest it. And what do you do about Eagle’s? You generally watch it and keep an eye on it. So that’s what I did until recently.

In my practice, we have always watched for this, and appliance therapy slows down the calcification process tremendously. To be clear it does not get rid of the problem.  The concern is the compromised airway and continued pressure placed on the carotid artery. Obviously, this is a concern that can lead to a stroke. This is why we have a CBCT X-ray completed from the neck up.

Now, back to my story. There came a time in middle to late 2022 when I was choking on most foods and literally gave up on all the vitamins and supplements that my doctor wanted me to take. I knew my hyoid ligaments were very calcified at this time. I took a good long look at my own X-rays and said, ‘That’s enough XXXX’, I need to deal with this problem. I made the call to the most wonderful ENT doctor that I have known for years. He and I discussed treatment and he explained he has dealt with these issues for many years now and knew exactly what to do. Needless to say, I knew I had to deal with this, so I scheduled a surgical intervention. His surgery involved correcting the deviated septum and removing the calcification from either side of my throat.

The next three days of my life were really rough. All I could do was to choke down the oxycontin and cry for the next five minutes or so. The oxy would kick in for a while and it was three days later before I could even think of consuming chicken broth or anything similar. So, for the next week, I would choke down my broth, and sometimes there was a bit of noodle in there as well.

At 12 days post-surgery, I am at the computer typing away with a very sore throat and just taking Tylenol as needed for the pain. Last night, I was able to choke down some noodles and sauce and it was a bit less difficult than the night before. No more oxycontin is needed. My nasal passages are also popping out lots of scabs these days and if I blow my nose, lots of junk comes out. Overall, it is getting better, but ever so slowly. I have been sleeping up to 12 hours each day; not sure if this is recuperative sleep from losing so much sleep over the years or just from the lack of sleep post-surgery. I am still having problems with swallowing, but the throat is still quite swollen, so I guess that’s par for the course.

So, how would I rate doing this surgery? The jury is still out. I do admit that I believe I can breathe a little better through the nose and hope this continues to improve. Also, when I take Tylenol, it does not get stuck in my throat nearly as much. The neck pain is still there – I had no expectations about curing that. Sleep is much better and definitely more restful. My main reason for writing this very long blog was to set expectations if one ends up doing such a surgery. Expect a lot of pain. Expect difficult days and rough nights. But in the end, as long as it helps, it was worth it!

The post The Case of the Calcification and the Correction or How I Handled Eagle’s Syndrome first appeared on Sleep & TMJ Therapy.

Now, let’s explore the implications of exercise and its impact on the effectiveness of TMD treatment. Engaging in activities such as running can subject the neck to significant impact, leading to compression of the spinous processes. Consequently, this compression can adversely affect the temporomandibular (TM) joints. Therefore, it is generally not advisable to engage in running while undergoing TMD treatment. An alternative to running is the use of an elliptical machine. This low-impact device provides an excellent cardiovascular workout without putting strain on the neck. It is crucial to prioritize the well-being of the TM joints and cervical spine during the exercise routine.

Read the Full Article:
TMJ Disorder and Exercise

The post TMJ Disorder and Exercise first appeared on Sleep & TMJ Therapy.

So now let’s discuss the ramifications of exercise and how it can and will affect the outcome of TMD treatment. When a person runs, as you can well imagine, the neck takes a pounding which compresses the spinous processes. This can, and will, in turn affect the TM joints. This is why running during TMD treatment is really not recommended. An alternative to running is the elliptical machine. This is a no impact device that allows for a great cardiovascular workout with no compaction to the neck. You have to keep your mind on improving the health of those joints and cervical spine.

Another aspect of exercise is weightlifting of course. Most people really do not want to hear that they should not be lifting weights during their course of TMD treatment. The reason for this is that when you lift something fairly heavy, this pulls on the neck muscles- the sternocleidomastoids. These muscles connect directly into the jaw joint and will pull on a displaced disc. You can well imagine that is not a good thing. Another factor is that lifting above shoulder level causes the body to pull more on the neck than it should. This can hurt the joints as well. Once again, this type of exercise will compromise your ability to heal.

Now let’s bring up a four-letter word that comes up quite often: GOLF. So here you are newly retired, living in a house at the country club, new to the game, or just looking to a retirement in place where you can play golf every day of the week. Along comes the TMJ specialist who tells you not to play until you are better. You have a choice: Get better or not. One path means that you must take a hiatus from using those amazing Ping custom made clubs and telling your friends about the hole in one you got. The best choice is to sit at home and use the elliptical machine and get better. This problem occurs whether it’s golf, tennis, or pickleball. You must make a choice and live with it for some time.  This is not permanent but when you get back into it, you may find your stroke and strength improved. As you can see, dealing with TMD takes some effort. For some folks it means sacrificing their normal activities so it’s good to understand all this before treatment begins.

The post TMJ Disorder and Exercise first appeared on Sleep & TMJ Therapy.

Did you know that a gorgeous smile with great teeth and well-supported Temporomandibular joints also means less neck pain?  It’s so true! Time and time again it has been shown that losing a tooth means that the structural integrity of the cervical spine is compromised. This is why it is not advisable to remove any teeth unless completely necessary. In so many cases, it is necessary to remove the patient’s wisdom teeth.  For this reason, many people would benefit from wearing the ALF appliances to maintain support of the bones of the skull during the healing process. When wisdom teeth are removed, the research indicates there will be about 16 square centimeters of holes in the skull and the bone has a tendency to collapse from this. The ALF appliance will help to support the bones of the skull and more readily allow the bone to fill into the holes created by the extractions, without causing a collapsing effect.

In the past, it was much more commonplace to have all your teeth pulled out and have dentures made. The problem with the denture route is that most of the time the dentist’s lab uses a type of plastic material and the dentures have a tendency to wear down quite quickly. What happens next is the top of the jaw – the condyle – will more readily jam into the socket and we have more TMD problems. This is why it is good to avoid dentures and go the implant route.

When a person has implants done, it would be wise to get the implant crowns to the proper height. This would require working with someone like a TMJ specialist who understands that the condyles must be in the right place to protect the joints from degeneration. By paying attention to the vertical height of the implant crowns, this will allow the patient to feel better with their brand-new smile!

Another facet of dealing with a gorgeous smile is that a great smile looks better if the bones in your skull are more balanced and symmetrical. When you think about it, it kind of makes sense. If your cranial bones are level, the body is happier and looks better. Again, this is what the ALF wire is all about – symmetry and balance – and this creates a more beautiful appearance too.

So, make sure that beautiful smile translates into a beautiful and healthy YOU!

The post The Case of Why We Need a Gorgeous Smile (From a TMJ Perspective) first appeared on Sleep & TMJ Therapy.

TMJ and sleep disorders are very common but not really understood.  This can explain why myths or misconceptions are out there.  The other side of this coin is this is also commonly misdiagnosed because symptoms vary from person to person and are similar to other problems.  One example of similarities is with Lyme Disease.  This is caused by a tick bite and the symptoms could be chronic headaches or migraines, jaw pain and tingling in the hand or fingers, notable symptoms of TMJ disorder. The big difference is Lyme disease does not have the clicking and popping or vertigo symptoms of TMJ disorder.  There are other examples as well; migraines, Trigeminal Neuralgia (short, sharp pain from touching of the jaw joint), or even a Ganglion Cyst (on the TM joint causing swelling and jaw pain).

Just remember all of us get sore muscles from time to time. The big difference is when the muscles in your jaw joints get sore and the soreness does not go away.  This is when you should ask your dentist for a referral. Otherwise, you could be prolonging the unnecessary pain or soreness and allowing the disc to possibly become further damaged.  TMJ disorder does affect other parts of your body. The myth of no popping or clicking means no TMJ disorder is not true.  These displaced discs can cause other symptoms of neck pain, backache, loss of balance, or hearing loss without the clicking or popping.

Another common myth is that TMJ disorder is harmless and that living with it will not cause problems.  It is true this condition is non-life-threatening but at the same time, it should be addressed.  Some possible development would be bruxism.  This process causes grinding of your teeth and clenching, wearing down your tooth’s enamel, and can cause sleep issues.  If the tooth enamel is worn down, then the potential of decay or tooth loss becomes greater.

For the sleep side of things, sleep can be interrupted by the clenching and grinding of your teeth.  Interrupted sleep or waking up unrefreshed is a symptom of both TMJ disorder and sleep apnea. It is not considered just a sleep issue.  The myth of sleep issues coming with age is not exactly true.  The aging process does decrease the tone in muscles and the airway muscles are not immune to this. The muscles in the airway no longer hold the jaw in the correct place and in turn, the airway becomes restricted. Your body is now fighting harder to breathe.  The use of a CPAP as the only treatment for sleep apnea is another myth.  The American Academy of Sleep Medicine has determined that an oral sleep appliance is very effective for mild to moderate apnea index.  This index tells us how many times your sleep is interrupted within a night.  The Epworth scale (tiredness level) in conjunction with the apnea index can determine if the oral appliance will be effective.

An interesting myth, sleeping on your side cures sleep apnea, actually helps with sleep apnea but does not cure it. By sleeping on your side, the tongue is not relaxed enough to obstruct the airway by falling back into the throat creating a blockage.  The tongue is off to the side allowing air to pass through the airway.  This is noted with mild cases of sleep apnea.  The side sleeping is most definitely not a cure but is recommended a lot for “positional apnea”.

There are so many more myths out there for both TMJ and sleep disorders.  Always consult with your dentist or physician when it comes to these issues.  You do want to address these symptoms because both these conditions will affect your brain and in turn affect cognitive functions, generating higher stress, and possible memory loss.

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