One of our success stories that really stands out is the daughter of one of my friends. The friend and my wife go way back – about 20 years – and that friend sent her daughter to see me earlier this year. She told me that her daughter was in so much pain that when she came home at night, she could do little more than curl up in a ball and cry herself to sleep. This young woman had already been to dozens of doctors over the years and could not function much longer with so much head and neck pain. She was even thinking that life was not worth it. We were able to figure things out pretty quickly and within a month she was feeling better than she had in years. This is how debilitating TMJ disorders can be and how remarkable it is when they are fixed.

Of course, there are failures – unfortunately, most of those are with the people who have been in really bad shape for too many years. The goal is always to avoid surgery but sometimes no matter what we do (appliance therapy, massages, laser treatments, etc.) we cannot get the disc back in place or it is already perforated. The analogy that I tell patients is that they should imagine their car having an oil leak, loud muffler, brake fluid leak, smoke-belching, etc. and the mechanic trying to fix it all to restore your car. This is just too much for any mechanic to totally fix. All you can do is hope for the best. In most cases, there can be some degree of improvement. This is how TMJ treatment can be at times. You hope for the best in a bad situation. In almost all cases, however, improvement is seen, and I am thankful and grateful for that.

As we close out 2023, I am grateful for the support of our friends, families and team members who have made all of our efforts so successful. My core team members are well aware of how much I appreciate their hard work and going beyond what is expected of them. We are now in a position to further spread the word about what we can do to help people improve their lives. Our office will be expanding as many of you have already seen when you visit. We will have a bit more space to be able to prepare the treatment rooms in advance of your visit to make sure our ‘on-timeness’ is really top-notch!

So, we end this wonderful year with good friends and family all around us. May you all have a most excellent 2024 and God Bless.

Dr. Jeff Brown

The post The End of Another Year is Here first appeared on Sleep & TMJ Therapy.

Over the many years of treating TMJ disorders, my office has realized a couple of things: Do not use appliance therapy that is fixed or cemented in the mouth and using the AGGA or similar devices like FAGGA, MARA, ARA, FORA and RPE may not be wise when it comes to achieving the goal of palatal expansion and/or moving the upper jaw forward. The first reason, and the biggest, was the decrease of effective oral care. The reason for the other appliances is a big one.  The bones of an adult skull will simply not move 10+mm forward as some AGGA practitioners claim. The only way to achieve such a distance is to surgically reposition the upper jaw and our office does not recommend that. The reason is the nerves and blood vessels may be damaged in the process. The only time MMA (Maxillary and Mandibular Advancement) is recommended is with hopeless apnea cases where all other modalities have failed.

I have personally seen a number of AGGA type cases over the years and have observed that most of them tip the upper teeth forward so quickly that the teeth will come out of the bone, leaving them mobile in many cases. The jawbone itself does not remodel and come forward as the advertisers indicate. This has been the problem all along: too much force too fast in adult cases. In my office we have never used and never will use the AGGA or similar device. This is why my office has also banned the use of RPEs (Rapid Palatal Expanders). When expanding the palate rapidly, the same effect can occur, whether in children or adults. If a palatal expander is ever used, it must be done slowly and carefully, regardless of the patient being a child or an adult.

A better device is called the ALF (Alternative Lightwire Functional) developed by Dr. Darick Nordstrom many years ago. With children the ALF provides expansion for crowded cases, but perhaps more importantly, it gently opens up the bones to provide relief from head pressure and pain. With adults, the ALF is not a palatal expander, but more of a support appliance. The analogy I use is that it is like an arch support in your shoe; providing support that has been lacking. It is quite the opposite of a forceful AGGA. To achieve relief from your TMD symptoms such force is neither logical nor necessary.

The ALF was developed to help avoid extraction of permanent teeth like bicuspids. When teeth are extracted, this can collapse the airway and change the position of the cervical spine (the neck). Using the gentle approach of the ALF can open up narrow arches in children and avoid the extractions which used to be the ‘norm’ for orthodontists. So in lieu of even the palatal expander, the ALF offers a better approach.

When it comes to patient care and the decisions you make for your family it is important to keep in mind that the FDA recommendations regarding AGGA are quite clear, and I wholeheartedly agree that the AGGA and similar devices have the potential to damage the jaws and the teeth. Ask your dental provider about the FDA concerns and be aware what it means to wear such devices. If you have any questions about these devices or your dental health, we welcome you to call our team in Falls Church, Virginia at 703-821-1103. Dr. Jeffrey Brown is ready to help you with all aspects of your smile!

The post Response to the FDA Concerns Regarding AGGA and other Similar Devices first appeared on Sleep & TMJ Therapy.

Why is sleep important? When the body does not sleep well, it is far more likely that disease processes can begin. As anyone knows, when your body is just tired all the time, it is far more likely you will catch the flu and infections are far more likely to set in. This is the case with cancer as well. When your body is debilitated from lack of sleep it is easier for cancer to set in.  There is now plenty of research to support this. If you simply Google ‘cancer from sleep apnea’ you will find that with moderate to severe sleep apnea, you are two and a half times more likely to develop cancer and three times more likely to die from cancer. This is a serious statement. What this means is that if you are not sleeping well, you are far more likely to contract kidney cancer, melanoma, breast cancer, and uterine cancer. Even though the risk of lung or colorectal cancers is less, it is just not worth the risk when you do not sleep well. TMJ disorder affects not only your joints but impacts the quality of sleep. A confirmation from UVA hospital’s research is that good sleep has been confirmed to be key to good health. With good sleep, the lymphatic system is regulated, and in turn, helps regulates many immune systems.

So, what is the message of this little blog? The message is to pay attention to your body. If the jaw joints are causing pain – headaches, neck or back pain, or even dizziness and tremors – then pay attention and have it looked at by someone who understands the situation. And this has now opened up another proverbial can of worms: Who do I see? TMJ disorder is so poorly understood that there is no consistency in diagnosis or treatment. So please stay tuned as the next blog will delve into the devious world of diagnosis and treatment.

The post Oral Cancer and TMD- Coincidence or Correlation? first appeared on Sleep & TMJ Therapy.