But now let’s be realistic.  If a potential patient reports that they have ‘TMJ,’ they really are just trying to say that their jaw is a problem, and it might need some help. The way to help such a person is to measure how big they can open their mouth, and then palpate the various muscles that attach to the TM joint. This goes a long way in diagnosing the problem. In many cases, it is necessary to further that diagnosis by ordering an MRI to determine what the articular discs are doing in the jaw joints. The articular discs are the cartilage that covers the top of the jaw bones and protects the joints from going bone on bone, which really can hurt badly.

In addition, a specialty X-ray called a CBCT must be done to further determine if the bones of the skull are out of alignment. So first, the MRI, then the CBCT to figure out what is really going on in the joints. At this point, a discussion must be done about how best to treat the problem(s). Each person has unique symptoms and determining the best appliance is critical. Often, wearing an appliance or an appliance for each arch in the mouth works to ‘decompress’ the joints. This is very effective. The appliance(s) must be worn for a year or more in order to be effective. Then a new MRI and X-ray must be done to see if the discs have moved or are moving back where they should be.

Sometimes,  unfortunately, the disc is either damaged or is not moving back. At this point, it may be necessary to do surgery to help move the discs back into place or remove the damaged disc. Other therapy options to help with the symptom management are prolotherapy, BOTOX®, or even stem cell therapy to help. Surgery is always the last-ditch option because it is more invasive than any other choice. It is, however, very effective and can provide much needed relief to that person who has suffered for many years. The other options, often called the ‘injectables’, help to lubricate the joints so the displaced discs have a chance to move back where they need to be. Sometimes this works quite well, other times not so much because they are not actually fixing the underlying problem.

So, if you do indeed have ‘TMJ’ problems then you most likely have other body pain or symptoms as well. The TM joint can be a problem and you will want to fix it. If so, see the right doctor, analyze the problem, and treat this before it becomes more difficult.

The post “I Have TMJ” What Does That Really Mean? first appeared on Sleep & TMJ Therapy.

Did you know that your tongue can hold fat deposits, just like your belly? If you were ever overweight in the past, your tongue would likely have fat deposits in it, and these are kind of hard to lose. The tongue, like any other muscle in the human body, needs to exercise. But like most patients who are referred to a myofunctional therapist, they don’t go, they won’t do it. It costs money and time, and they feel like it’s kind of silly to exercise this area of the body. Well, folks, it does work and does make lots of sense, so get out there and start exercising that tongue!

In so many cases where a patient has sleep apnea, the tongue is quite large and is full of fat tissue. This can readily be seen on an X-ray that shows the tongue and what can be seen is that the tongue is elevated because it is thick due to fat deposition. Like so many areas of the human body, if you exercise the tongue and surrounding tissues, the fat will decrease over time which will effectively open the airway for better breathing. Snoring usually reduces as well as the tongue becomes smaller and tighter. The tissues around the tongue also become more toned with these exercises so if you have sleep apnea, it might reduce as you exercise this area over time. In fact, in many of the dental sleep medicine training programs, it is taught that myofunctional exercises are mandatory to improve a patient’s health.

There are other obvious benefits to exercising your tongue.  Your speech and articulation of words are improved, caused by the weakness in the tongue. If you have Dysphagia (trouble swallowing), your ability to develop a stronger tongue able to move more easily and then swallowing becomes easier. Finally, another plus is the jawline. Tongue exercises include the muscles groups below the chin and toning of the jawline begins.

So once again, dear reader, consider sticking out your tongue and making it work like it has never worked before. Get that tongue at attention! Get that tongue out there into the real world! Make that tongue healthier, happier, and improve your life!

The post The Case for Tongue Exercises – REALLY? first appeared on Sleep & TMJ Therapy.

In the world of dealing with craniofacial and TMJ disorders, it is critical to look at any asymmetries or irregularities that might exist within a person’s skull. This can be as simple as just visually sitting down in front of that patient and looking at them from a critical viewpoint, or as detailed as taking X-rays from all angles and making photographs part of the assessment as well.

When a patient is examined initially by the doctor, they need to look at their face, their posture, their neck, and shoulders as well. Here is the first part of proper treatment planning for any orthodontic or craniofacial pain case. Are the eyes even? Are the ears level? Is the sclera more evident on one side or the other? How does the jaw open – does it open straight or does it swerve to one side upon opening and closing?

Although this extremely basic analysis seems mundane, it is quite useful in determining the outcome of a case. For example, if the eyes are not even or level, then the sphenoid bone is not level, which leads to imbalances in the jaw bones (condyles) and so moving teeth might make this imbalance worse and cause pain. If the ears are not even, then it is highly likely that the glenoid fossas (jawbone sockets) are not level and performing orthodontics on this patient could end up pushing the condyles deeper into the disc on one side or the other. creating head and neck pain. The analogy is this: If the front-end alignment is off with your car, there really is no point in putting two new tires on the front of the car. So, if the teeth are moved around by orthodontic treatment and the skull is not in good alignment, then further distortion can occur which will lead to pain in the head and neck. From the diagram, distortions from the cranium can affect the shoulders, hips and through to the feet.

To do the best orthodontics possible, it is important to have the dentist understand craniofacial asymmetry and what to do about it. Most regular dentists are trained to use the RPE (Rapid Palatal Expander), however, this device will not level bones that are not in good alignment to begin with. The RPE will just widen what is already there and widen the asymmetry which is detrimental to the patient’s overall health.

There is a particularly useful device called the ALF (Advanced Lightwire Functional) that will nicely align the cranial bones given enough time and patience. Unfortunately, there are only a few dental practitioners out there who have the training and understanding of how the device works. It is NOT a palatal expander, not at all. It is a quite simple device that levels the bones within the skull, achieving balance and stability. Another analogy: it opens the vise grip on a person’s skull so the bones can settle in more balanced. It’s as simple as that! If you have any questions for our team or to schedule an appointment, we welcome you to give us a call at 703-821-1103 today!

The post Why Should We Look at Facial Asymmetry? first appeared on Sleep & TMJ Therapy.