Going to the dentist is almost always about teeth, gums and dental health. But it can also involve the joint that makes the jaw work and avoiding temporal mandibular disorder (TMD).
“It’s fairly common,” said Dr. Eric Anderson of Anderson Dental Group. “With our retired population, a majority will have had symptoms at some point in their life.”
The disorder manifests in pain in the jaw joint itself (TMJ), down along the jaw, in the muscles of the face and head and even down the neck.
“The causes can be from be from derangement (problem) in the joint itself, from inflammation or trauma,” Anderson said.
The joint problem can arise from a misaligned bite, which sometimes comes from the loss of teeth. Bite adjustments, crowns, orthodontics, or, in more severe cases, a full mouth reconstruction can correct the problem.
Diagnosis begins with quizzing the patient about the primary site of the pain and its intensity. Anderson said several tests can determine if the pain is coming from the joint, the muscles or both.
He said many cases start with stress; with many patients clinching or grinding their teeth at night when they can’t control it. “That tightens the muscles. Some people are putting up to 200 pounds of pressure on their back teeth,” he said.
The disorder can cause extreme pain. Anderson said one woman came to him in so much pain she wept. On a pain scale of 0 to 10, she rated the pain at plus 10.
He gave her a device called an anterior discluder to stretch and relax the muscles. After just 10 minutes using the device, her pain vanished, he said. Patients can take the device home to use whenever they have a pain episode. Moist heat can also treat the pain as can several medications, Anderson said.
Sometimes, he also makes a splint for patients to wear at night to keep the joint in the proper position.
Anderson is in his 15th year of practice in Payson, taking over the business founded by his father, Scott, in 1971, who was for a time the only dentist in town.
“Payson is blessed with a wonderful group of dentists now,” Anderson said.
He added that science is discovering there is more and more of a connection between oral infections and problems elsewhere in the body.
“According to recent studies, bacterial infections in the mouth can increase the risk of heart disease,” he said.
He also pointed out that oral cancers account for almost 2 percent of all cancers and can afflict people who have never smoked or chewed tobacco. “If someone has lumps and sores in their mouth for 10 days or more, they should see their dentist,” Anderson said.
“Remember, prevention is the key and will save you money in the long term,” he concluded.
Physical therapy and TMD
A physical therapist can also help deal with TMD, according to Richard Staudt, master’s of occupational therapy and occupational therapy registered and licensed.
Staudt, who is with Rim Country Health Skilled Nursing and Rehabilitation, is also a Myofascial Release practitioner. He uses this specialized therapy to help clients suffering with TMD and its related problems.
“We look at their symptoms and evaluate the whole body alignment and posture,” he said.
Many TMD patients have ringing in the ears and popping and clicking in the mouth or head. The therapist can both feel and hear the pops and clicks during an exam, he said.
Staudt said any number of things can cause TMD. “Hip imbalances can contribute to jaw issues because of fascial connectiveness. Trauma anywhere in the body can result in the disorder because of the connectiveness,” he said.
Fascia is the web of uninterrupted connective tissues that “ties” our bodies together. Falls, whiplash, surgery, inflammation or poor posture can all damage or strain the fascia. Therapy includes gently stretching and moving fascia to make the tissues more relaxed and flexible.
Staudt said doing Myofascial Release therapy helps restore balance in the tissue.
“We re-educate the mind-body awareness to reduce bracing (clinching/grinding teeth) patterns,” he said.
Those using the Myofascial Release therapy learn both external and internal oral techniques to address TMD problems. “The objective is to bring awareness into the person’s tissues and functions without having to make irreversible structural changes,” Staudt said.
“We whole-heartedly recommend a dental health professional be involved if the symptoms are not resolved within a month,” he added.