You got TMJ?

Most people don’t think too much about their joints or how they work, until they start to hurt. Often they are perceived to hurt right where the pain is. But there are ways a joint might be hurting but not hurt. You could research the number of women, especially, who have languished in TMJ pain, depression, and suffering; going from specialist work-up to specialist work-up: taking pills, getting shots, having chiropractic adjustments, rehabilitation modalities, and psychiatric or psychological sessions; even following “special” diets, receiving acupuncture treatments, seeing egregious dentists, visiting neurologists, orthopedic surgeons, and epidemiologists. Thousands of dollars and months or years later they still, suffer, suffer, suffer with undiagnosed TMJ related pathology.

Of course you do have a TMJ, ( a TemporoMandibular Joint).  If I were to say the TMJ is a ginglymoarthroidial joint, you might suspect it could cause a lot of trouble. It allows you to eat by chewing or masticating. A fantastic historical perspective on it is Richard Wrangham’s, Catching Fire: How Cooking Made Us Human . The TMJ’s functionality also influences prosody (the rhythm, stress, and intonation of speech).

Its symptoms are not always recognized but getting the right treatment is the real bugaboo. However, if you are lucky enough to be correctly diagnosed at the onset/outset, the most complicated part of TMJ pathology is simply receiving competent, efficacious treatment by a qualified specialist.

The truth is, just finding a dentist who can make and then adjust a correctly fitting appliance can be a truly toilsome assignment.

Bruxism and clenching may be part of some TMJ histories and may be reasonably easy to address if that’s the only issue. Trauma may ensue from the chronic parafunctional activity  challenging the neurological (mechano receptors and free nerve endings) and mechanical forces (lever systems) mentioned in prior blogs. Except when the teeth are touching (occluded), mandible activity and posture is entirely a function and result of the other stomatognathic structures (mouth parts , however you wish to define them, upper (maxilla) and lower (mandible) jaw, pharynx, and many other structures) involved in mastication, deglutition, and speech.  Even if you bite your cheek or tongue you may have temporary mandible dysfunction (many dentists prefer to call it TMD but for our discussion we will stick with TMJ).

The hyoid bone and its attached structures are very often over looked as “a” or “the” primary place to look for the “clue(s)” for making the accurate diagnosis.

The genome project is fast underway trying to find out WHO and WHAT we really are. But until some researcher finds the “TMJ-stomatognathic” gene comlex(es), we have to look a little more “mechanically” at a patient’s pathology. Most people think of bones as determining our posture and our physical “look”. The hyoid is one of them but probably few people know of it or its role in our physical and emotional lives.

TMJ can begin with any number of physical traumas: such as auto accident, sports, fall off a bike or over a broken sidewalk, orthodontic brace removal, but also from poor posture; some form of what I would call a compensatory forward head posture.  What’s important is to recognize that every pain you have should be diagnosable; and the diagnosis, if properly explained to you by a competent healthcare professional, should make sense to you so you believe and understand what TMJ you have.

My next blog will discuss: Posture and the TMJ headache.