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TMJ

So what’s TMJ?

TMJ India, TMJ Treatment In IndiaTMJ is the name of the joint that the lower jaw forms with the skull. It’s a hinge joint, just like the hinge of a door. Apart from opening and closing movements, some sideways movements and twists are possible in this joint. Its full form stands as Temporo Mandibular Joint. Learn Phonetics’ at https://www.youtube.com/watch?v=bHgBZyb2KpY. It’s also called as the jaw joint. So essentially it’s a joint between two bones one of the skull called as the temporal bone and other of lower jaw called as the Temporomandibular joint.

How do you feel it?

Put your fingers in front of the ears in the middle and open and close your jaw. You feel something moving that’s tour joint. Evolution wise, it grew from a small piece of cartilage named as Meckel’s Cartilage, while the original jaw, during the Reptilian age of evolution, receded to become ear bones or ossicles responsible for hearing. At that time, the jaw used to do the job of hearing through vibrations, like it’s done still in snakes.

What does it look like?

It’s like a ball and socket joint. Ball is shaped like a fist. And its housing or socket is similarly shaped.

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Fist like TMJ sits into the blue part a socket shaped similarly, into a bone of skull called as the Temporal Bone.

Why is it such an important joint?

It’s such an important joint, because the literature based on observation and cures suggests that this joint could be the cause behind several medical diseases with no cure without drugs. Over 80 years of observation suggests this. Chronic body pains to Respiratory disorders, to ENT problems to Kidney problems to Eye, Nose, Gynecological, Psychiatric and even Cancers have been blamed to this unassuming joint.

What could be the cause behind it?

While there have been several theories afloat about this, all make sense or make sense partially. There is a wide acceptance being gained by a theory that I proposed some years ago, which I named “Arora’s Infratemporal Catastrophe theory”.

Various theories are as under:

1. A.C. Fonder’s stated, that,Under the mentorship of dental research group of Chicago, from 1940’s to 1980’s, Jack Stenger., Jim Ricketts, using cineflourography and other techniques and A.C Fonders, did bodily postural studies, along with Casey Guzay, a student of Physics, medicine and Engineering and they concluded a “Quadrant Theorem”, where they described the role 136 muscles above and below the mandible pivot the jaw and apex of the combined control of muscles is located at Dens, between the Atlas and the Axis vertebrae.

The National Heart Lung and Blood Institute (NHLBI) of the National Institution of Health (NIH) published CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS. This report considers the entire spectrum of disorders related to temporomandibular disorders source: Wikipedia.

2. Another theory suggests that due to misalignment of teeth, the muscles of mastication get tired and their work is now shared by adjacent muscles of face and neck. This extra work by these muscles is the cause of various orofacial pains-neuropathic, myalgia’s etc. Seems difficult to understand, nevertheless this is a theory.

3. Still another theory suggests that, it is the misalignment of jaw that leads to misalignment of jaw muscles, which leads to misalignment of other connected parts which leads to the misalignment of next set of muscles and so on. This causes a cascading mechanism and hence the entire body goes into misalignment, spends more energy to maintain balance or homeostasis, both at rest and work. This leads to a greater wear and tear of the body. This not only applies to muscles, joints but also the trachea and esophagus, the wind and food pipe and underlying fascia, visceral organs including blood vessels, nerves and the autonomic nervous system. Entire body posture and alignment goes haywire.

Seems, plausible, and is seen frequently in cars. A slight misalignment causes a massive load on the engine and various mobile parts of the car.

4.Infratemporal Catastrophe theory” by Dr. Sanjay Arora,
Infratemoral catastrophe is an event into the infratemporal fossa and the space behind it, due to the medial displacement of the disc, due to which there is a literal churning of the 17 structures packed in one cubic inch of that space. Essentially, it comprises of some very important Cranial Nerves and veins and arteries. Largely number 5 to number 12 cranial nerves, meningeal artery, and internal carotid artery, Internal Jugular vein (the main drainer of bad blood and whenever it is affected, it is considered to be the main cause behind the Multiple Sclerosis), sympathetic trunk, parasympathetic fibers, C1,and C2 fibers and in the middle of all this lies the lateral Pterygoid muscle, already acting as a churn in a pathological joint. This is the first muscle to get deranged during a TMJ Disorder, and is literally lying between all these most vital structures.

Now the closest with .25-.5cm zone on the inner circumference of the mandibular fossa or the housing of the fist like ball of the joint lies backward forward- are structures-Internal Jugular vein (IJV), accessory or the 11th cranial nerve, sympathetic trunk, c1, and c2 fibers and the middle meningeal artery (MMA).

Next in .5-1cm zone lies the Vagus nerve, Internal Carotid Artery (ICA)-the fresh blood bringer to the brain, parasympathetic fibers.

According to me, the MRI images in motion, that is Kinematic MRI’s clearly show that during a type of TMJ Disorder where there is a medial migration of the disc, or the inward displacement of 1.75-2 inch disc, almost half of it slips into this space. Although, the disc is separated from this space on the inner side by a capsule, its really very thin and stretches and probably tears allowing the jerky disc to come directly into contact with these structures or pushing them, jostling them with a reasonable energy.

Therefore depending on the exact direction, let’s say its backwards, due to irritation of IJV –it should lead to Multiple Sclerosis, if a little forward, due to irritation of ICA, Parkinson’s or hypertension, somewhere in between due to irritation of the eleventh nerve, head malpositioning, causing chronic body pains (mechanism explained a little ahead), and chronic respiratory problems and allergies, even kyphosis and scoliosis-the bends in the body or the slouches, due to number 5 nerve irritation, which lies in the forward area- the Trigeminal Neuralgia, the Neuropathic and the atypical Oro-Facial Pains and Myalgia’s, the Myofacial Pain dysfunction syndrome or MPDS, or the vascular pains due to irritation of MMA and the various other blood vessels or the Sympathetic Trunk and PS Fibers, which may also be responsible for the Psychiatric Complications.

Mechanism by which Chronic Body Pains are caused:

The irritation of the first nerve, which is the closest – the eleventh cranial nerve, causes, head to mal position on the center of gravity (COG) of the body. This happens because, this nerve essentially controls just two muscles, one in the neck- a large one, the Sterno-Cliedo Mastoid, and the upper shoulder and neck muscle- the large Trapezius. These two muscles, amongst themselves, in assistance with some vagus nerve fibers, intertwined in the accessory nerve control the position of the head on the COG. Irritation of one or both nerves accordingly shifts head to one side or forwards. This leads to almost three to five times increase in weight of the head. In Physics, this is called as the apparent weight increase. This leads to the head load either falling on back and legs in straight framed people or neck and knees in curved framed people. The muscles of these region of joints, eventually tire up and one initially may suffer from myalgia’s and spasms, and then the joint and neuralgic pains or loss of sensation and function due to disc displacement in some joints.

Mechanism of Respiratory Problems and allergies:
The above act of head mal positioning also creates a twist and bend in the windpipe or the trachea. This leads to a turbulent flow of the air, instead of the laminar flow. This causes micro-irritation of the tracheal passage. This irritation causes inflammation leading to formation of

  • Fluids, which causes one to perpetually trying to clear the throat.
  • Redness, or the engorging of blood vessels and opening up of the capillaries, leading to easy access of allergens into the blood stream after diluting in the gas dissolving fluids of the tracheal passage.
  • Swelling, which leads to further narrowing of the tracheal passage. This leads to further increase in turbulence and pressure to the passage of air by four times. This is described in physics in the Poiseuille’s law, which states that whenever there is a narrowing of the diameter by one unit, the pressure of the fluid passing through that passage increases by four times. This leads to either Asthma like situation where smooth muscles are incompetent and Sleep Apnea where the muscles are competent.

Similarly, severe breakdown of muscles can explain autoimmune disorders and deeper aspects beyond the scope of this article, can even explain malignancies/cancers.

To my mind, this is a complete hypothesis, which can explain the most diseases, including those of ears, eyes, hormones etc.

What is TMJD?

It is the disorder of TMJ, expanded it says- Temporomandibular Joint Disorder or Disease. The term is however not really defined clearly as per me. I make an attempt here to define it.

TMJD can be defined as a disorder of

  • Muscles of mastication, – MPDS (Myofacial pain dysfunction syndrome, Orofacial Pains, Myalgia’s
  • Anterior or forward disc displacement- MPDS may overlap here, with limited mouth opening.
  • Medial or inward disc displacement- Body pains, MS, Parkinson’s etc., Respiratory disorders etc.
  • Antero Medial disc Displacement –MPDS, Trigeminal Neuralgia, Oro-facial pains, Neurological, Neuropathic, and Neuritis etc.
  • Joint Arthralgia’s or, jaw clicks and deviations depend on the involvement of bones mostly due to time lapse-Arthralgia will be seen.
  • Pre-TMJD stages can have Bruxism, Clenching and Sleep Apnea, dental disorders. They may continue once TMJD sets in.

So how do I get my TMJ Cured? Do I need to go for TMJ Surgery? Are there some TMJ Exercise’s that can help me? What is the success rate of TMJ cure?

The answer to the last two is Big No and No again. Surgery is and should the absolute absolute (repeat word is for stress) last resort and at Sanora TMJ treatment Center TMJ Surgery is the last resort, in fourteen years we have not resorted to a single surgery with over one thousand (1000) cured TMJ cases, and according to only when there is ankylosis (fused bone) or fracture. Rest all times; it’s just that you are yet to reach the right specialist. Almost all TMJ Disorders respond to Neuromuscular or TMJ dentistry without fail.

Success Rate of TMJ Cures/Therapy: It is the Doctor’s inability if his success rate is less than high 98% in curing TMJ Disease/Disorder. We also have had one failure in fourteen years out of thousands of cases. Anybody who broke the cycle wasn’t considered as a failure.

 
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Place your tongue for 30-60 seconds at the place where it touches on the palate, when you speak “N”
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Right/Left slide, without clenching force, of lower jaw.
 
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Opposite side Slide of the lower jaw.
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Gentle circular massage on Temple muscle called as Temporalis.
 
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Press the jaw backwards while pushing the lower jaw forwards.
 

So, in a nut shell, exercises help but only should be used as an S.O.S. Myalgic or TMJ symptoms are to be taken seriously as it can affect your body to your psychology. It needs an expert, even if local pains are minimalistic. It is a serious disorder if you consider its participation in causation of other body disorders, (ref Infratemporal fossa Catastrophe). Exercises can only help alleviate local symptoms for a short to medium term. Don’t forget to notice other changes in the body once you become a TMJ Disorder patient.

How can I get my TMJ cured?

Follow these steps

  • Search the net for a doctor with large, very large number of testimonials who are now without any plate, mouth guard or orthotic. Nothing removable in the mouth.
  • Go ahead talk to lot of such patients.
  • The doctor should be the one who avoids Occlussalequilibration that is balancing of the back teeth. It’s required extremely rarely and very minor.
  • The TMJ specialist attaches lot of importance to the front teeth.
  • TMJ treatment is costly and takes a number of hours.
  • Has definitely instruments like T-Scan, Bio-EMG, Biojva, Jaw Tracker, Isometrics and Mat Scan, and uses them copiously. A best TMJ dentist or hospital does not work on may be’s and assessments, it’s too dangerous to try curing TMJ by the eye.
  • Go ahead and trust the doctor’s treatment plan completely now.

Success Rate of TMJ Treatment:

A good 97%. But remember 3% of times it would produce no relief. With mouth guards or orthotics, to be precise- Cranio-Sacral Orthotic, the success rate is merely 70% and they can break adding to the cost, cause teeth to shift and may produce bigger damages if left for over 1-3 months. A perfectly balanced orthotic with above tools, works out to be pretty costly, around a 1000 dollars and may work out to be cost ineffective. One must avoid orthotic and straightaway go for tooth angulatory changes on the recommendations of a doctor who fulfills the criterion given above.

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