Living with TMJ

[toomuch]

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I'm starting a self-designed research project on how tmj disorders can interfere with the lives of students.

Actually anyone with some type of facial pain.

My motivation is due to the fact that many grad and health prof students cannot get dental insurance at all through their school that will pay for TMJ problems.

And ENTs will rarely deal tmj anymore

And the FPs refer students to TMJ specialists for their clicking jaw and the medical insurance company won't pay for their visits b/c these specialists are dentists. If anyone has stories please feel free to pm me or if you're interested in being a future research subject..

tm

 

[johntara04]

Ummm...Hopefully everyone lives with TMJ. If they didn't, how could they talk or chew? 🙄


😀

 

[DrJeff]

😉

Ummm...Hopefully everyone lives with TMJ. If they didn't, how could they talk or chew? 🙄


😀

Actually you better hope they're living with 2 of them😉

In general for many TMJ (or more appropriately TMD = Temporomandibular Disease/disorder), it gets viewed more as a low grade chronic disease than an acute crisis type disease. For many, many TMD patients, the discomfort they experience is readily manageable with standard OTC NSAIDs and quite often a source of warm heat (compress/shower water, etc). Top that off with a nighttime occlussal splint and thats how the majority of TMD patients are managed.

In SEVERE cases, where physical destruction of the TM Disc has occurred, then surgical intervention is needed. Unfortunately when a case gets severe enough that surgery is required, the results of the surgery are often quite less than 100% resolution of the pain.

Anecdotally, I have noticed in my own practice that TMD tends to effect middle aged females of upper middle to upper class socio-economic status far more frequently than any other age/social demographic out there.

 

[1992Corolla]

I'm starting a self-designed research project on how tmj disorders ...

For you sarcastic people...😀

My oral surgeon told me he stopped doing TMJ simply because of the fact that the majority of the cases were mental instabilities as opposed to actual problems with the TMJ.

TMJ problems can also be cause by clenching/grinding teeth. I know as finals near my back muscles tense up and I am constantly subconciously clenching my teeth. Stress is the major cause of clenching/grinding in students becaue of the workload/pressure to get grades.

Those are some areas to venture into I guess.

 

[DrJeff]

For you sarcastic people...😀

My oral surgeon told me he stopped doing TMJ simply because of the fact that the majority of the cases were mental instabilities as opposed to actual problems with the TMJ.

.

Very true, and it really shouldn't be much of a suprise to see that many of the "TMJ specialists" out there will use anti-depressants as a significant component of their therapy.

Then again you can get into a big debate about why/how/and if anti-depressants actually work, since its one of the few drugs where you can't do a blood test to check for serotonin levels or take a film to measure health/disease of depression. Do they really work because of pharmocology, or is it purely a psychosomatic effect???😕 😱 🙄

 

[johntara04]

Do they really work because of pharmocology, or is it purely a psychosomatic effect???😕 😱 🙄

Yes..😛

 

[1992Corolla]

Very true, and it really shouldn't be much of a suprise to see that many of the "TMJ specialists" out there will use anti-depressants as a significant component of their therapy.

Then again you can get into a big debate about why/how/and if anti-depressants actually work, since its one of the few drugs where you can't do a blood test to check for serotonin levels or take a film to measure health/disease of depression. Do they really work because of pharmocology, or is it purely a psychosomatic effect???😕 😱 🙄

good points👍

I think the same ideology/beliefs work for people wanting cosmetic surgery 'just because'. Every case is different.

 

[toomuch]

Do dentsists really prescribe anti-depressants?

I've always understood that there are many etiologies of TMJ, but who is the best person to diagnose it, even if one's etiology is related only to stress. There are many cases not caused by stress that do cause chronic pain unless diagnosed and treated properly, especially by musculoskeletal disorders.

Who can diagnose it?

 

[aphistis]

Do dentsists really prescribe anti-depressants?

I've always understood that there are many etiologies of TMJ, but who is the best person to diagnose it, even if one's etiology is related only to stress. There are many cases not caused by stress that do cause chronic pain unless diagnosed and treated properly, especially by musculoskeletal disorders.

Who can diagnose it?

TMJ/TMD is virtually always best diagnosed by a dentist.

Low-dose antidepressants can provide an analgesic effect in some chronic pain patients.

 

[johntara04]

Do dentsists really prescribe anti-depressants?

I've always understood that there are many etiologies of TMJ, but who is the best person to diagnose it, even if one's etiology is related only to stress. There are many cases not caused by stress that do cause chronic pain unless diagnosed and treated properly, especially by musculoskeletal disorders.

Who can diagnose it?

TMD is best diagnosed and treated by a dentist. TMD is also a very controverial topic. Some dentists swear by night guards and other feel they are worthless and believe more in physical therapy for the muscles and joint (read JADA August 2006). The more I read about TMD the more I feel that both are right. Each case is different and each case will require different treatment. It all depends on the patient. I am excited to learn more about this as my schooling progresses.

 

[toofache32]

Do dentsists really prescribe anti-depressants?

Who can diagnose it?

1. Yep. We also prescribe muscle relaxants and antivirals. We inject people with cardiac drugs (lidocaine) more than any other specialist.

2. Dentists or anyone else who understands the intimate interactions between occlusion, the joints, and the muscles of mastication (nobody else).

 

[ca_dreamin']

My motivation is due to the fact that many grad and health prof students cannot get dental insurance at all through their school that will pay for TMJ problems.

tm

We run into a similar problem here. We do have a physician in the immediate area who is very well trained in TMD, so our referrals go to him and the treatment is paid through medical insurance.

 

[Dr. Dai Phan]

I'm starting a self-designed research project on how tmj disorders can interfere with the lives of students.

Actually anyone with some type of facial pain.

My motivation is due to the fact that many grad and health prof students cannot get dental insurance at all through their school that will pay for TMJ problems.

And ENTs will rarely deal tmj anymore

And the FPs refer students to TMJ specialists for their clicking jaw and the medical insurance company won't pay for their visits b/c these specialists are dentists. If anyone has stories please feel free to pm me or if you're interested in being a future research subject..

tm

TMD is a discipline that we as dentists still do not fully understand. There are no specific treatment guidelines but rather based on what we were taught or read in the journals. At this current time, conservative reversible treatments are recommended and irreversible invasive approach are only for last resort. The proper way to treat TMD is:

1. Stress reduction (get a new husband, girlfriend...).
2. Medications ( muscle relaxants, NSAIDs, anti-depressant meds).
3. Self therapy ( massage with heat pad).
4. Avoid food that require hard chewing ( chewing gum, jaw breaker, beef jerky).
5. HARD occlusal splint that places the condyles in CR with anterior guidance. The appliance MUST have all teeth contacts to prevent super-eruption that can cause anterior and posterior open bite.

TMD is like having arthritis in your joints or diabetes. It is a chronic condition that can be managed succesfully without going into surgical mode. Surgery or injection the fossa with steroids are reserved in more severe cases and not recommended. I am sure oral surgeons think otherwise. DP