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TMJ vs TMD — The Difference

Temporomandibular Disorder – TMJ vs. TMD

Most everyone has heard of “TMJ” and most associate TMJ with jaw issues – usually clicking noises, pain when chewing, and sometimes the jaw locking in place, but few realize that ‘TMJ’ actually refers to the jaw joint or ‘temporomandibular joint’. TMD or Temporomandibular Disorder is the general term dentists use to describe misalignment in the TMJ. According to the National Institute of Dental and Craniofacial Research, more than 10 million Americans are affected by TMD, and most commonly; women. Of those, symptoms range from mild to severe, and about 15 percent have more severe symptoms that require professional treatment.

Looking TMJ in the Mouth

The temporomandibular is the joint located to the front of the ear, linking the jawbone to the skull. With TMD the muscles of the jaw and neck as well as the bones of the skull and face can be affected. In addition to recurrent issues in the areas of the head, neck, or jaw – the function of the whole body can become altered over time.

Although most people have relatively mild forms of the disorder, researchers point out that up to 85 percent of patients who suffer from severe TMD also experience painful conditions in other parts of the body. Some radiating effects of a misaligned jaw can include;

  • Inflammation
  • Arthritis in the TMJ – due to aging or trauma
  • Muscle Spasm –can appear when the jaw is held open for long periods – as in the dental chair
  • Postural changes – which can lead to back and shoulder issues
  • Fractures – at the time of injury, often undiagnosed
  • Breathing issues (sleep apnea)
  • Difficulty walking and foot problems (due to postural changes)
  • Digestive issues
  • Migraine headaches
  • Facial fatigue, swelling
  • Generalized stress and depression

TMD results from the jaw being out of position – a situation that can create intense pain in the jaw, ear, and head. It’s important to diagnose Temporomandibular Disorder as quickly as possible – particularly if there is pain, to alleviate the adverse side effects that can lead to long term health issues.

Treating the Milder Cases at Home

The most common jaw joint and muscle problems are short term and simple treatment may be all that is necessary to relieve discomfort. There are steps can be taken that may ease symptoms, such as:

  • Avoid hard, chewy foods
  • Use ice packs, or moist heat
  • Keep jaw movements to a minimum (no gum chewing)
  • Don’t stress out – take some time to relax and let the jaw mend itself
  • Once the initial pain subsides, incorporate gentle jaw stretching exercises

If pain persists and symptoms of TMD do not subside on their own, making an appointment with a holistic dental practitioner is the best way to address the problem. When properly diagnosed and treated TMJ can most often be resolved in a relatively short period of time, without the need for drugs or surgery.

When the Pain and Popping Persists

There are a number of treatment options a natural dentist might recommend – depending on the health of the patient and the severity of symptoms. The conventional approach to treating TMD is usually aimed at alleviating the symptoms; discomfort and pain. But natural dentistry focuses on rooting out and treating the cause. Therefore, treatment options considered are drug-free, nontoxic and carry no side-effects.

 

Resources:

Temporomandibular Disorder (TMD)

http://www.physio-pedia.com/Temporomandibular_Disorders

What Conditions May Overlap with TMD?

http://www.tmj.org/Page/41/23

Temporomandibular joint and muscle disorders

http://www.nidcr.nih.gov/OralHealth/Topics/TMJ/TMJDisorders.htm

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Holistic Dentistry Done Right

Who’s Afraid of a Little Dentistry?

 

It turns out that quite a few people are afraid of the dentist; up to 75 percent of adults report that they experience some form of dental anxiety. For the vast majority of dental anxiety sufferers, it’s the more invasive procedures – such as oral surgery – that really sets them off, while more routine procedures are much easier to deal with and provoke only a mild sense of anxiety.

 

Up to 10 percent of those same adults lean towards phobic on the fear scale, to the point that they avoid dental work until it’s too late. This, of course can lead to more severe dental issues resulting in the necessity of more time in the dentist’s chair, which then results in … more fear of the dentist. A vicious cycle for anyone trying to avoid the dentist. What’s the alternative for someone who experiences anxiety when it comes to dentistry? One answer is; sedation dentistry.

 

What is sedation dentistry?

 

Sedation dentistry describes the use of medication to induce a sense of relaxation in patients during dental procedures. Most patients choose the mildest form of sedative, making it possible for them to be awake yet still very relaxed (Conscious Sedation Dentistry). The opposite end of that spectrum is general anesthesia which induces complete unconsciousness. The full range of options runs from minimal – awake and relaxed, moderate – more deeply relaxed (may not remember procedure), deep – still aware but on the edge of consciousness and can be easily awoken, to deep sleep under general anesthesia. Sedation dentistry may also be appropriate for people who:

 

  • Have a low pain tolerance or very sensitive teeth
  • Require extensive dental work
  • Have anxiety associated with needles

 

Patients who chose to remain fully to somewhat conscious during the procedure are undergoing what is generally called ‘Conscious Sedation’. Although patients are not completely unconscious while undergoing Conscious Sedation Dentistry, many patients are so relaxed that they may nap through the dental appointment and very few associate any unpleasant memory following the experience. Some added benefits of sedation dentistry may include;

 

  • A shorter treatment time
  • Less jaw pain following procedure (particularly in people who suffer from TMJ)
  • More dental work can be done in a session
  • Less back/neck/shoulder strain (sometimes associated with sitting in a dental chair)

 

For sedation dentistry, a prescription medication is administered which induces a drowsy, relaxed feeling. This medication can be administered orally or intravenously (IV), depending on the desired results. The use of any sedation medication – with the exception of nitrous oxide – requires the patient to have someone available to drive them to and from the dental office, due to the relaxing effects of the medication that tend to linger after the procedure.  The patient’s vital signs are monitored throughout any procedure involving sedation.

 

Most Common Sedatives Used in Dentistry

 

Inhaled minimal sedation. This form of sedation uses nitrous oxide (laughing gas) mixed with oxygen which is inhaled through a mask over the nose. The dental practitioner is able to control the amount of sedation, and the effects of the gas usually wears off quickly.

 

Oral sedation. The level of sedation achieved using oral sedation can range from minimal to moderate. This involves the ingestion of a pill called Halcion, (related to Valium). This pill is usually taken about an hour before the procedure resulting in a drowsy wakefulness. A slightly larger dose produces a moderate level of sedation – the level most commonly associated with sedation dentistry.

 

IV moderate sedation. This requires the use of a sedative applied intravenously. It works quite rapidly and is readily adjustable by the dentist making it possible to regulate the dosage to a patients’ comfort level easier than some other sedation medications

 

Deep sedation and general anesthesia. Using the above method of application, medications are administered that result in near-to-total unconsciousness during the procedure. While under general anesthesia the patient cannot be easily awakened until the effects of the anesthesia wear off, or until they are reversed with medication.

 

Who Should Avoid Sedation Dentistry?

 

As with any medication there is a risk in taking anesthesia. When administered by an experienced dentist who has pre-screened the patient for any potential complication, sedation dentistry is quite safe. Some high risk groups should talk to a doctor before undergoing any type of anesthesia, including those who have a known heart condition, are obese or who suffer from obstructive sleep apnea. Other known risk factors include;

 

  • High blood pressure
  • Recent heart health incident
  • Uncontrolled hyperthyroidism
  • Angina pectoris
  • People taking antidepressants, beta blockers or cocaine

 

SOURCES:

Armfield JM, Stewart JF, Spencer AJ (2007). “The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear”. BMC Oral Health 7: 1. doi:10.1186/1472-6831-7-1. PMC 1784087. PMID 17222356.

 

Rai, K, Hegde, A, and Goel, K. Journal of Clinical Pediatric Dentistry, 2007; vol 32: pp 1-4.

 

American Dental Association: “Policy Statement: The Use of Sedation and General Anesthesia by Dentists.”

 

Joel M. Weaver, DDS, PhD, dentist anesthesiologist; emeritus professor, College of Dentistry, The Ohio State University; spokesman, American Dental Association.

 

American Dental Association: “Guidelines for the Use of Sedation and Anesthesia by Dentists.”

Reviewed by Michael Friedman, DDS on November 29, 2015

© 2015 WebMD, LLC. All rights reserved.

 

Kleinknecht RA, Thorndike RM, McGlynn FD, Harkavy J (January 1984). “Factor analysis of the dental fear survey with cross-validation”. J Am Dent Assoc 108 (1): 59–61. PMID 6582116.

 

Armfield JM, Stewart JF, Spencer AJ (2007). “The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear”. BMC Oral Health 7: 1. doi:10.1186/1472-6831-7-1. PMC 1784087. PMID 17222356.

 

Armfield JM, Spencer AJ, Stewart JF (March 2006). “Dental fear in Australia: who’s afraid of the dentist?”. Aust Dent J 51 (1): 78–85. doi:10.1111/j.1834-7819.2006.tb00405.x. PMID 16669482.

 

 

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The Chao Pinhole Surgical Technique (TM)

Well, if you’re the patient getting operated on, maybe you don’t think it’s so cool. Unless you’re the rare exception who likes needles in your gums.

But you should be excited, because this technique will allow your gums to be shaped with minimal risk, pain, and down-time. Its inherently minimally invasive and low-maintenance. There is no cutting or suturing, and healing is quick.

This technique was developed fairly recently by a man named Dr. Chao, and it is taking off internationally as the preferred method of gum shaping after periodontal or gingival treatment.

Note that this is solely meant to restore the gum line for the purpose of aesthetics and functionality. It is not gum disease treatment, and it must be done in a disease-free mouth. So this is something I’d do after my patient has successfully undergone therapy for gum disease and only needs the gums to shrink back up around the teeth.

It sure beats the traditional method, however, of grafting gum tissue from another area of the mouth.

Dr. Sperbeck, West Los Angeles

http://www.dds4smiles.com