Your patient is in pain, has difficulty swallowing, is in constant fear of triggering the pain, cannot sleep in certain positions and is posturally eccentric. Dizziness and headaches are present despite being seen by five different physicians including a neurologist, otolaryngologist, psychiatrist, internist and general practitioner, all with no specific diagnosis or effective treatment.
Some agree that there may be a combination trigeminalglossopharyngeal neuralgia, or even psychosomatic problem that will probably require at least partial resection in the nerve trunks. Presently the patient is taking Dilantin®, muscle relaxants, anti-depressants and analgesics with only minor relief, and symptoms are increasing.
Upon the patient's opening of the mouth for his regular dental exam and recall, a lateral jaw deviation and a clicking of the jaw joints is detected. Further, TMJ craniomandibular examination results in discovery of other pertinent symptoms. He starts non-surgical TMJ therapy and after just one week of wearing the oral removable orthopedic appliance and one office visit, the patient demonstrates dramatic improvement in all areas of head, neck jaw dysfunction and pain. Presently, the patient goes off all forms of medications and the possible plans for neurosurgery have been cancelled. This case is not hypothetical. It is a true case presentation of a patient who had been seen for many years by his general dentist who recently learned to recognize that jaw clicking and deviation was abnormal.
TMJ dysfunction, also known as TMD syndrome, problems have often been described as the "phantom syndrome" and are often confused with a multitude of other disease entities. Statistically more and more patients are seeing medical specialists for strong head and neck symptoms, which in many cases are of TMJ dysfunction origin.
Otolaryngologists, neurosurgeons, orthopedists and chiropractors are often unable to determine the cause of their patient's pain and dysfunction symptoms. There are many patients who stated they were willing to face surgically invasive procedures in hopes of reducing the pain, constant irritation and ultimately the psychologically debilitating factors preventing them from enjoying a pain-free existence.
TMJ symptoms of the number of patients who are eventually treated show dramatic improvement, if not complete resolution of the complaints, if there are fracture or organic joint disease factors.
TMJ anatomy, physiology and biokinetics are comprised of many inter-dependent variable factors and practitioners who have not had formal TMJ therapy training could easily be discouraged reading through any number of TMJ journals because of the strong discipline and dedication it would require to get through it, understand it, and ultimately apply the information gathered. The most important service a practitioner can provide is to at least diagnose that something is not functioning properly or recognize that a patient is suffering from symptoms which a physician cannot resolve.
Just by the dentist recognizing what the symptoms are and by taking the first step, afflicted patients invariably look at the diagnosing dentist as a heroic figure. Finally, they feel relief from their great pain and dysfunction is now a strong possibility.
A very simple three step test can provide confirmation of suspected TMJ dysfunction symptoms:
- Look -- popping, clicking and jaw deviation upon wide opening.
- Listen -- use stethoscope for detecting rasping or popping sounds.
- Feel -- touch muscles of the face, head, neck and the joints themselves for any soreness.
While this may appear to be an over simplification of detecting problems in this highly complex system, it is probably the most direct.
It is gratifying to know that unless there is organic joint disease, fracture or disfigurement, most cases can be improved upon greatly with non-surgical, non-invasive methods. Adjusting the occlusion is not one of them, unless all other parameters have been addressed.
Any patient who demonstrates any head, jaw and neck symptom that cannot be identified should signal that TMJ dysfunction must be taken into consideration. Much of the time the suspicion is correct. Most practitioners who have utilized the three-step method are discovering symptoms of patients that for many years have gone undiagnosed.
If you're interested in TMJ treatment, call us at 1-866-970-0441. We'll put you in touch with a great dentist today!