Dr. Chris Anderson is a Pankey© Institute trained Dentist.

What is TMJ?

TMJ stands for "Temporo-Mandibular Joint". Your temporo-mandibular joint is the hinged joint which connects your jaw to the temporal bones of your skull. A problem or disfunction of this joint is referred to as TMD or Temporo-Mandibular Dysfunction. While not totally accurate, many times, the terms TMJ and TMD are used interchangeably to describe Temporo-Mandibular Joint disfunction.

The top diseases associated with Temporo-Mandibular Dysfunction (TMD) are:

  • OMD (Occluso-Muscular Disharmony)
  • Physical damage to disc or ligament of the joint
  • Osteoarthritis
  • Avascular Necrosis
  • Progressive Condylar Resorption
  • Arthritis
  • Osteochondritis Dissecans
  • Infection
  • Lyme Disease
  • Cancer
  • Cyst
  • Others….
  • Nearly 80% of TMD is caused by OMD. This is good news for most people who suffer with TMD, as it can usually be solved with the proper therapies.

    OMD (Occluso-Muscular Disharmony) is a condition whereby the teeth, muscles, joint, and central nervous system are “out of sync”. The mouth is a machine, no different than any other complex machine. If one portion of the machine is not functioning correctly, the rest of the machine suffers. In the case of the mouth, this can mean sore muscles, tiredness, headaches, sore teeth, worn, broken and loose teeth, painful joint(s), noisy joints (popping or clicking), ear aches, etc….

    This “machine” of ours is comprised of teeth, muscles, bone, joint, ligaments, and a brain that controls it all. A change in any one area will affect the others. The easiest part of this machine to tune is the teeth. We cannot easily make changes to the other parts (without surgery). By affecting a change to the teeth, we can effect the other parts of the system and improve the "machine's" function.

    So what therapies are available for OMD?

    The first and most common is splint therapy. Splint therapy is a way to artificially create an ideal bite to create harmony in the system. Many times, teeth get in the way of the joint properly seating; when this happens, muscles have to brace and work harder to stabilize the joint. A splint can correct this issue and allow the muscles to relax and seat the joint into a “fully seated joint position.” Splint therapy helps the dentist figure out what is happening with the system. This treatment is diagnostic, but can also be therapeutic. Splints are more than a piece of plastic your dentist sends off to a dental lab be made. They require extreme precision and skill to tune to create a positive change in a patient’s musculature and joint. Splint therapy can take multiple visits over many months.

    Another method of OMD treatment is DTR or Disclusion Time Reduction Therapy. A little background information is needed to explain this: Every tooth in the mouth is connected to the bone via a periodontal ligament (PDL). These PDL’s give sensory information to the brain that then send signals to the muscles. If teeth hit at the wrong time, then muscles get information telling them to become hyperactive. In contrast, if the correct teeth hit at the right time, the muscles get signaled to relax. Hyperactive muscles can become painful. You know that burning, sore sensation in your muscles after working out? That is caused by Lactic Acid. This same process can occur in our chewing muscles.

    Most dentists continue to use a century old technique of looking at someone’s bite with ink paper. This is an entirely subjective way of determining force and timing of the bite. While it may suffice for a single filling, this technique cannot measure the entire bite at once. Also, there is no quantitative data using this technique, and many times, dentist’s incorrectly adjust patients teeth and restorations because they are interpreting bite marks incorrectly.

    With the proper, relatively new technology, it is now possible to see the timing and force of someone’s bite, measure the muscle activity, and obtain objective, reproducable data. Using the Tekscan (TScan) Digital Occlusal System, a digital bite analysis system, allows a trained dentist to quantitatively measure a patient’s bite force and timing. Combined with an EMG (electromylogram) that measures the electricity going through the muscles, we now can really see what is going on in the patient's bite "system". Using this data, a trained dentist can properly and conservatively tune the bite to cause the muscles to relax and seat the joint. This creates harmony in the system and a reduction or elimination of the TMD symptoms. Patients and their dentist no longer have to trust subjective interpretation of ink paper marks. The Tekscan system gives the patient and their dentist objective, measurable, comparitive, reproducable, and graphically displayed before and after data!

    In many cases, it is important that your dentist "look through" your joints, to ensure no pathology exists. Current technology allows 3D imaging to be done in minutes using CT Scanning technology, such as the Instrumentarium OP300 Maxio, which our office has. Using a CD-Scan and the proper software, we can look through your "Temporo-Mandibular Joint" (TMJ) a millimeter at a time.

    Our office regularly employs the use of all these technologies.

    Therapies for the other 20% of TMD include, but are not limited to, splint therapy, physical therapy, medications, orthodontics, surgery, arthocentesis, botox, and others.

    A thorough evaluation of the patient, history, range of motion, imaging (3D), listening to the joints, and review of the bite should be done prior to any treatment of TMD.

    Please call our office to schedule an appointment should you have the need or desire to treat your TMD issues. Note that there are TMD forms on the Forms Tab that you will need to complete.

    Here is a one page summary of TMD issues that you can print out and keep for later reference.

    Below is a snapshot sample of the graphical results that can be obtained from the T-Scan device: