As on of the only non-dental TMJ specialists in the country, Dr. Scoppa is uniquely poised to provide holistic and results driven treatment plans to his patients suffering from TMJ pain. Sometimes this is stand-alone treatment within his clinic, sometimes it is co-management with a dentist or orthodontist, myofunctional therapist, or other professional. However, it ALL starts with the right diagnosis, and hearing what the patient actually wants out of care. Some people with TMJ pain just want to get out of pain (easier and cheaper), others want to address the common causes of TMJ pain (more expensive and a longer process).
Unfortunately the world of TMJ treatment is a mess, and difficult to manage for patients. Most professionals don't really understand the mechanisms we describe below, the underlying causes of TMJ pain and dysfunction. Rather, they have 1 treatment they throw at all patients suffering from TMJ pain, and then cross their fingers. How can you treat TMJ pain without diagnosing the underlying causes of TMJ pain? Kudos to you for taking the time to understand your condition, and if you need further assistance we do offer Zoom case reviews for those that are not in the Seattle area, where we diagnose your condition and list potential treatment options. Or, we can go over treatment plans you've been offered, and based on the diagnosis provide insight into the one we feel would be the most beneficial in regards to your needs and goals.
Without further ado, here are the most common causes of TMJ pain!
Disc derangement: The TMJ is comprised of the condyle of the mandible (jaw bone) which sits in the temporal bone of the cranium. In-between the jaw bone and temporal bone is a small disc. When you open, the jaw bone rides this disc forward. If there is a problem with the way the jaw bone sits on this disc, or if it's off the disc, we call that disc derangement. It's a common cause of TMJ pain, and if you have clicking or popping when you open or close, or a jaw that goes off to one side when you open, you likely have it.
Bite problems, grinding, clenching: The way your teeth articulate together has an impact on where your jaw bone sits. It's important to remember that misaligned or crowded teeth are a symptoms of a larger dysfunction, which is why most cases of orthodontia relapse within a few years (they only treat the crooked teeth, not what causes the teeth to become crooked or crowded). Grinding and clenching can create bite problems, but can also cause alot of muscle pain and asymmetrical muscle tension within the head and mouth. All of which can lead to TMJ pain.
Maxillary underdevelopment: The bone where your upper teeth connect into, which is also called the mid face, is called the maxilla. Maxillary underdevelopment is common, and if you have a narrow palate, crowded teeth, or if your tongue seems too big for your mouth (it's actually that your mouth isn't big enough for your tongue), you probably have maxillary underdevelopment. This will often cause the lower jaw to become pinned back, causing TMJ pain.
Tongue dysfunction: The tongue attached into the TMJ and the base of the skull, and when it's in the correct position it pulls the jaw down and forward (which is a good thing). However, when the tongue is the wrong position, the jaw is jammed back and up, leading to jaw pain.
Ascending influences: Many areas of the body have a profound influence on the way our teeth come together and the way our jaw articulates with our skull. The feet, pelvis, SI joint, neck and cranial bones all factor into the bite and condyle position of the jaw. Sometimes correcting these issues will fix the TMJ pain and dysfunction, sometimes more is needed, but if you try and address the TMJ pain and dysfunction without addressing potential ascending influences, it will likely fail.
Cranial dysfunction: Although it's difficult to find someone that is really skilled with cranial work, or craniopathy, finding a good craniopath can be a goldmine for someone suffering from TMJ pain. The teeth connect into the skull, as does the TMJ, making cranial work a vital part of the process when it comes to TMJ pain. If there is dural tension within the cranium which creates asymmetrical pulling, or if there is vertical imbalance between the two temporal bones, TMJ pain will often be a symptom.
Is your practitioner aware of these common causes of TMJ pain? Make sure you're getting a thorough assessment from someone that understands this condition, not just someone that has "TMJ" on their website. This will save you alot of time, money and heartache in the long run.