TMJ pain and/or migraine headaches tend to have some or all of the following signs and symptoms.
Observable signs include:
- Locking or clicking of one or both lower jaw joints (TMJ), with or without pain.
- Limited jaw opening.
- Facial asymmetry with one side puffier than the other.
- A protruded lower jaw. This compromises the airway so the head is held forward (the forward head posture strains the cervical vertebrae – the thoracic and lumbar vertebrae must compensate, and now either one shoulder or hip is lower than the other).
The primary symptoms include:
- An intolerance of light, requiring sunglasses during the day, and difficulty driving at night.
- Headaches preceded by warning signs minutes to hours before the pain begins. The signs are in the form of colors, blurred vision, or dots in one or both of the eyes, or dizziness, and lightheadedness. The pain is restricted to one side of the face, and head – usually in the temples, back, or top of the head.
- The pain may travel to unusual areas such as in front, or behind the ears, and jaws, or in the sinuses; and there is chronic neck, shoulder, and lower back pain.
The jaw and headache pain are the result of chronic compression of one or both jaw joints. The joint becomes displaced posteriorly and affects the circulation of the external carotid artery.
The muscles and ligaments supporting the joints attempt to protect the compressed joint by splinting, or restricting the movement (similar to limping after spraining an ankle). If the compression is chronic, the muscles ultimately fatigue, and pain occurs.
The joints may become compressed from a variety of causes; however, three causes comprise the majority and are the most easily recognized:
- Accidents which tear or stretch the ligaments and muscles supporting the joints;
- Untreated misaligned teeth or jaw size discrepancies, which prevent symmetrical closure of the jaws. (Ultimately, one jaw becomes compressed because of the uneven pull of the muscles which close the jaw).
- Orthodontic treatment with a headgear to correct an overbite, in conjunction with removing the upper premolars (not lower premolars). This creates an upper jaw smaller in circumference than the lower jaw. The arc of closure of the lower jaw is now restricted, resulting in compression of one or both joints
Treatment is essentially directed at decompressing the joints and allowing the ligaments and membranes to relax. This allows the muscles to stop the splinting process, thereby allowing unstrained movement of the TM joints.
Since the spine helps splint the other joints of the body, Cranial Osteopathy is the treatment of choice before and after the TMJ appliance is fabricated.
In 1874, Dr. Andrew Taylor Still founded a new profession and named it Osteopathy. The word “Osteopathy” is derived from the words “osteo,” meaning bone, and “pathos,” meaning disease or suffering.
This does not entirely describe the true nature of our profession. Traditional Osteopaths do not focus exclusively on bones. Rather, we focus on recognizing an inherent intelligence that perfectly, and with precision, is working to establish wellness in the patient at all times.
This higher intelligence, which we call the “Health,” is conscious, precognitive, omnipresent and is a direct reflection of the Divine. The Health does not diminish, and is not affected by, disease. Dr. Still recognized this innate wisdom and, guided by it, in addition to a strong understanding of anatomy and physiology, developed the science of Osteopathy.
Dr. William Garner Sutherland, a student of Dr. Still’s, expanded the osteopathic concept by developing the cranial concept. He described a series of phenomena that work in response to the Health. These phenomena are an integral part of our teaching and a major focal point of our research.
Depending on the chronic nature and severity of the TM joint compression, and the causes, improvement of the symptoms will vary from weeks to months. The body’s healing tempo will dictate how long the healing process will take.
Once the symptoms are alleviated, a decision will be made on how to stabilize the joint in its unstrained position. This can vary from splints to orthodontics, to crowns, and bridges.
Prior to beginning treatment, a complete examination with appropriate tests must be completed to rule out that the symptoms are not due to tumors, aneurysms, circulatory diseases, or nutritional deficiencies. It is essential that we are certain the symptoms are of dental, and joint preexisting conditions, and not other origin.
TMJ Cranial Osteopathy Sequence Treatment
First Phase Treatment - Comfort Phase
The primary purpose is to eliminate the pain, clicking, popping, locking, headaches, neck aches, backaches, and other symptoms that are frequently related to a condyle that is improperly positioned in the fossa, and discs that are frequently displaced forward in the fossa.
The TMJ appliance repositions the mandible in such a position that the condyles are centered in the fossa, and any impingement of the tissues is reduced. The treatment time usually takes at least 6 to 12 months.
You will usually start to notice improvement of at least some of these symptoms within three days to three weeks after treatment is started; however, it usually takes at least 6 to 12 months for the injured tissues in the joint area to heal.
When TMJ dysfunction is due to displaced condyles; where the teeth used to fit together, no matter how good the occlusion looked, the Temporomandibular joints were not in the proper position, and when the temporomandibular joints are in the right place, the teeth will no longer fit properly.
This new mandibular position usually creates a more prominent chin, and a posterior open bite – the degree of which is related to the original depth of the overbite, and to the degree that the mandible had to be brought forward.
Second Phase Treatment
From the Comfort Phase of TMJ treatment, you will move into Second Phase treatment:
TMJ recall – If you feel fine, and have no symptoms when the splint is out, and can move your mandible back to its original bite position, you will be placed into “TMJ Recall”, and no further treatment is planned.
You should be checked on a periodic basis for a year or two to make sure you remain symptom free. If TMJ symptoms return, Osteopathic treatment, and reevaluate the TMJ appliance will be necessary.
It is important to understand that once clicking or trauma to the TM joints is present, the TM disorder is considered a permanent dysfunction because torn, or stretched ligaments will not completely heal (similar to knee and elbow joint injuries). Since the injury to the ligaments is permanent, occasional flare-ups are not unusual, and can be expected to recur during, or after treatment.
TMJ Cranial Osteopathy treatments are supporting the whole patient (Physically, Mentally and Spiritually) to learn the necessary tools to overcome the challenges of life. The true commitment of the Practitioner is to synchronize with the Health and treat the patient as a whole being.
Structural alignment is an important part of optimizing one’s health. I normally use NST as one of my main tools for this purpose.
However, cranial osteopathy is another highly effective intervention, if properly performed. I am fortunate to have Dr. Garcia working in our center as she is one of the leading practitioners in this field.
She also happens to be my personal dentist. She is one of the few dentists who have excelled in this type of therapy that was originally developed by D.O.’s.
Dr. Garcia has been able to help some of the most seriously ill patients that come to our office. She is a real blessing to have on staff.