The TMJ: A Most Unique Joint
The temporomandibular joint (TMJ) is the most unique joint in the whole body as it is two joints in one. The two joints, one on each side of the head, are connected by the jawbone. One joint may influence the function of the other joint. Because they are fused in the midline, this means that you cannot move one joint without moving the other.
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TMD: The Great Imposter
Chronic recurrent headaches as well as facial and neck pain are a common occurrence in millions of North Americans. in addition, people frequently suffer from ear symptoms including pain, ringing, buzzing, loss of hearing or clicking or locking of the jaw which can make chewing, speaking or moving the jaw painful or difficult.
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The Connection Between TMJ and OSA
The core of an evaluation for TMD and/or OSA at the “Center” is founded on the well documented co-morbidity of TMJ Dysfunction, headaches and sleep disorders. Many times a clinician will evaluate and treat a patient who has symptoms or complaints of head or facial pain without first evaluating the airway or patients sleep.
Seventy percent of patients with sleep related breathing disorders clench and grind during sleep and they do it with 5 times more force than they would when awake. There is also no motor muscle response in the unconscious state so the patient grinds or clenches all night. The resultant stresses on the jaw and muscles of mastication can produce significant discomfort. The origin of the pain however is the clenching in response to an airway problem such as Obstructive Sleep Apnea (OSA). The reduction of symptoms and TMJ rehabilitation therefore requires that we develop a patent airway and reduce parafunction (clenching and grinding) during sleep in order to heal.
The origin of TMD symptoms can also be a structural problem elsewhere in the body that manifests itself in the jaws. Clenching in response to foot pain or back pain for example will stress the jaw joints and result in pain in the head and neck area. That is why we believe that a proper diagnosis and emphasis on origin rather than symptoms is the key to successful treatment.
