Whom should you consult with for TMJ (Temporal Mandibular Joint) Syndrome first.

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If you suffer from TMJ, bruxism (teeth grinding or clenching), and experience the chronic tightness in the neck and shoulders and morning headaches that often accompany the condition, or the clicking jaw you may be wondering who you should see first.   TMJ can be a dental problem, but it can also be an expression of an old injury to the jaw, braces that were applied years ago, chronic gait problems, a lack of flexibility or perhaps, back problems that you had treated or do exercises to prevent may be the root cause of your jaw problems. If you ask for help on community health groups such as Facebook, you will realize there is no shortage of healthcare practitioners that claim they can help relieve the condition. There is a long history of dentists who over the years recommended expensive and restrictive bracing that ultimately did not help or worse, aggravated the problem.  Performing myofascial release treatment on sore and tight muscles often helps relieve the condition, but the tightness usually returns if the underlying problem has not been addressed. Visiting the chiropractor and having your spine adjusted may help too, but manipulations by themselves are not enough without muscle work and without a full understanding of why your jaw is problematic.  If you have already tried a number of approaches to the problem without long term success, you will want to read on. A complex holistic approach to TMJ is the more logical approach.  If you find a healthcare provider who can perform myofascial release to the muscles, cranial work to the bones that form the jaw socket and the skull, as well as someone who is looking at your back and legs and how it affects the jaw, you and your healthcare provider are likely to have a better outcome overall. TMJ treatment is often a team sport, since you may also need a dentist who can realign a bite that is working poorly due to an extracted tooth or perhaps, tooth grinding that is affecting jaw alignment at rest in conjunction with a holistic healthcare provider. If there are deep emotional problems that are affecting you at night, it may also need to be addressed with a counselor or psychologist. A chiropractor is often your best first choice for holistic physician who will look at you, your body mechanics, as well as your jaw.   By ignoring the body below the neck and jaw, you are ignoring many of the factors that affect the jaw, its alignment and how it functions. Chiropractors who use a multifaceted approach to TMJ are your best first choice for primary physician to manage the condition, since they can coordinate care between a dentist and other healthcare providers if needed. Below is everything you need to know about evaluating and successfully treating and either improving or resolving many jaw problems. Temporal Mandibular Joint Syndrome is commonly misdiagnosed as common tension headaches, sinus headaches, inner ear infections, dental problems as well as other functional disorders. Sometimes the problem is obvious with a jaw that cracks a lot or it may seem get stuck. The jaw is primarily a muscular joint and the muscles attach to the temporal bone ( the small skull bone above the ear) and the mandible (jawbone). The joint the mandible inserts into is the Temporal Mandibular Joint and a disc in this joint cushions movement of the jaw. Since the muscles in the jaw are what move the joint through chewing, talking, and other activities, pain syndromes can develop when these muscles dysfunction and cause the Temporal Mandibular Joint to become irritated. There are also known relationships between the Eustacian tube (which supplies air to the inner ear) and the upper cervical spine (neck region) which account for many chronic headache scenarios as well as earaches/ear infections. The lower back and gait system can also affect jaw function and alignment, because of the effects of the fascial system.


Neck Pain. Headaches which wake you out of your sleep or are present when you awake in the morning. Jaw soreness, especially in the morning. Jaw locking at times. Headaches lasting for days. Upper neck stiffness or kinking sensation. Jaw cracks upon opening or during eating. Ears that seem clogged or stuffed. Pain just below the ear on one or both sides, aggravated by chewing.


Although there are many theories about how most T.M.J. syndromes occur (trauma, grinding teeth, malocclusion syndromes, too much hard chewing, stress), there is little real scientific consensus on how the syndrome occurs, and even less on how to treat it effectively. Most of these syndromes develop over time with the onset of symptoms, often years after the actual dysfunction began. The joint is controlled primarily by muscles, and the syndrome is often a secondary effect of muscular dysfunction.


T.M.J. has been treated with numerous methods with varying degrees of success. Some patients were given night gards by their dentists and told to wear them daily. Others were treated with various chiropractic techniques, with varying degrees of short lived success. Still others relied on muscle relaxants and pain medication. The worst cases often opted for surgeries, expensive therapeutic regimens and even extreme forms of bracing, often costing thousands of dollars and offering little or no long term relief. Sometimes, aggressive approaches may worsen the problem.


A well accepted approach to treatment is Myofascial Release Technique. Simply explained; the jaw is a muscular joint and muscular dysfunction within the joint may cause the jaw to deviate from its normal alignment. If there was a way to cause the muscles to work properly again, with both sides being of equal length (as opposed to uneven pulling of the jaw muscles), theoretically, the joint will stay in proper alignment and should work properly. This is the reason Myofascial Release can yield consistent results in the treatment of T.M.J. syndrome. Myofascial Release Technique simply restores normal muscular function without the use of drugs, splints or surgeries. Over time, muscles develop scar tissue from overusage which shortens the muscles. Eventually, pain and stiffness are experienced at the muscular insertions creating the symptoms associated with T.M.J.. When the T.M. joint dysfunctions, the joints in the upper neck reflexly tighten creating the familiar T.M.J. headache in the morning (often mistaken for sinus headaches). Myofascial Release Technique’s yields consistent results by stripping away (by hand) the scar tissue and adhesions in the fascia surrounding the muscles allowing them to relax and the muscles in the jaw are no longer tight. Unlike most methods, the changes are instantaneous. Often the symptoms are gone quickly and chewing feels different because of the normalized alignment of the T.M. joint.


While myofascial release treatment is important, if the bones and articulations surrounding the region are dysfunctional, the effect of treatment may be temporary.   Spinal and extremity adjustments restore movement to the region and allow for proper function of the fascia and the musculature.   Gentle work on the cranial bones also known as cranial sacral therapy can restore integrity to the temporal mandibular joint which helps to stabilize the jaw as well.


Myofascial Release Technique’s offers a significant therapeutic advantage over other interventions for the jaw in treating this condition. Combined with manipulation of the jaw, spine and extremities, it will improve jaw balance and motion. The more stable the joint is, the better the expected outcome should be in treating the condition.  If there is a dental problem such as a missing tooth causing a malocclusion, the chiropractor and your dentist should work together as a team to balance the jaw.  Sometimes, it may be necessary to use a retainer or a soccer guard for more severe bruxism.