Posted by Clint on March 21, 1999 at 19:34:58:
In Reply to: tmj posted by Barbara A on March 21, 1999 at 03:57:17:
Dear Barbara,
I am a twenty year practicing general dentist who
has just begun to have cluster headaches. I have also
been priveleged over the last two years to have studied
under Dr. Peter Dawson (widely regarded as the
world's leading authority on occlusion and its
relation to TMJ like disorders) and his associates
in St. Petersburg Florida at the Center
for Advanced Dental Learning. They are a wonderful
organization.
Dr. Dawson et. al are not flashy, but are the best
educators that I have encountered in all of my years
of throwing money away at dental continuing education.
I was also priveleged to learn from Dr. Parker Mahan
at the University of Florida College of Dentistry,
who is also regarded as perhaps the world's leading
authority in facial pain and occlusion.
TMJ simply stands for Temporo Mandibular Joint, the
articulation of the head of the lower jaw (mandible)
with the cranium in the temporal area. Between the
two boney surfaces exists a cartilage disc that rides
between the head of the lower jaw and the skull as
we open and close our mouths. Put your index fingers in
front of the external opening of your ears as you
open and close slowly and you can feel this joint at
work.
Several different muscles have to function together
in order for our jaws to open and close in a coordinated
manner. If they don't, that disc can click or pop on
opening and/or closing. That is only a sign of instability.
But it is a warning sign.
When someone has "TMJ" one of two things is happening,
or they are happening at the same time: (1) They are
experiencing internal destruction of the joint, by
a condition such as arthritis, a tumor, or an infection
or even previous trauma. This can result in an inability
to open and close the mouth properly, or can entirely
change the bite. (2) Or they are experiencing the buildup
of lactic acid in muscles that are fatigued, because
a misalignment of their teeth will not allow the muscles
to rest properly when their teeth are closed fully
together. This can also cause clicking and popping
painful masticatory muscles, headaches (they can be
unilateral, or one-sided).
Stress is a factor in symptoms worsening or becoming significant
but is not the main factor. There are a number of ways to treat
the symptoms, including stress reduction, massage,
medications, and other techniques. But the cause is
instability in the occlusion, which results in tired,
fatigued overworked muscles and ultimately damage to
the joint. Of course, remember I said tumors, trauma,
and other factors may be involved.
Barbara, if you've gotten this far, let me say that
not just any dentist is trained or equipped to treat
or diagnose these problems. Most dental schools have
had woefully inadequate emphases in this area.
If you or any one you know needs a dentist to rule
out or treat TMJ, then inquire if the dentist has gone
to courses at the L.D. Pankey institute in Coral
Gables, Florida, or Pete Dawson's courses. There
are probably other good avenues of pursuing such
training, but for a dentist to be involved with either
of these organizations means they are willing to leave
their practices for extended periods to get the education
they are willing to make significant financial outlays
to get there, they develop wonderful relationships with
other like minded professionals from all over the
world. These organizations are for dental education
in the area of TMJ and occlusion what the Mayo Clinics
are to the ultimate in medical care.
You may write me at me email address (cwilk@iu.net)
if you have further questions. Barbara, are you still
awake? Ha! Hope I haven't gone on too long.