Temporo-Mandibular Joint and Muscle Dysfunction
The temporomandibular joint is one of the most complex joints in the body. No other joint has teeth that interfere with joint function. In many cases the teeth are actually in the way...in other words, where the patient bites, grinds, clenches, swallows, functions etc. is not where the jaw fits into the jaw joint. Most patients can get away with this, but some just can’t stomach this discrepancy. These patients will experience symptoms such as: jaw or facial pain, ringing or swishing in the ear, headaches, tooth wear, limited opening, etc. TMD is a very controversial and political (with the emphasis on the political) arena in dentistry. The evidence is clear (evidenced based) but many of your orthodontic program pundits (chairmen) will put down its’ significance in achieving ideal orthodontic tooth function. Orthodontics alone will not treat a TMD problem! If you are a TMD patient, you must go through splint therapy first; even then you are a TMD patient throughout the treatment stages, including orthodontic treatment post-orthodontics and retention. Thus, mounted models on an articulator will be required before, during and after orthodontic treatment and retention...followed by a possible equilibration. Often what makes any practice interesting (among practioners) is the controversy that ensues as to the best approach to a problem. Certainly the best approach to treating TMD is responsible for a great deal of acrimony and even “food fights” at the very least!