Severe Bruxism/ Neuromuscular Dentistry/ Dental Sleep Medicine/ TrigeminoCardiac Reflex and SPG Blocks are all connected and part of the same system

Dr. Shapira TMJ 0 Comments

What is the common underlying link of all of these.  The Trigeminal Nerve and the Autonomic nerves of thee Sphenopalatine Ganglion.
Self-Administered SPG Blocks can improve many autonomic issues in patients.
This is the connection of TMJ disorders to problems with the gut.
The connection of Aiirway collapse secondary to dental issues has been well established.
Bruxism is far more than a habit it is part of a medical group of disordrs.
. 2018 Aug; 4(8): 329–331.
Published online 2018 May 18. doi:  [10.1016/j.hrcr.2017.06.013]
PMCID: PMC6092563
PMID: 30112280

Grinding to a halt: Stimulation of the trigeminal cardiac reflex from severe bruxism

Key Teaching Points

  • • The autonomic nervous system has an intricate relationship with the heart; severe vagal stimulation can produce bradycardia and asystole.
  • • The trigeminal cardiac reflex is a powerful brain stem reflex that can be associated with a sudden onset of parasympathetic dysrhythmia, sympathetic hypotension, or gastric hypermotility.
  • • Bruxism, which is reported in 8% of the population, can stimulate the trigeminal cardiac reflex and lead to profound vagal effects on the heart.

Introduction

The trigeminal cardiac reflex (TCR) is a unique, powerful, and well-established neurocardiogenic reflex that is a result of stimulation along the path of the fifth cranial nerve (trigeminal nerve). It can produce adverse cardiorespiratory changes including hypotension, bradycardia, and asystole, as well as gastric consequences such as hypermotility. This reflex has been reported to occur in various surgical conditions, as well as in neurosurgical interventions.

Sleep bruxism, thought to be a more intense form of rhythmic masticatory muscle activity, has a prevalence of about 8% and has been explicitly linked to the TCR.We report a case of a young woman with severe bruxism who incited her TCR, which subsequently produced profound nocturnal pauses that ultimately required dual-chamber pacemaker implantation.

Case report

A 27-year-old woman presented with palpitations and syncope. Three years prior to presentation she developed nocturnal and early morning nausea and vomiting that would often wake her from sleep. She was noted to have a long-standing history of severe bruxism with physical signs on examination of significant attrition. This had persisted despite the use of a retainer and bite block. Evaluation with Holter monitoring revealed sinus bradycardia, intermittent second-degree type II atrioventricular (AV) block, and a pause of 8.6 seconds (Figure 1). Interestingly, the rhythm strips showed simultaneous effects on both the sinus and AV node, suggesting an autonomic etiology. Of note, these rhythm disturbances were principally nocturnal in nature. While she was wearing the Holter, the husband was awake and corroborated that she was having severe episodes of bruxism. Further cardiac evaluation was unrevealing, including a normal echocardiogram, cardiac magnetic resonance imaging, sleep study, and thorough autonomic testing. With her constellation of symptoms—severe bruxism, AV nodal block with cardiac pauses (that were predominantly nocturnal), and gastrointestinal symptoms—we diagnosed her with hypervagotonia from stimulation of the powerful TCR from severe bruxism (Figure 2). Out of concern for risk of cardiac death from these pauses without a stable ventricular escape, we elected to place a dual-chamber pacemaker for bradycardic prevention.

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Holter monitoring revealed sinus bradycardia, intermittent second-degree type II atrioventricular block, and a pause of 8.6 seconds

An external file that holds a picture, illustration, etc. Object name is gr2.jpg

Illustration of the trigeminal cardiac reflex. X = motor nucleus of the vagus nerve; ∗ = Gasserian ganglion; V = trigeminal nerve.

Discussion

This case highlights the intricate and noteworthy relationship between the autonomic nervous system and the heart. Our patient developed high-grade AV block and syncope owing to significant and profound hypervagotonia. Based upon her evaluation and corroboration of these events by her husband, we deemed that her intense vagal stimulation was a consequence of her severe bruxism, which was eliciting the TCR.

The TCR (Figure 2) is a powerful brain stem reflex that can be associated with a sudden onset of parasympathetic dysrhythmia, sympathetic hypotension, or gastric hypermotility. The proposed mechanism of this reflex is stimulation of the sensory nerve endings of the trigeminal nerve (Figure 2, cranial nerve V), which sends signals via the Gasserian ganglion (Figure 2, indicated by asterisk) to the sensory nucleus of the trigeminal nerve (Figure 2 inset). The afferent pathway then continues along the short internuncial nerve fibers in the reticular formation to connect with the efferent pathway, the motor nucleus of the vagus nerve (Figure 2, cranial nerve X). The last part of the reflex is formed by cardioinhibitory efferent fibers, which connect the motor nucleus of the vagus nerve to the myocardium.

Bruxism is a common occurrence in the population (8%) and has been associated with alterations in the autonomic nervous system and stimulation of the TCR. The mechanism behind the TCR stimulation is felt to be 2-fold. Firstly, masticatory movements (rhythmic masticatory muscle activity) and secondly, teeth contact can stimulate mechanoreceptors in the periodontal tissue. The link between bruxism, TCR, and alteration in the autonomic nervous system is important to highlight as it is well established that the autonomic nervous system plays a critical role in the pathogenesis of various cardiac arrhythmias, particularly atrial fibrillation. Although not specifically related to our patient, the fact that bruxism is so common raises the potential role it could be contributing to autonomic drivers of atrial fibrillation, and this is something that requires further research examination.

Conclusion

When evaluating patients who present with symptoms of significant hypervagotonia, it is important to consider sleep-related causes, in particular sleep bruxism and its role in the TCR.

Footnotes

Dr DeSimone is supported by an NIH T32 training grant (HL 007111).

References

1. Reding G.R., Rubright W.C., Zimmerman S.O. Incidence of bruxism. J Dent Res. 1966;45:1198–1204. [PubMed]
2. Schames S.E., Schames J., Schames M., Chagall-Gungur S.S. Sleep bruxism, an autonomic self-regulating response by triggering the trigeminal cardiac reflex. J Calif Dent Assoc. 2012;40:670–671. 674–676. [PubMed]
3. Arasho B., Sandu N., Spiriev T., Prabhakar H., Schaller B. Management of the trigeminocardiac reflex: facts and own experience. Neurol India. 2009;57:375–380. [PubMed]
4. Gastaldo E., Quatrale R., Graziani A., Eleopra R., Tugnoli V., Tola M.R., Granieri E. The excitability of the trigeminal motor system in sleep bruxism: a transcranial magnetic stimulation and brainstem reflex study. J Orofac Pain. 2006;20:145–155. [PubMed]
5. Chowdhury T., Bindu B., Singh G.P., Schaller B. Sleep disorders: is the trigemino-cardiac reflex a missing link? Front Neurol. 2017;8:63. [PubMed]
6. Sjoholm T.T., Piha S.J., Lehtinen I. Cardiovascular autonomic control is disturbed in nocturnal teethgrinders. Clin Physiol. 1995;15:349–354. [PubMed]
7. Okada Y., Kamijo Y., Okazaki K., Masuki S., Goto M., Nose H. Pressor responses to isometric biting are evoked by somatosensory receptors in periodontal tissue in humans. J Appl Physiol. 2009;107:531–539. [PubMed]

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What to Do If You’re Experiencing Jaw Pain

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Are you suffering from jaw pain or migraines? It may be more serious than a little lock jaw or a slight bump to the head. If you’re experience jaw pain or continuous migraines, read on to find out what may be causing these symptoms or stop by our office to talk with us about your pain.

So, What Exactly is TMJ?

jaw_painTMJ, short for Temporomandibular Joint, is more commonly known as the joint in your jaw. TMJ is also commonly referred to as temporomandibular disorder, in reference to the pain and dysfunction it can cause. These two joints allow you to chew food, speak, sing, laugh, and talk with your friends, pain-free. So what happens when these joints don’t work as smoothly and continuously as they should? When your joints don’t work as well as they should, it may be a case of TMJ. TMJ can be serious if not treated correctly. Often, TMJ can easily be mistaken for a migraine, an eye infection, or a sinus headache.

What Can Cause TMJ?

TMJ can be caused by a number of factors, some that are preventable, and unfortunately some that are not.

  • Shifting teeth
  • Missing teeth
  • Injury to the jaw joint
  • Misaligned jaw
  • Sleep disorders
  • Clenching your jaw
  • Arthritis

How We Can Treat TMJ

TMJ treatment varies from patient to patient. There are many different solutions that we can adjust to meet your specific case.

When our team at Think Better Life determines what your exact diagnosis is, we will start prescribing you one of three phases of treatment. The first phase is to get your life back to normal. This phase typically involves non-surgical treatments such as physical therapy, chiropractics, and orthotics. Our second phase revolves around getting your life as painless as possible in the long term. This phrase may include procedures like coronoplasty and occlusal equilibration. In some cases, we can reduce your pain in the long run by using orthodontics to create a healthier smile. Our third phase, which most patients do not need, is joint surgery. This is a very rare occurrence, as most cases can be taken care of with the help of our first two steps!

We want you to live your best life possible, free from the pain or discomfort of TMJ. If you would like to find out more about TMJ, or if you think TMJ may be causing your pain or discomfort, take our TMJ questionnaire online or swing by our office for a consultation.…

Jaw Pain, Muscle Soreness, Ear Ringing, and Dentistry

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Jaw pain, muscle soreness, ear ringing, and…dentistry? How it all relates

Jaw pain, muscle soreness, ear ringing and….dentistryMany people do not realize how much impact the mouth can have on the rest of the body. The muscles and tissue in the immediate area of the jaw are much stronger than we often assume. What this means is that disorders in the temporo-mandibular joint can result in unrecognized symptoms that may appear as some other medical problem.

Migraine headaches are perfect examples. Many people who suffer from migraines think any medical problem is associated with the aching area of the head, when in fact it can be the result of pressure created by a TMJ disorder.

TMJ jaw pain explained

Jaw pain is a general indicator that there is some type of disorder or alignment problem in the TMJ. Misalignment is common, but arthritis and osteoarthritis are also examples of medical conditions known to cause jaw pain in some instances.

Pain is not necessarily confined to one side of the jaw in either event. Jaw pain can also be associated with a heart attack or angina in certain cases, but more often than not, jaw pain causation is usually located in the TMJ.

Why your ears may be ringing

Ringing ears is also a condition that is not normally associated with jaw disorders. While this can be a symptom of the ear disorder tinnitus, ringing ears can also be caused by the TMJ. Other symptoms can also arise, as some patients experience throbbing or pulsating pain in addition to ringing ears.

The TMJ joint is one of the most complex regions of the body, and is actually hinged just below the ear. Ringing ears tends to be one of the most common symptoms with TMJ patients, but the symptom can also be an indication of other problems.

How TMJ causes muscle soreness

Muscle soreness is also very common for patients with a TMJ disorder, and physiologic dentistry can often provide an effective diagnosis and treatment regimen. Once again, the complexity of the body region surrounding the ear means that there are multiple medical disorder possibilities.

Muscle soreness is a symptom of unusual pressure being placed on the muscles connected to the TMJ . Very often the soreness will go away after the TMJ is effectively treated.

Do you have TMJ?

If you are suffering from pain or discomfort in these regions of the body a physiologic dentistry professional will be able to help diagnose the problem and provide an accurate prognosis.

If you would like to learn more about how TMJ might be affecting you, please take my free questionnaire.







Patient Testimonials: TMJ, Orofacial Pain and Sleep Disorders

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Dear Dr. Shapira,
I wanted to thank you for taking my sense of fatigue seriously and trying to help me overcome it. You noticed things that sent me to a surgeon to stop my snoring and fashioned a mouth guard for me. This is in addition to other tips you have given me.

I appreciate you asking for my recent blood tests and analyzing them. You even went a step further and contacted my internist. She suggested, as did you, I see an endocrinologist. I have an appointment next month and will request you receive a copy of the results.

Again, thank you for caring.

– Bonnie S.


Dr. Shapira, or as I like to call him, Ira, is an angel in every sense of the word; blessed with a great brain and a greater heart and his hands work pretty good, too. His top qualities are that he provides great results, he’s an expert, and he is creative. I will never forget his devotion to one client he met with for eighteen months, on a weekly basis, at Rush Pres St. Luke’s who still has never received a bill for all services provided. May God bless you and yours always.

– Patrice C.


My longtime acupuncturist recommended Dr. Ira Shapira as an expert on Sleep Apnea when I shared with her my frustrations with my CPAP. Less than three months later, (and a sleep study to prove it), I am cured of my moderate condition of sleep apnea. Dr. Shapira created an oral appliance that is easy to sleep with and maintain. I am so relieved, feeling much better, significantly fewer headaches and more energy I would recommend Dr. Shapira to anyone. His knowledge of dentistry goes well beyond the norm. Anyone that suffers from TMJ and or sleep disorders should have a consult.

– Karen G.


I saw Dr Shapira for TMJ problems and chronic Migraines. I wore a plastic appliance for several months. All of my issues with jaw locking and clicking resolved as did my daily headaches and chronic migraines. I no longer have dark circles under my eyes either.
I could not afford a full mouth reconstruction but have been wearing a permanent appliance for several years on my bottom teeth..Expensive but worth it.
I did have 10 veneers done and now have killer smile, partially because I am no longer in chronic pain.

K.C.

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I have been a patient for over 15 yrs. When I came to Dr. Shapira I was in very bad TMJ pain. He and his staff worked with me for hours and when I left that day the pain was gone. I continued treatment until my bite was fully corrected and not only that but thanks to Dr Shapira’s talent in cosmetic dentistry, my teeth look more beautiful then they ever have. Dr Shapira and the staff continue to gain education on the most innovative ways to help people look and feel good. The staff there are very kind and I always so cared for when I go for my appointments.

Michelle H.

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I received TMJ treatments from Dr. Shapira and I was pleased with the results. I had terrible migraines as well as smaller headaches for as long as I could remember and they dissipated upon receiving treatment. I would recommend Dr. Shapira to anyone with TMJ.I received TMJ treatments from Dr. Shapira and I was pleased with the results. I had terrible migraines as well as smaller headaches for as long as I could remember and they dissipated upon receiving treatment. I would recommend Dr. Shapira to anyone with TMJ.

– Christopher J.


I was referred to Dr. Shapira for TMJ issues almost 30 years ago. Not only did the TMJ treatment plan resolve my issues but, over the years, I’ve also received excellent dental care and had some cosmetic work done, which I am very pleased with. Dr. Shapira has a real passion for what he does, and that passion has brought him vast knowledge and expertise. I trust him completely. Also, Barb has been my hygienist over those 30 years and I am completely pleased and satisfied with her skills and commitment to keeping my teeth and gums in the best condition possible. I’ve had Dr. Amidei a few times over the years when Dr. Shapira was not available and those interactions led me to believe that he is of the same top caliber as the rest of the Delany Dental Care staff.

– MK


Rating: 5.0 5.0 stars,
By: Charlene Bown
On: Google, 05/11/2018
Comment: I cannot imagine my dental work ever being done by any other dentist than Dr. Shapira!! I have been seeing higm for several years to help correct my sleep apnea. I cannot tolerate CPap so Dr. Shapira created an oral device that has literally been saving my life!!! I am a high risk patient and absolutely swear that I might not even be here if it weren’t for this incredible Doctor! He knows more about medicine from all different perspectives than most of my doctors and has exceptional skill in the practice of dentistry!! I truly believe this man is also a philosopher, a practitioner in natural remedies and has become a very special person in my life. Don’t even bother seeing any other dentist cause after you have seen Dr. Shapira you will be horribly disappointed!! I highly recommend Delany Dental for a real experience in what dentistry should be and rarely is!!!

I’ve been seeing Dr Shapira since 1998. In college I developed severe TMJ symptoms where I could no longer open my mouth more than an inch. I saw numerous specialists all over the state, visited top hospitals including the Mayo clinic. My family spent a lot of money and I got no relief from my symptoms. It wasn’t until my mom called the TMJ association in Texas and got Dr Shapira’s name. I was skeptical when I had my first appointment at Delany Dental Care but I was told it’d be a long road to recovery but I’d eventually be pain free. Within the first month of treatment, I noticed the headaches lessened. A few months later I could open my mouth further and within a year I had many days were I was able to forget about TMJ. This practice gave me my life back. While I still have some symptoms a few days a year, I am overall pain free. I was told though once you have TMJ as severe as my case; it would be something that I would have to deal with for the rest of my life but for the most part; most days I will not even know I have it.

– MEK


I am so grateful for Think Better Life and Dr. Shapira. I have been suffering from TMJ for 10+ years and have been to countless dentists who all have told me that I am “fine.” Dr. Shapira was the first dentist to actually listen to my pain, thoroughly examine me, and talk me through my options. My first meeting with him lasted over an hour! Dr. Shapira is not only a great dentist, he is an incredible human being: kind, compassionate, and sincere. After only a month, I am already beginning to feel relief from my chronic headaches and facial pain. It is a feeling I honestly didn’t know was possible. Think Better Life is a warm, caring, and friendly office. Dr. Shapira and his entire staff have are truly competent and hospitable!

Laila N.


When I came to Doctor Shapira I was at the end of my road with severe TMJ pain. I went to many doctors and somehow no one could solve my problem. After many months of research I found Dr. Shapira’s website. I was hesitant to make the appointment due to the distance I would have to drive and feeling hopeless, but after being astonished from watching all the testimonials on his website I thought it was worth a shot.

At the first visit I could instantly tell he had superior knowledge about my issues than other doctors I met with previously. He was open and honest about my condition, the long treatment plan, and the high cost of care. Although this information was intimidating, I finally knew what the saying meant “health is wealth”, life is not worth living in constant pain and discomfort. Therefore, I decided to proceed with his treatment plan.

1 year later I can honestly say that it has been the best money I have ever spent. I am about ~80% better and I will hopefully continue to improve over time. The constant clicking and popping of my jaw is gone, I have normal range of motion again, and most importantly I am mostly pain free.

Not only is Dr. Shapira one of the best and most knowledgeable practitioners I have encountered, he treats you like family and is honestly one of the most interesting people I have ever met. I never leave his office without learning a fun new fact. He truly cares about his patients and work. You can tell he loves what he does. I can’t recommend him enough if you have TMJ pain/issues.

BRITTANY B.


I’ve been seeing Dr Shapira since 1998. In college I developed severe TMJ symptoms where I could no longer open my mouth more than an inch. I saw numerous specialists all over the state, visited top hospitals including the Mayo clinic. My family spent a lot of money and I got no relief from my symptoms. It wasn’t until my mom called the TMJ association in Texas and got Dr Shapira’s name. I was skeptical when I had my first appointment at Delany Dental Care but I was told it’d be a long road to recovery but I’d eventually be pain free. Within the first month of treatment, I noticed the headaches lessened. A few months later I could open my mouth further and within a year I had many days were I was able to forget about TMJ. This practice gave me my life back. While I still have some symptoms a few days a year, I am overall pain free. I was told though once you have TMJ as severe as my case; it would be something that I would have to deal with for the rest of my life but for the most part; most days I will not even know I have it.

– MK


Dr. Shapira has been treating me for TMJ. We started with an oral appliance to relax the jaw and make a better bite. Then we went to a DNA Appliance. I have been pain free since almost day one. Now I can’t wait to see the results of the DNA which will reshape my jaw so I won’t need an appliance in the future. Dr Shapira is a miracle worker. His staff is Awesome as well!

Suzan B.


Very Caring and professional staff! Most definitely the best dentists I have ever been to. After an orthodontic mistake that left me disfigured and with a few less teeth, I was feeling very sad and hopeless. I decided to check out restorative dentistry. They basically pointed out everything and how your jaw can affect your entire body. The doctors were very kind, considering I was in tears. They were completely understanding. They also specialize in sleep dentistry. They did a sleep study on me and I got to choose where I could have it done. They will definitely get my business in the future.

– Marty S


Terrific place for Dental and TMJ healing…I’ve been a patient for 13 years. Not only did they fix my cavities very well, but the incredible relief from my jaw problems was unexpected. My jaw would sometimes lock up on one side, and Dr. Ira discovered that my bite was misaligned. I had the painless TENS treatment, wore a plastic appliance made for my mouth (like a retainer), and then my jaw was fixed, my bite was fixed, and my jaw pain was gone!!
Better still, this treatment apparently also aligned my sinuses, because my life-long sinus congestion disappeared. AND, I no longer require a small shim my right shoe for which I had long ago been diagnosed as having needed “because” one leg was longer than the other — which is no longer the case! Alignment works! This is a great place to get healed for life!!

– Marty S


I have going to this practice for 23 yrs. with Dr. Mark Amidei as my dentist and Dr. Ira Shapira for my Sleep Apnea.
I can not say enough about their staff, friendly and professional.
I enjoy going to the dentist.
A+ all around. Do yourself a favor and look no more, call and make an appointment. You will not be disappointed.
I began working with Dr. Shapira several months ago regarding a case of debilitating TMJ. He uses innovative technology to measure jaw movement, ensuring that his splint treatment is precise. He also works with patients to help them understand and treat the muscular component of TMJ (something not offered by the four previous dentists I had seen for my condition). Dr. Shapira works in conjunction with Dr. Mark Freund of Natural Care Chiropractic for TMJ cases; together they are relentless in finding a solution for their patients. I have been particularly impressed that both doctors continually seek out further education and knowledge in their respective fields. I cannot recommend their work enough!

– DS


I don’t know where my health would be without Dr. Shapira. I have been a TMJ patient for 20 years. I had no idea that TMJ treatment can effect your sinus, sleep, and migraine health as well. Dr. Shapira has been a lifesaver for me more times than I can count. This past January we started DNA treatment which stands for Day and Night Appliance. The improvement I’m already feeling is incredible! I wear this new, comfortable appliance 12 hours a day-basically after dinner and while I sleep. It is expanding my upper and lower jaw which is going to correct my TMJ, open my breathing passages, and greatly improve my allergy and chronic sinus infections. It’s mind-blowing how all of my medical issues are inter-twined with what Dr. Shapira treats. He is always on the cusp of the newest technology and treatments and many of his treatments offer instant relief. Dr. Shapira and his staff treat everyone like family. You couldn’t be in wiser or better hands.

Barbara K


I have been a patient of Dr Shapira and Dr Amidei for the past 24 years. My husband, myself and our three sons are all patients here and I cannot speak highly enough about everyone there! Dr Shapira diagnosed me with TMJ issues about 15 years ago and I have worn a night guard appliance from him ever since. I noticed a remarkable difference within a few nights of starting the appliance and have never had any uncomfortable issues with TMJ since then. Both doctors have seen all three of our sons since they were toddlers. Barb, one of their hygienists, has been treating our entire family these past 24 years and she is the absolute best.
Two years ago, Dr Shapira helped me with the decision to get porcelein veneers and I am thrilled with the results! The level of expertise he has, the wealth of knowledge that both doctors have, the kindness and care that everyone there displays – honestly, there is no place I would rather go and I have recommended many friends to this practice.
You can really tell that at Delany Dental Care, everyone there is treated like they are part of their family. Everyone there makes you feel like you are as important to them as members of their own family. I highly recommend this practice to anyone looking for themselves or their entire family to be treated! You cannot go wrong with choosing Delany Dental!

– DS

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Jaw Pain, Clicking & Popping

Dr. Shapira Chicago, Clicking & Popping, Deerfield, Evanston, Highland Park, Jaw Pain, Jaw Pain Clicking & Popping, Kenilworth, Lake Bluff, Lake Forest, Libertyville, Lincolnshire, Mettawa, Morton Grove, Northbrook, Northfield, Skokie, Vernon Hills, Wilmette, Winnetka 0 Comments

An answer to jaw pain, clicking and popping

tmj-jaw-painJaw pain, clicking or popping when you move your jaw while talking, chewing or yawning?

This is not only uncomfortable but can be annoying when communicating and eating. It can also become embarrassing when it has reached the point that opening your mouth results in a locked jaw.

If this sounds like you, we think it’s time to be looking for an alternative diagnosis, because the problem could be caused by your temporomandibular joint (TMJ) and misaligned bite.

How your TMJ can cause your jaw to ache

If no other diagnosis has been found, your jaw cracking or locking could have something to do with your TMJ. Your TMJ is the joint that connects your jaw to your skull. It’s what allows you to eat, chew and talk through up and down, back and forth and sideways movements. It’s comprised of an intricate network of bones, muscles, nerves, connective tissue and, padding it all, cushioning discs.

You have two temporomandibular joints – one at each side of your face . If either one, or both, are misaligned or not functioning properly, they could be the source of your jaw pain. If this is your case, you could be suffering from what we call a temporomandibular disorder (TMD).  Aching pain is most commonly coming from muscles (myofascial Pain around the affected joints).

TMD may be relieved by realigning the bite

It might surprise you to learn that these sometimes alarming symptoms can be corrected. As noted above, TMD is often the result of your bite not being aligned correctly.

Friction caused by this misalignment can:

  • stretch the jaw’s ligaments
  • breakdown in the bones (arthritis) or cartilage
  • cause scar tissue to form  or,
  • alter the joint’s lubrication system

causing the disk to become stuck out of position leading to pain, jaw locking, jaw clicking and popping. Treatment to help realign your bite can help to relieve the jaw pain and the associated clicking and popping that goes with it.

The most common type of jaw clicking and popping is the Reciprical Click.  It is associated with and overclosed or posterior positioned bite.  The clicking on opening  the mouth is the sound created when the disc goes back into its proper place.  The squeak or dull noise on closing is the sound of the disc going out of place and is often associated with itchy ears.

Tackle TMD with physiologic dentistry

physiologicBy arranging a consultation with a dentist trained in the principle of physiologic dentistry, you can start to tackle the symptoms caused by TMD.

Step 1: Assessing jaw function

There are various advanced techniques used to assess the condition of your TMJ. One is called a Sonography which can monitor joint noises, such as popping and clicking sounds coming from your TMJ, indicating that your jaw isn’t functioning correctly. Another is the MKG (mandibular Kenesiograph or CMS (computerized Mandibular Scan) that can show the physical displacement associated with the noise and how it affects jaw movement.  There is also an autonomic nervous system test which determines your current bite’s strength and if it can be improved.

Step 2: Muscle relaxation

The next step is to get the jaw muscles to relax. This is done through the use of a ULF-TENS (Ultra Low Frequency Transcutaneous Electrical Stimulation) machine that relaxes the jaw muscles by emitting minute electrical stimuli at an ultra-low frequency.

Step 3: Reassessing jaw function following muscle relaxation

This is the key to Physiologic Dentral Treatment.  Once your muscles have started to relax, your bite can be accurately evaluated without the chronic muscle spasm, and shortening. The gently realigned  jaw  position or physiologic rest position is recorded three dimensionally through the use of a physiologic bite.  This bite is taken by stimulating reflex movements of the jaw giving outstanding accuracy.  The use of  non-invasive orthotic appliance or diagnostic physiologic orthotic is used as the first step in relieving pain and establishing a physiologic state ideal to induce healing.  Healing will cause postural corrections over time.  It is essential that the process continue to allow healing to progress.