Many patients who experience problems with dental work can possibly be TMJ patients. Some are easy to diagnose as TMJ patients because they already know about their issue or they have some symptomatology with their joints (popping, crepitus, pain upon palpation, limited opening, etc.) Some patients, however, are classified as subclinical TMJ patients and they do NOT know or exhibit any obvious symptoms… other than histories of headaches.
These are the last identifying characteristics that TMJ patients exhibit:
11. Missing Teeth/Partial Edentulous Condition?
Loss of teeth causes loss of jaw support. Loss of jaw support puts unusual stress on the jaw joint, nerves, and blood vessels of the brain. Reconstructive methods, including implants must be used to bring back balance to the jaws and head. Partial dentures cannot provide optimal TMJ support. Soft liners and properly fitted prosthodontics at the correct vertical may help but they are not long term solutions.
12. History of Reconstructive Dental Work?
Changing the size and shape of teeth can make them more attractive but can also cause unusual bite circumstances. When cosmetic dental work on multiple teeth is performed there could be consequences of bite problems or changes. This can lead to head pain problems especially if you change the lingual guide planes or leave open occlusion on posterior teeth! Retroclined anterior teeth can cause mandibular displacement which exacerbates symptoms.
13. History of orthodontic treatment?
Ortho can be used to make changes to the occlusion and “Functional Orthodontics” is often used to treat head pain problems. At the same time, orthodontics can cause head pain problems if the craniomandibular relationship is not diagnosed and stabilized properly. In future newsletter we will cover more ortho protocols.
Crowding and narrow arches can lead to TMJ and headaches as the dentition cannot provide optimal jaw support and can lead to an unbalanced jaw relationship.
As explained in previous newsletters: Don’t forget to check for premolar extractions!
Additional Factors to Consider:
14. Does patient get frequent sinus infections and sore throats?
If they have exhausted the medications prescribed by their ENT doctor then maybe the true cause is a jaw problem. Even if they don’t have headaches or other symptoms, jaw imbalance problems can lead to sinus issues. The lateral pterygoid muscles attach directly to the sinus walls.
15. Does patient feel tired during the day?
Sleep Apnea may be a cause of the pain. Many pain patients require a sleep study. If they’re having fatigue problems you need to get to the root of the problem and find out if they have a constricted airway (snoring, breathing difficulty, asthma, sleep apnea, etc.) or a pain induced narcolepsy. Sleep apnea can be a major contributing factor behind many pain issues discussed here. Additionally, many health issues can be directly attributed to Sleep Apnea.