Matt Wallden | TMJ Dysfunction (or “TMD”)
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TMJ Dysfunction (or “TMD”)

TMJ Dysfunction (or “TMD”)

Do any of these sound familiar:  headache, eye pain, earache, bags under your eyes, tooth grinding, neck pain, cheek biting, eye twitching…?

These are just some of the more common symptoms associated with jaw joint (or TMJ) Dysfunction. Of course, jaw pain or clicking in the jaw joint, as well as restriction of mouth-opening are also strong indications that something isn’t working optimally in the joint.

A simple test you can do is to see if you’re likely to have a TMJ dysfunction is to see if you can put all three fingers into your mouth from index to ring finger, up to the middle knuckle. If you can do this easily and without clicking or pain, and you’re otherwise symptom-free in this area, then it’s likely the joint is functioning well.  However, if it’s a struggle to accomplish, painful or impossible, then it may be worth investigating further.

But why is it that Temporomandibular Dysfunction (TMD) can be such a challenge to help? Well, aside from the fact that the jaw mechanics are determined largely by the way the teeth and bones of the face are formed (which obviously take a long time to change), the joint itself is very highly innervated with nerves making it highly sensitive.

The upshot of this sensitivity is that our bite is surprisingly accurate and has tremendous precision; but when something goes wrong, pain is often sensed at levels higher than in the rest of the body.

 

 

 

To add to the mix, TMD is also one of an array of conditions known to drive sensitisation in the central nervous system, known as central sensitisation, and this central sensitisation can go on to result what’s been termed a central sensitivity syndrome (CSS), see below.

Certain conditions are known to contribute to central sensitisation and may result in a central sensitivity syndrome (CSS) – and temporomandibular dysfunction (TMD) is one of them.

The interesting thing about the central sensitivity syndrome is that it can do several things

  • it can make you more prone to developing other conditions (TMD patients, for example, often present with chronic fatigue syndrome [CFS[LINK]], irritable bowel syndrome [IBS[LINK]], tension-type headaches [TT HA] or with Migraine).
  • it can also lower pain thresholds meaning that even the slightest irritation (in the jaw or elsewhere) can feel extreme.
  • central sensitivity can perpetuate pain or other symptoms long after the original issue has healed.

So, what to do about it? Well, luckily there are several things that can be done:

  1. Firstly, there are a series of simple exercises known as the Rocobado 6 x 6 which can provide tremendous relief if committed to regularly (see patient resources here[LINK]).
  2. Secondly, you can work with a manual therapist, who specialises in TMD who will both be able to give you more specific advice, to address associated factors (such as head and neck posture), and will have treatment techniques to release tension and reduce pain.
  3. Usually manual therapists who specialise in TMD work closely with dentists who also specialise in TMD (which is a very small proportion of dentists – less than 1%).  Getting the right person to work with, who has the right level of expertise is very important for optimal outcomes.
  4. You can assess your level of overall physiological load, which correlates with your likelihood of central sensitisation, by booking an appointment at our clinic [LINK] or by taking our free online screening here, or a more in-depth screening here [LINKS].

How I got involved in studying and working with the TMJ was, in part, through my original training as an osteopath, but more specifically and in-depth through my training with the CHEK Institute.  In the late 1980s, Paul Chek the world-renowned holistic health expert, decided he would specialise in patients with craniofacial (temporomandibular) disorders, as they seemed to be the most challenging group of patients to work with… And Paul likes a challenge (you can hear Paul’s story on my FC2O Podcast here[LINK])!  Due to his successes, Paul was asked to write a chapter called Posture & Craniofacial Pain, for a medical textbook called in 1993 “A Chiropractic Approach to Head Pain”, which is still one of the best resources available on the topic.

I was lucky enough that, around the year 2000, I went to one of those business breakfast meets and was introduced to a dentist called André Hedger who works a couple of miles away from me. It turned out that Andre not only had an interest in TMJ, but he was arguably the leading dentists in this field in the UK (you can hear more about Andre’s expertise on my FC2O podcast here (LINK). André took me under his wing and taught me huge amounts about TMJ dysfunction directly and through various courses he recommended; as well as through co-working on countless patients together.

After a few years of working with André, I began lecturing on the TMJ to various undergraduate groups, eventually training the faculty of some osteopathic colleges, and teaching post-graduate groups (including some Premiership Football medical teams). I now teach a full day on TMJ dysfunction for the CHEK Institute as part of an eight day training course, here, in the US and in Denmark.

If you’d like to contact me to find out more about how I work with people who have TMJ Dysfunction, please drop me a note here [LINK].  If the central sensitivity syndrome image above resonates with you, you might be keen to find out more about your physiological load here [LINK], which can drive central sensitisation.

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