Dentist
Dr. Scott Tamura was born in Los Angeles and has practiced dentistry in Marina Del Rey California for over 25 years. He is a member of the American Dental Association, California Dental Association, West Los Angeles Dental…
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TMJ the Imposter: Why Your Aches and Pains May Be Related to TMJ
Posted in TMJ by Dr. Scott Tamura on Oct 05, 2011
My last post was called “The Great Imposter,” because TMJ is a disease that takes many different forms and manifests itself in different patients in different ways. Because of this, TMJ is like an “Imposter,” with the symptoms of TMJ mimicking other diseases.

I previously listed nine different types of symptoms the TMJ patients I see present with:
(1) Dental Problems

(2) Ear Problems

(3) Muscular Problems

(4) Structural/Postural Symptoms

(5) Neurological Problems

(6) Airway Problems

(7) Cardiac Problems

(8) Gastrointestinal Problems

(9) Endocrine/Hormonal Problems

Over my next three or four posts, I will go into detail about how problems with the way your teeth fit together can cause so many different types of symptoms. Today’s post will deal with numbers 1, 2 and 3 above.

I Am In the Minority of Dentists


You would think in an established profession like dentistry, there would be agreement among dentists about dental problems and how to fix them. For the majority of the problems general dentists treat there is.

However, when it comes to Malocclusion (problems with the way the teeth come together), there are many different philosophies and schools of thought. The majority of dentists believe the way your teeth come together has no correlation to problems inside of your jaw joints. They also do not believe that pain of muscular origin, like headaches, neck aches and backaches have anything to do with your teeth or your bite.

The reason the majority of dentists in the United States believe this is because that is what they were taught in dental school. That is what I was taught when I went to dental school. It was only after what I was taught, didn’t jive with what I saw in my patients, that I began to search for other philosophies that would explain what I was seeing in the patients who were coming to my office with headaches, popping and clicking in their jaw joints and ear problems.

After many years of searching, what I discovered was that the upper jaw is fixed to the base of the skull and does not move. The lower jaw moves relative to the fixed upper jaw through contraction of muscles which attach to the lower jaw. If the teeth hold the lower jaw in a place that causes the muscles that attach to the lower jaw to be stressed, those muscles will become painful and spasm. A patient will feel these spasming muscles as a headache, neck ache or shoulder ache.

There is, however, a place for the lower jaw to be (relative to the fixed upper jaw) where the muscles that attach to the lower jaw can be relaxed. We call this relaxed muscle position of the lower jaw your Neuromuscular (NM) position. Note that the NM position has nothing to do with the teeth. The NM position is a “Muscle Determined” position. I am a Neuromuscular Dentist. That is because I use the muscles to determine where the lower jaw should be to allow a patient who has pain of muscular origin to heal.

Most dentists do NOT use the muscles to determine where the lower jaw should be; that is why I am in the minority. I put together the following video to explain how a bad bite can lead to problems with the muscles that attach to the lower jaw, cause problems in your ears like ringing (in your ears), vertigo or congestion and cause your jaw joints to pop and click or get stuck (locked) with limited range of motion.



In my next blog post I will be discussing problems (4) and (5) and explaining why a problem with the way your teeth fit together can cause hip, knee, ankle and foot pain.

Until then, stay on trajectory,

Scott L. Tamura DMD, LVIF


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16
I took my daughter to see the dentist a few weeks ago, because she has been complaining of jaw pain. She said that it was just always sore, and that sometimes it would lock up. She also mentioned that her teeth were sore. I thought that she must have a cavity or something. When I took her in, the dentist took a look at her mouth and suggested that I take her to see a neuromuscular dentist . He said that she didn't have any cavities, but that she might just have temporomandibular joint disorder. I did take my daughter to see a neuromuscular dentist , like he suggested, and the neuromuscular dentist gave my daughter a night guard to wear while she is asleep. She has been wearing it faithfully every night, and hasn't complained of any jaw pain ever since.
By Taylor Parker  Aug 22, 2012
15
Anyhow, I underwent surgery for Meniere's and I now have a Bone Anchored Hearing Aide. But I am wondering if TMJ and Meniere's is somehow related?
By johnlasseter  Mar 14, 2012
14
Dr. T - Question. I've always been given a night guard or what you call an orthotic by my dentist for my upper teeth. A mold is made of my upper and lower teeth, and a hard plastic guard made to snap on all my upper teeth. Is this what you mean by an orthotic for the mouth? This appliance only causes me to constantly "chew" on it grinding constantly at night. It seems to make my jaw joint worse. I only wear it because if I don't I started breaking my teeth from spasms of my jaw as I said in other posts. What kind of appliance is normal to fix this?
By LindaSD  Dec 08, 2011
13
Dr. T - thanks for your reply to my comments. Google comes up with the dentists I have seen, including my regular dentist who what to charge $600 for a computerized evaluation of my bite and from there decide which teeth to reshape. Many dentist say they specialize in TMJ but they really don't. All the dentists I have seen over the years including my current dentist give me a plastic bit guard like I have now that makes my jaw muscles worse. Just the night guard costs $300. I don't know what other kind of appliance there is since I've only been given a plastic night guard.
By LindaSD  Dec 04, 2011
12
Rhonda,

Yes, TMJ and Minerre's Disease are very much related. If you look at how the human fetus develops, the middle ear and the TMJ joint develop from the same embryologic tissue. There is a ligament called the "Discomalleolar Ligament" which directly connects the ear with the jaw joint. When there is dysfunction inside the jaw joint, it can directly affect the ears.

Doctor Tamura
By DoctorT  Dec 04, 2011
11
kysmit,

TMJ stands for TemporoMandibular Joint. It is the (jaw) joint between the Temporal Bone (side of head) and the Mandibular (lower jaw) Bone. Although TMJ is the name of the jaw joint, right in front of your ears, the abreviation has become synonomous for a Syndrome that encompasses a myriad of problems. That is why people call it "The Great Imposter". Because there are so many different types of symptoms associated with TMJ and not all patients exhibit the same symptoms.

I hope that answers your question.

Dr. Tamura
By DoctorT  Dec 04, 2011
10
Nittney,

TMJ and it's associated ear problems can be diagnosed by a dentist who specializes in TMJ and Craniofacial Pain. Try googling Neuromuscular Dentist and your City.

Good Luck,

Doctor T
By DoctorT  Dec 04, 2011
9
stantheman,

You asked the question: what did you discover is a fix for TMJ? The answer is in the video I made "TMJ for Dummies". It is a Removable Neuromuscular Lower Jaw Repositioning Orthotic.
By DoctorT  Dec 04, 2011
8
LindaSD, I am sorry you have not found a dentist who can address your problems. If your jaw muscles clamp down and slam your jaw shut, you have some serrious dysfunction in your jaw joints. I am glad you did not let any dentists do irreversible procedures like grinding on your teeth. I highly recomend you see if you can find a qualified dentist who specializes in treating paitents with TMJ. You should try googling "Neuromuscular Dentist" and your "city/town". They should be able to help you find someone who can give you a removable jaw repositioning appliance that can center the balls within the sockets of your jaw joints which should help to decompress your jaw joints so they can articulate smoothly.

Good Luck,

Doctor T
By DoctorT  Dec 04, 2011
7
MaruskaPogo, If you are clenching against your appliance, it is because the appliance does not position your lower jaw in a place that makes the muscles that attach to the lower jaw relaxed. Your muscles do not like this and cause your jaw to clench against the appliance in an attempt to get the muscles comfortable. A nightguard or splint is NOT a neuromuscular lower jaw repostioning appliance. Although they look similar, they are two completely different things. I agree with you that trigger point work can be helpful for patients in pain to get some relief from muscular spasm. The problem is that the trigger points and painful muscles are a symptom of an underlying problem with your bite. If you can correct the bite so that your teeth hold your lower jaw in a position that allows your muscles to be relaxed, they will not spasm and the trigger points will go away.

Good luck finding your bite...

Doctor T
By DoctorT  Dec 04, 2011
6
Can TMJ cause Meniere's Disease?? I have had TMJ for about 20 years, even a little longer, but about 10 years ago, the hearing in my left ear gradually went, but I remember it being kind of sudden. Anyhow, Started getting vertigo really really bad, sometimes for DAYS. Slept on the bathroom floor quite a few times.

Anyhow, I underwent surgery for Meniere's and I now have a Bone Anchored Hearing Aide. But I am wondering if TMJ and Meniere's is somehow related?

Any insight would be helpful.

Thanks!
Rhonda
By justmeinAZ  Oct 29, 2011
5
sorry but what does tmj stand for???
By kysmit  Oct 10, 2011
4
Omg I have had ringing in my ears and recent sinus problems that I never had before..and when I chew gum or something that takes a longer time and harder to chew.. I get a tight feeling in my posterior cheek muscles near the TM Joint..And I can actually alter the "pitch" if you will of my Tinnitus with the movement of my jaw at times...very strange..I have been thinking for a long time they may be related just don't know where to go get help seems nobody wants to explore it...I have been to 3 ENT's to rule out any other reasons for my Tinnitus..all they do is tell me to get the supplements on the martket.. how is TMJ accurately diagnosed (X_RAY?) and by what type of DR???
By Nittney  Oct 07, 2011
3
I am glad that after many years of searching, you discovered that the upper jaw is fixed to the base of the skull and does not move. So what did you discover is a fix for TMJ?
By stantheman  Oct 06, 2011
2
My tmj was diagnosed when I was 29 and now at age 63 I still don't have a working solution to the problem. I have wear a night guard because I'm chipping and breaking teeth when my jaw muscles clamp my jaw shut, slamming my teeth together in an odd alignment. The night guard causes more problems, headaches, sore loose teeth. My bite is so bad I have trouble chewing food. Dentist wanted $600 to evaluate my bite and more to grind down teeth to make them fit. I know from experience that make it worse so I refuse to let him do that. I'm really interested in what these articles have to say. It is interesting that dentists can't take care of this.
By LindaSD  Oct 05, 2011
1
Dr. T, I like the graphics in the video but the words could be a little larger for us middle aged people with vision challenges. I also agree with the concept of muscle spasm and misalignment of the bite. I have used an appliance and only found I bit on it even harder causing more jaw pain and muscle tension, so it didn't work for me. As a Certified Massage Therapist I have had great success with neuromuscular/ trigger point work on the masseter and pterygoid and scalenes that relieves pain, decreases clicking and popping and resolving headaches.
By MaruskaPogo  Oct 05, 2011
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