The TMJ System™

What is TMJ?

Temporo-Mandibular Joint disorder can be confusing for the Dental and Medical practitioner because of the wide range of symptoms that these patients can exhibit. The profile of the TMJ patient is highly variable. Sometimes it is perceived that it is just a joint problem, like jaw clicking with pain, or with limited opening, or a bruxing problem. More complex symptoms like head, neck and ear pain lead to suspicion of a stress or psychological related disorder. Dentists commonly attribute all the symptoms to an occlusal or bruxing problem.

Bruxing and malocclusion are perceived as the major cause of TMJ Disorder as Dentists. A common conception is that it is assumed that the patient is bruxing and grinding their teeth. Particularly Oral Surgeons often look for pathology in the joint and using MRIs and X-rays to detect pathology in the joints, but quite often there are no signs of degeneration in the joints. TMJ Disorder is then often ruled out as cause of the pain. In many cases, there are no signs of even clicking or limited opening, the joint appears normal, but the patient has many painful symptoms. In the absence of these factors, many Dental and Medical practitioners perceive the symptoms of TMJ Disorder are all psychological and respond to appropriate medication. The theory that the patients are all mad is quite often an opinion voiced in some groups of the Dental and Medical professions.

One of the problems is that the symptoms are so diverse and the diagnostic criteria can be so variable depending on the training of the professional, the outcome of the diagnosis and the following treatment can be highly variable between both the patient and the treating practitioner.

As shown by the American Journal of Orthodontics, the prevalence of TMJ signs and symptoms in children and young adults is 35 – 72%, so this indicates that it is a wide spread problem and also it may be associated with growth and development problems. The number of children presenting in an Orthodontic practice with TMJ Disorder is well above 60% according with the journal.

TMJ Disorder is certainly many times associated with an occlusal problem, but what causes the occlusal problem? (See information on soft tissue dysfunction). TMJ Disorder certainly can be related to muscular, Para functional and myofunctional problems, but these also effect the position of the teeth and the occlusion. The damage to the TM Joint from a blow to the jaw can clearly cause joint problem. This intra-capsular problem from trauma can also be caused by soft tissue dysfunction, like incorrect swallowing and mouth breathing. (See video information on TMJ and myofunctional habits) The myofunctional research approach looks at the myofunctional habit and what effect they have on the joint. More information on the ethological factors and the TMJ Disorder is contained in our library on TMJ. Understanding this key aspect, markedly improves diagnosis and treatment success.

The myofunctional TMJ diagnosis and treatment system now involves two-phases. It is simple, quick and patients love it.

The TMJ APPLIANCE™ which has been available as an immediate diagnosis and treatment system for more than 10 years has been a breakthrough in immediate diagnosis of TMJ Disorder. Good symptom relief from this appliance, ideal for night time use.

With the introduction of the TMD APPLIANCE™ featuring a harder semi-flexible, customizable day time splint, we have an ideal dually effective, easy to use system. The TMD APPLIANCE™ is ideal for daytime use, designed to work in conjunction with the night time TMJ APPLIANCE™.

Treatment with these appliances covers both intra capsular and extra capsular TMJ treatment. The TMD APPLIANCE™ is effective where molars are missing. The myofunctional aspect of TMJ Disorder is addressed with the TMJ APPLIANCE™ tongue tag and guard features. Although some variations in this disorder in the individual patient would lead towards treatment with either primarily the TMJ or the TMD APPLIANCES™, the use of the 2 phases system commonly covers the dual complexity in diagnosis whether the problem is just the Joint (intracapsular) - clicking, pain in the joint or limited opening or a cranio-mandibular/MPD type disorder (extra capsular). These two categories are often so overlapped that the majority of patients have both intra and extra capsular symptoms and causes.