Diagnosis and Treatment of TMJ Disorders
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- Опубликовано: 26 июн 2024
- Temporomandibular disorders or "TMD", often referred to as "TMJ", are disorders affecting the jaw joint and the muscles for chewing. They cause pain in daily life and restrict range of motion in the jaw. This talk provides an introduction to the subject and discusses the diagnosis and treatment for these disorders.
Speaker: Michele Jehenson, MD, Clinical Assistant Professor, Anesthesiology, Perioperative and Pain Medicine at Stanford University Medical Center
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This Lady Is Dynamic, and humble as can be.
It`s very terrible that there`s not any consensus about TMJ/TMD in the academic world. Every professional has a different opinion about it. And it`s terrible for the patients.
It’s that way across many medical fields, not only TMJ issues
@@trwilli25 There're many medical issues that doctors have an average consensus about diagnosis and treatment, but tmd is multidisciplinary and doctors have different methods..and updated each year, hopefully after many years of reading and discussion, i've found the prothetic conservative treatment way..which is special for every patient..
Agreed. I feel like a guinea pig
Yes this was very useful. I learned a lot. You’re a great teacher- thank you.
Thank you so much for this lecture
I'm glad the ear pain was brought up. That is the worse with the TMJ to me. I have to talk a lot, and by the end of my work day, I'm in a lot of pain.
buy massage machine, its like 50 dollars and it will worth millions to u
buy the vibarite ones
and do wim hof method
Good luck
I have such bad ear pain and dr thinks its TMJ. How did you find relief?
@Chrissy P I found a cold compress really helped me find relief 🙏
Outstanding program. It all made sense for this long time TMJ, osteoarthritis, etc. person. I am grateful that I didn't go down the permanent change route the doctor referred to even though it was pushed by so many of the providers I went to. I get the adaptability part. I understand that after 4 hip surgeries, so I feel like I have a new tool box now to work with. Thank you for a great program.
How can I get the program help that Mel is referring me to
Did you fix your issues? If so what did you do?
Very informative, thankyou
Brilliant lecture!
awesome video please continue to share
Excellent video content! Forgive me for the intrusion, I would appreciate your initial thoughts. Have you heard the talk about - Franaar Painless Smile Formula (erm, check it on google should be there)? It is a great exclusive guide for curing the TMJ disorder minus the hard work. Ive heard some interesting things about it and my BF at very last got amazing success with it.
Everyone who suffers from Tmd: you should check if you have a TONGUE TIE first and get it released, that’s often the root cause other than posture. Lots of people have resolved chronic pain and issues just from getting the tongue released and doing mouth and body posture exercises along with tmj exercises.
How do you get it released ? Where would I go to ?
Nice to read- getting mine released in a few weeks- been doing myofunctional therapy but doing it for other reasons, makes sense it could help tmjd also.
This is antiquated. Pain is pain. This lady needs to spend a week with her jaws partially locked and unable to open much and stiff and in pain. She needs to put up with the pain of arthritis in the Temporomandibular joint and headaches and jaw aches and then she'll shut up about psychology.
she made a slide at around 25 min's in, where she lists the 4 different causes/ categories of drivers of the pain. Centralized pain (what you referenced) is not the same as Chronic micro-trauma (locking, grinding). She is just trying to help educate us all & she seems pretty compassionate to me.
@amyloukate I have two dislocated temporomandibular joint discs without reduction and I have daily headaches, migraines, jaw pain, teeth pain, grinding night and day, worn down teeth, jaw locking. Dentists have to massage my jaws on each side to get them to unlock to close when I have dental work. I don't even remember what this lady said but I remember it was pretty uneducated and ignorant of reality. I'm reality. I live it.
Also forgot to add neck pain and ear neuralgia pain accompany mine
Nice video!!! For clearing doubts abt splint
Do you have a reference list for this please?
I am in so much pain from my jaw I looked it up and apparently it might be tmj I find it really difficult to sleep and I’m in so much pain it hurts to open my mouth
Hi, I'm a patient with diagnosed bruxism. I recently felt pain in one of my jaw joints, but it went away after a week. During the pain I went to dentist and he suggested me wearing splints JUST at night to prevent my teeth from wearing, and to help cure the painful joint - is it OK to wear the splits at night, or can it cause some more trouble for the joints?
Botox gave me some much needed relief. I still have to stretch my neck often. At the very least it can shed light on which muscles could be causing the problem. It didn’t fix it completely but it focused me more on my neck than my actual temporalis or massetter. Posture and mobility exercises help. Being a fuddy duddy and being lazy is terrible for tmj.
My issue is Crepitus. I hear/feel crunching each time I open my mouth. Also moderate pain on wide opening but Crepitus is mostly my problem?
Ive had so many treatments yet my bites still off ive has dental bonding teeth shaved down, multiple different Mouthguards and even has wisdom teeth removed... And ive has botox into my facial musxles 4 times yet its not getting better they refuse to do surgery's tho here in the uk...
What if u can’t open ur mouth wide but and u have no pain while trying to open ur mouth wide? Because I have ear pain and when I move my jaw it kinda hurts my ear and I barely can open my mouth and when I open my mouth pretty wide it doesn’t hurt.
actually a soft splint or a hard splint is not a matter of comfort or choice... It has to do with the diagnosis and the treatment plan. A splint is not a piece of molded plastic that fits between your teeth. It adjusts the occlusion in order for the patient to bite as correctly as possible.
@ Dr. Jehenson : What about Botox injections to the masseter muscles? i clinch my teeth badly and sometimes when i wake up the pain is unbearable! my question is, does it work? and is it just a couple of treatments 3 months apart, or is it a life-long thing? i asked a doctor and he said just a couple of treatments, 3 months a part, so overt the period of 6 months the muscles "forget grinding".
i asked a Dentist, and he said, no, its a life-long treatment, one injection every six months. please advise.
not life long, they wear out.
i stopped the video at 4 minutes and 26 seconds because i disagree that popping without pain does not imply a "disorder". if the tmj is "popping" then the articular cartilage disk is not in place when the condylar head is fully seated into the glenoid fossa. it also means the the condylodiskal ligaments have been torn. just because a person can adapt to an injury doesnt mean that they dont have a "disorder". i am going to resume watching now
100% agree
I have severe TMJ, Its really getting worse as I get older... :(
This woman doesn’t know what she’s talking about. She clearly doesn’t have this condition
Yes, I agree with you.
DrGlennChiarello sir plz if you can reply to this ...my mouth doesn’t hurt while opening wide and chewing but I have headaches and ear,neck exhaustion after my bicuspids extracted for braces because of this foolish orthodontist of mine ..am really angry sad and this thing is getting me to depression
I would like to make an appointment please
I'm experiencing Tinittus, ear pain, associated with dizzinnes what will I do?
Thank you! I learned a lot and I am just your basic 47 year old woman off the street searching to educate myself on this new jaw, neck and migraine pain I am getting for a few weeks now. Been going to a decent chiropractor but unable to find relief yet. Went to my dentist today, she said to have chiro work on my jaw joint but if he is unable to get results she would send me through pt. Sounds to me like I may consider giving my beer loving husband an ultimatum so I can reduce MY stress load. Let him have the pain in the neck. Lol.
Did you find anything that helped you? Doing physio now and I don’t think it’s really helping since I’m still getting pains although I suspect it’s the nightguard
@@socialmediag5485 I no longer have jaw pain. I went to a chiropractor that specialized in "chiropractic bioPhysics". They put me through traction and regular chiropractic treatments and taught me how to stretch. I walked in using a cane and a year later after the program I am still free from fibromyalgia and tmj. I also, in conjunction with this whole time frame, found out I was diabetic, went on medication, changed the way I look at food now and spend time educating myself on nutrition, I found myself wanting to connect with like-minded people and joined a church and actually got involved. I also went back to work at a job that doesn't satisfy the bills for everything yet is enough and the job feeds my soul. I also did remove the stress-filled marriage by becoming separated. I pray daily now, all day Jesus is first in my life and I believe these changes did more to give me the jump start I needed with the chiro but kept me going by teaching me how to release stress and manage it so I can live with a heart I am proud to have and I CHOOSE to let it shine every day. I pray you will find the relief you are seeking.
23:30 Maybe correct, but I'd like to see what they actually did in those studies. Just because what they did failed doesn't mean there is no correct procedure. It may simply mean what they are doing doesn't work. I'm also not convinced that TMD is a dental problem, but I'm skeptical of vague research claims that don't specify testing or treatment method and extrapolate that to all future testing and treatment.
I agree that splints don't help in fact caused mine. Interesting video however it left out some major issues and treatments for TMJD. I do not believe at all that dental treatment should be recognized as a treatment. I've had TJR both sides and it's the ONLY thing that's ever helped me with function, dislocation and pain. I love my 3D printed joints
@@favoriteandcuriousmusic4389 total joint replacement, i think
Is that when they put a metal black in your jaw??? Damnnnn I’m assuming it was painful as hell .l. Is that something that’s one and done or they gotta open you up again at some point ... I’m scared I’m headed that way
Does anyone else experience teeth slamming together while sleeping? It wakes me up so I know I do it often and my husband has heard me doing it. I don’t grind but I slam them together very hard, it’s very painful and only happens when I’m sleeping. None of my dentists have ever heard of or seen this before. Can’t find any information about this particular kind of “bruxism”.
is collagen good for a person with TMJ disorders?
trauma during sparing to jaw, Knee to the Jaw, Jaw clicked Backwards, and then clicked forwards on both sides. Immediate Discomfort. I grabbed my Jaw, Pulled Down and Forward, and the leftside, clicked and immediately felt better. However, I have never been able to fix the right rise and it still is very uncomfortable. Please Help! Should i Just Try to pull harder on the right ride?
Is it possible to a dislocated jaw to push or close the ear canal?
Don’t ever push or pull. You might injure and change the whole setting. Make it worse. Get expert advice and physio.
madam i need this book
kaplan a. s. and assael l. a. 1991. temporomandibular disorders. diagnosis and treatment.
I have disc displacement with reduction and every splint I tried made my pain unbearable and overall worse off than I ever had before trying splints.
Anything get better for you? Got a custom splint and started off fine but I keep getting pains now and. Suspect it’s that that’s causing me the issue . Got an appointment in 2 weeks and I’ll try and convince for more tests to find out the root cause cause I don’t want this crap for life lol (although I suspect it’s cause of my deviated septum but still waiting for the surgery)
@@socialmediag5485 no, it never got better. Some days I’m in so much pain. Nothing really helps long term. Every splint I had made it worse… I’ve considered surgery but the risks are scary.
Same I had a hard guard made a soft one and a fancy splint all made worse it jacked up my bite. I had Botox aswell and that literally made my left joint lock... It got worse after I had my wisdom teeth removed seems we get no help from dentists or Drs I've seen every single Dr under the sun specialist dentist's, oral surgeons, Maxifacial surgeons. And pyhsios it sucks honestly.
What causes the pressure/clogged feeling by the joint? That is my main complaint.
Me too! Have you found any relief? It feels like everything is “bunched up” in that area.
@@amberray3081 I think arthrocentesis would help? I believe it's a build up of fluid in the joint
can anyone explain the self limiting nature of osteoarthritis? I have it in my left tmj and it's reassuring to hear that it has the potential to heal, but i've read of many people online who have arthritis in their jaw joints and end up getting tmj replacements because of how significant the damage is over time. is it self limiting only in certain scenarios/cases? I've acquired a very minor open bite as a result of the osteoarthritis, but have never once felt any pain associated with it and have had crepitus already for 2-3 years.
What is your current status ...?is ur tmj alright
@@deepamonimoral7574 Hello
I still have this "issue" but it remains painless. From my understanding after seeing a few jaw surgeons, it appears as though the remodeling process that my condyle underwent due to the arthritis has actually somewhat stabilized my joint. I still have the grinding noise when I open my mouth, but it has remained painless for all these years and my bite has not worsened.
@@akshayoberoi9626 same here 😭
What's ur age ?? I got it in my 19
And where r u form
@@akshayoberoi9626 I have the same question and sounds I have a larger overbite. No pain but ear fullness/pressure. Wished I knew best sleep position if also have OSA
@@deepamonimoral7574 do you have arthritics in jaw joint
Dear Friends, hope you all are keeping well.
I had the same issue and i had spent many days and nights with this extremely severe pain, I did remember one day the pain was unbearable that i even could not sit and kept walking in my room.
Hight capacity pain killers are effective for sometime only so i can consider the situation you are into,
But luckily, one of my brother in-law who used to be a wrestle visited my home and asked me what happend, i explained him the issue, he said give me some olive oil and i will message you i said okay, He took some oil in his palm and apply on my left side neck and gently started going up and down and after 3/4 minutes he started doing with little bit more power then i had sensation kind of thing in my neck and behind the left ear he kept doing it for few more minutes and instantly i felt relaxation, he asked me to do the same 2/3 time more, i let the oil there and dried it with dray cloth, and after 15 minutes had good bath with luke warm and from that day i am all okay so i would suggest you to do the same.
If any question ask me freely.
Wish you all very good health.
What about an over or under bite where one part of the jaw has less growth it's never mention
Dr Jehenson- overall I would say your presentation was excellent. However, I do feel you are misleading the public when you tell people to avoid orthodontic treatment. What should be noted is orthoDONTIC treatment without orthoPEDIC consideration should be avoided. That is, specifically, orthoDONTIC treatment without regard to the position of the TMJ's. There are in fact patients who do respond positively to orthoDONTIC treatment that includes orthoPEDIC correction. Obviously, as a dentist, you can appreciate the implications of a patient with a severe deep bite or class 2 DIV 2 malocclusion. Besides cosmetics, if there in fact was TMD issues, due to the condyles being displaced too far posteriorly in the mandibular fossa, would you not agree that the goal would be to orthoPEDICALLY move the condyles forward into a more "ideal" location in the fossa? As you stated in your lecture- sometimes you see patients that have good joint position but develop TMD, and patients with bad joint position that have no TMD. But the opposite is also true in BOTH situations. As well as some people may respond to orthodontic/orthopedic intervention, and some may not. But don't take it off the table if it will benefit the appropriate patient. If the research doesn't match the clinic, then the research is wrong. TMD is a multifactorial mystery and the methods for treating it are still evolving. Thanks again for your wonderful presentation.
So if ones teeth don’t agile at all, it’s not an issue? There’s no way for my jaws to rest or my teeth to meet lol that causes pain
Seriously no “science” can tell me it doesn’t cause pain haha
Mine slippes frequently while eating,and it is happing daily now,like it goes for picknik every day and comes back with a lot of pain 😓😫
Same. I only get the pain after eating, usually only once a day
Are you available for online consultation.. I am from India
Can TMJ problem cause tinnitus? I can increase the volume of my tinnitus when clenching my jaw, stretching my neck.
yes, its one of the most common symptoms
however, it usually subsides if adequate treatment of TMD is received
I saw this video by a Doctor. Check it out. It has great information. Hope it helps
ruclips.net/video/lrBYH-8IzQs/видео.html
@@singhshredz where to get proper treatment
Thanks for the upload..!!..XD
Excellent Video! Apologies for butting in, I am interested in your initial thoughts. Have you considered - Franaar Painless Smile Formula (probably on Google)? It is a smashing exclusive product for curing the TMJ disorder minus the hard work. Ive heard some extraordinary things about it and my cooworker after many years got cool results with it.
Hello, is there a way to determine if the lateral ligament or TMJ capsule is torn/detached after trauma?
you can place your pinky into the external auditory canal with the soft part of your pinky facing forward. ask the pt to open and close, you are now feeling the lateral pole of the condylar head, if you feel "rumbling " or something moving under your finger that does not feel like an osseous structure it is likely to be the articular disk moving. now you know that the lateral ligaments have been torn or stretched (at the very least). if you dont feel something moving then it may also be possible that the articular disk is locked anterior to the condyle and is not reducing as the patient closes.
this is a more serious issue and definitely implies the possibility of torn ligaments.
@@DrGlennChiarello Thank you for this info, much appreciated. Is there an imaging option such as MRI to confirm if the lateral ligament or TMJ capsule are detached? Also, what is the treatment for a torn/detached lateral ligament?
@@starchaser28 if you suspect that you have a stretched or torn lateral condylodiskal ligament then you probably hear a click or a pop on the same side. mri views in the open and closed positions will confirm that the articular disk is out of place in the closed view and likely in place in the open view. the issue is that the ligament allows the articular disk to rest in front of the condyle in the closed position. the bigger question is though, is it the entire articular disk or just the lateral pole (the side closest to the outside of your face).
if it is just the lateral pole then mitigating the injury by keeping muscles relaxed is the best treatment. orthotic therapy is usually the best and easiest but is sometimes followed by a bite correction (that is easier than it sounds in a lot of cases in other cases bite correction requires orthodontics). if the entire disk is dislocated it may be best to tether it back into place surgically. keep in mind that a surgical repair is only required in extreme cases and most people have only a partial dislocation or even a lesser part time displacement.
@@DrGlennChiarello Thank you so much for this information. I do indeed hear clicking/popping on that side, and feel certain that I have a torn/detached lateral ligament and capsule. It occurred suddenly after biting down on hard candy 3 years ago. I subsequently had restricted opening of 22mm, so I pursued splint therapy treatment which restored range of motion to 43m, however my lower jaw is canted slightly, and my right TMJ is hypermobile. I'm searching for the possibility of ligament repair surgery, but haven't been able to find anything that addresses the lateral ligament specifically. Any guidance or referral would be greatly appreciated. Thanks again
@@starchaser28 what you have described sounds to me like a little more than just the lateral pole ligament tear. it sounds like a total disk displacement and dislocation. two doctors i would feel comfortable referring you to are Dr Mark Piper, and Dr Edward Zebovitz. they are both surgeons who can repair your injured joint. you also may want to look at the website of Dr John Droter, he has a lot of information about tmj disorders/disease for lay people. easy to understand. if you are on the east coast or even if you are not, these are the folks that you want to consult with. Dr Droter may be the best starting point for you. good luck
I’m so confused! What the hell should I do? I’m suffering here. I have dizziness, buzzing in my ear, neck and should pain. I can’t take this pain any longer. I’m so depressed!
Got any better? If so how?
I was diagnose while eating a breadstick, my mom has it, plus I have all the symptoms.
Is TMJ cause problems with n face nerve?
Yes
I need help plzzzzzzz for my this pain plzzzzzzzz help me
I cannot eat it painsand makes a cringlt sound
This is riduculous. The whole 'never do orthodontics'! if someone's teeth don't fit and its causign their jaw problems they will have to have braces.
have you ever heard of bite pressure tests?
You can't fix a problem if you don't figure out why it's happening in the first place.
You likewise can't tell someone what they should do when you can't tell them why they have a problem.
There are flaws in thinking and recommendations by many in TMD medicine. They form conclusions about 'the evidence', which includes many quite flawed studies. Studies flawed because the authors didn't understand key points about physiology and why TMD develops.
When one understands the reason for a persons TMD, one then can individualize patient care, and in that individualization of care know the solution is the most appropriate to the case.
Physicians who try to use randomized controlled trials to find out 'what works' in TMDs, often do not understand TMDs. TMD's are systems disorders. They're not jaws, and jaw joints, and teeth problems. But disorders of systems. A fact that is rarely, if ever, really acknowledged in research studies of TMDs.
TMDs are a phenotypically diverse patient population to which RCTs are quite limited in evaluating. The study design itself prevents 'really modeling the problem'. You can't really figure out what works for 'TMD' when every persons TMD is different and requires personalized care. You certainly can't blind the study. You also can't have a placebo.
Trying to use Research Diagnostic Criteria that simplifies the TMD population so that they can perform those studies leads to an inherent misrepresentation of 'what's really happening'. And thus, what 'really works'.
That physicians provide recommendations upon such flawed thinking is WHY the field of TMD medicine is full of unsatisfied patients.
The most important message one can take away from this presentation is that the physician doesn't know how to fix TMDs, therefore, the advise being provided isn't based upon efforts to fix TMDs. Which means, why would they know what does and does not work when they haven't been studying that.
no pain... no disorder?! Popping and clicking is the disc displacing and reducing. That implies the disc is not functioning as it should. It doesnt hurt yet... but it is the dsyfunction that eventually leads to the retrodiscal tissue getting compressed causing pain and eventual degeneration. Why is the disc displacing and reducing? MRI evidence suggests hypertrophy of lateral pterygoid... the muscle that connects directly into the disc. Maybe we should start working on the pterygoid muscle and address imbalances and postural issues in patients with popping and clicking but no pain rather than waiting for the problem to degenerate further.
Best comment. Thank you :)
My mouth doesn’t hurt while opening wide and also I don’t have pain while chewing but I got headaches and neck ear discomfort after teeth extraction for braces please if anybody knows what this symptoms are am getting anxiety
Urgyen Lhamu Eustachian tube dysfunction or it could be wide spread pain that needs to heal due to the extraction and the braces
I`ve been anxious to search for remedy for my facial discomfort and other associated TMJ symptoms and had suddenly discovered this TMJ treatment. I`ve used this TMJ treatment for somewhat over 12 days now and the results are extraordinary. I have never felt comfy sleeping in my bed up to now that I got rid of my facial pain and headache. The guidebook I a.m talking about, I found it by Google. visit here t.co/s5Or7HLh0w
will braces help tmj?
Mam i faced the pain in wide opening time of mouth and chewing i how to recover this pls give me a solution😢
In accordance with all my signs I`ve been clinically determined by a holistic doctor as having TMJ and he had advised this TMJ treatment t.co/s5Or7HLh0w to me. I heed his suggestion and proceeded to read through the manual for 11 days and it has been successful. I experienced alleviation of pain because of its distinct tactics. I`m now pain free from the face and jaw..
♣♣♣♣Can anyone explain the self-limiting nature of osteoarthritis? I have it on my left tmj and it's reassuring to hear that it has the potential to heal, but I have read many people online who have had arthritis in their jaw joint and ended up getting a TMJ replacement because of how significant the damage was over time. does it limit itself to only certain scenarios / cases? I had a very small open bite due to osteoarthritis, but never had any pain associated with it and have had crepitus for 2-3 years. For more information click here: tinyurl.com/yxp26daw?GerTUs1 > ♦♦♦♦
I e recently developed this terrible condition my God man…
How is it now
I just have popping and clicking no pain or locking up. I guess I don't have TMJ then lol.
I suggest this TMJ treatment t.co/s5Or7HLh0w to all my patients who`ve got TMJ . The truth is, anyone who has read it can attest to the effectiveness of its guidelines through showing recommendations on how the book transformed their lives. Surely, this program is the most beneficial one I have found from the ones I`ve accumulated..
I have clicking in my ear and my ear was hurting so badly yesterday
20:00
4:07 so what the fuck did i have?
No pain, no limited opening but clicking, what is this?
bad dogs
at time marker 9 minutes and 24 seconds the speaker said that muscle pain in the masseter or temporalis muscles is a common tmj disorder-REALLY????!!!!
It is for me
In my experience, they can certainly be co-morbid.
I think the lady is overestimating the psychological component in the experience. This is secondary to the pain not the primary concern imo.
In accordance with my signs and symptoms I was clinically diagnosed by a holistic physician as having TMJ and that he had advised this TMJ treatment to me. Right after adhering to the advice for 11 days , it had transformed my life. I experienced comfort of pain due to its distinct techniques. The face and jaw pain had entirely vanished. The tip I am talking about, I found it on Google. Name of it is Cora Tmjocυn
hope
Unfortunately, this is not informative nor helpful. It pretty much explains how stupid the healthcare system is and how tmj falls into a gap between providers. It’s fucking frustrating and at this point in my journey, preposterous.
This presentation was pathetic. No any useful information that could translate to actual practice.
We need more experimental data than hunch feeling of individual patient adaptation and resilience that practically have no value to a practicing dentist in terms of TMD improvement.
I wish I could give this a 1000 dislikes.
I mean where is the information in this video.
If things are not adding up, a more scientific approach would be to make adjustments to your hypothesis and look it more closely with more data,
NOT RESORT TO USELESS FEELING OF INDIVIDUAL RESILIENCE AND ADAPATATION. Dentistry research is clearly lagging behind.