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Medical Forum / General / Dentistry / September 20083 major causes of tmj pain
In my practice, I see three major causes of TMJ pain, (1) OCCLUSION....MEANING PTS HAVING GROUP FUNCTION OR BALANCING SIDE FUNCTION (2) FIBROYMAGLIA (3) JOINT PROBLEM If those are the 'causes' what do you think is the solution? BTW, all caps are rude. Steve > In my practice, I see three major causes of TMJ pain, > [quoted text clipped - 4 lines] > > (3) JOINT PROBLEM "(3)" interests me. Joint problem. Well, the TMJ as a joint/s can have problems that run the gamut from essentially inconsequential to catastrophic. The gamut of solution options is where my interest lies in this thread. If the joint problem is in the realm of "disastrous and catastrophic", one needs to determine the cause of such condition. Then... there are the solution options ... and that is when the real dilemma begins. Webby > If those are the 'causes' what do you think is the solution? > [quoted text clipped - 10 lines] > > > > (3) JOINT PROBLEM > If those are the 'causes' what do you think is the solution? > > > (1) OCCLUSION....MEANING PTS HAVING GROUP FUNCTION OR BALANCING SIDE > > FUNCTION Treatment: put patient into anterior guidance > > (2) FIBROYMAGLIA Treatment: send to physician who usually uses drugs---usually low dose Elavil. > > (3) JOINT PROBLEM Treatment: rest. then rest, then send them to other providers. The question is what are the numbers of who has what. Joint problems are fewer than fibromyaglia. Occlusion problems are by far the greater number. I saw a patient this week, in her early forties, who told me they were going to do TMJ surgery about 10 years ago, but she couldn't afford it. She changed her occupation from answering the phone at blue cross blue shield to medical coding. She has a small lower jaw. And also, another patient I saw this week, age 29, has TMJ, with a lower jaw, and she lives with it. She has the popping and a small lower jaw. In article <344a8d5a-ee09-42eb-8910-e8e3e7663c1c@b1g2000hsg.googlegroups.com>, > > If those are the 'causes' what do you think is the solution? > > [quoted text clipped - 23 lines] > lower jaw, and she lives with it. She has the popping and a small > lower jaw. What did the occupational change have to do with anything? Chances are, she did *not* need surgery on her TMJ/s in the first place. "Need" is a funny "thing". Personally, I'd be very interested in knowing the name of the "TMJ surgery" that she was told she needed about ten years ago (making it around 1997-1999). And the 29 yr old who "has TMJ" ... what is her real diagnosis? Webby > In article > <344a8d5a-ee09-42eb-8910-e8e3e7663...@b1g2000hsg.googlegroups.com>, [quoted text clipped - 37 lines] > > Webby- Sheesh, Webby, don't make it so tough on this guy by asking reasonable questions. :-) - dentaldoc In article <ee21e756-1078-47b1-bff4-83a073c90fa8@f63g2000hsf.googlegroups.com>, > > In article > > <344a8d5a-ee09-42eb-8910-e8e3e7663...@b1g2000hsg.googlegroups.com>, [quoted text clipped - 42 lines] > > - dentaldoc You know, I can't figure out whether he *believes* this stuff or because it pays to "believe" this stuff, he "believes". I'm trying to be diplomatic but that isn't easy when AC is calling out "Danger Will Robinson" and others such as yourself are raising red flags. I coined a term more than a decade ago and it seems to fully apply to this situation. "TMJism." Maybe we should toss the term around a bit. Hmmm. Webby O > > > If those are the 'causes' what do you think is the solution? > [quoted text clipped - 15 lines] > > are fewer than fibromyaglia. Occlusion problems are by far the > > greater number. > What did the occupational change have to do with anything? Chances are, > she did *not* need surgery on her TMJ/s in the first place. "Need" is a > funny "thing". Personally, I'd be very interested in knowing the name > of the "TMJ surgery" that she was told she needed about ten years ago > (making it around 1997-1999). When a patient told me she needed TMJ surgery 10 years, I left it at that. She said she changed jobs because she talked too much. By not talking so much, she was able to deal with her symptoms. Rest can cure many orthopedic problems. She seems fine and did not complain to me that she still needed it. I asked her if she had any problem sleeping, or if she had pressure point problems and she said no. She wears no dental appliance. In my practice, I see very few people with joint problems, and to see 2 people in the same week is rare. Most TMJ PROBLEMS, and you can call it whatever you wish, is due to occlusion, followed by fibromyaglia, and then to faulty tmj anatomy. And if you have faulty anatomy, when is surgery necessary? Are people who have fibromyaglia being misdiagnosed as anatomy problems? What percent of adults have faulty anatomy? I do discuss this in my book, "Insider's guide to gum disease, orthodontics, and dentistry. What is not taught in dental school. " David DiBenedetto, DMD Writing a book takes alot of time. Anybody who has written one will tell you. It gives me a foundation for what I believe and then others can say they disagree with parts of it. There are alot of unanswered questions in the book. > And the 29 yr old who "has TMJ" ... what is her real diagnosis? > > Webby In article <f1b1eca9-b740-4dd5-9e6f-1ec2603dcb0d@25g2000hsx.googlegroups.com>, > O > > > > If those are the 'causes' what do you think is the solution? [quoted text clipped - 51 lines] > > > > Webby In other words, her problem is not *inside* her joint ... otherwise, you'd have a more definitive diagnosis, wouldn't you? No wonder "medical insurance" thinks joint disease of the TMJ is *bogus*. Would you *know* the real thing if it came into your office? Webby In article <f1b1eca9-b740-4dd5-9e6f-1ec2603dcb0d@25g2000hsx.googlegroups.com>, > When a patient told me she needed TMJ surgery 10 years, I left it at > that. She said she changed jobs because she talked too much. By > not talking so much, she was able to deal with her symptoms. Rest can > cure many orthopedic problems. She seems fine and did not complain > to me that she still needed it. I would have a hard time *not* asking what "it" (the surgery) was, as in *the name of the surgical procedure*, at the very least!! I'm glad she doesn't think she still *needs* it ... whatever "it" was ... There are people who for very limited reasons have need for surgery on the TMJ. As I wrote before, that is where the *real* dilemma begins. What do you do with patients who come to you with a history of TMJ surgery and for whom their troubles permanent chronic and/or progressively degenerative? I'm sincerely hoping that you don't have any in your practice. But if you do, who do you manage their needs? Webby > In article > <f1b1eca9-b740-4dd5-9e6f-1ec2603dc...@25g2000hsx.googlegroups.com>, [quoted text clipped - 21 lines] > > Webby I have seen one patient in 28 years of practice who came to see me who had surgery on one TMJ by an oral surgeon. I saw her 10 years after the fact. From what I remember, she had constant ringing in her ears. The surgery helped her but did not cure her. She had surgery on on TMJ. I was surprised when I saw her that she had what I called bad occlusion: balancing side function. I took it away and put her in anterior guidance. It helped her a little bit. I lost seeing her because of fee dispute. I would have liked to have followed her. She also traveled a good distance to see me. Most dentists don't see enough TMJ surgery results. Dentists don't follow orthodontic results, and you think they are going to follow tmj surgery results. Is there any review of the literature about your surgery and the results? I would probably send you to physcal and occupational therapists. For pain problems, that is a sticky problem. I've seen chronic pain with apicoectomies near the sinus, sinus surgery, and third molar extractions. Patients who have amputations may have chronic pain. Vit D therapy may lessen pain for some. In article <ec6e916e-021e-4c43-8d66-fe7c0dc6a154@c58g2000hsc.googlegroups.com>, > > In article > > <f1b1eca9-b740-4dd5-9e6f-1ec2603dc...@25g2000hsx.googlegroups.com>, [quoted text clipped - 36 lines] > surgery results. Is there any review of the literature about your > surgery and the results? My surgery? Dare I ask which one? As for the last bilateral TMJ surgery, *yes*, there is review literature about the surgery and the results. > I would probably send you to physcal and occupational therapists. > For pain problems, that is a sticky problem. > > I've seen chronic pain with apicoectomies near the sinus, sinus > surgery, and third molar extractions. Patients who have amputations > may have chronic pain. Vit D therapy may lessen pain for some. Webby ROFLMAO! Steve Most TMJ PROBLEMS, and you can > call it whatever you wish, is due to occlusion, followed by > fibromyaglia, and then to faulty tmj anatomy. Just realized that this guy is also treating patients. ;-( Steve > ROFLMAO! > [quoted text clipped - 4 lines] >> call it whatever you wish, is due to occlusion, followed by >> fibromyaglia, and then to faulty tmj anatomy. Reminds me of HC Fields  Signature/ Amatus / > > Just realized that this guy is also treating patients. [quoted text clipped - 10 lines] >>> call it whatever you wish, is due to occlusion, followed by >>> fibromyaglia, and then to faulty tmj anatomy. >Reminds me of HC Fields Huckleberry Fields ? Thought it was Strawberry... Can you make it to San Antonio ? Would you believe this is the first year in about 15 that I chose NOT to pay my ADA dues? If everyone else is going, I will have to figure something out. What are the dates? Signature/ Amatus / > >>Reminds me of HC Fields [quoted text clipped - 4 lines] > > Can you make it to San Antonio ? October 16th-19th. I'm flying in on the 13th and leaving on the 19th. D > Would you believe this is the first year in about 15 that I chose NOT to pay > my ADA dues? If everyone else is going, I will have to figure something > out. What are the dates? I am up to my eyeballs with taxes and new bills from the sale of the practice and the new house. Let me see what the budget will allow, but I may not be able to swing it this year. Signature/ Amatus / > > October 16th-19th. [quoted text clipped - 6 lines] >> pay my ADA dues? If everyone else is going, I will have to figure >> something out. What are the dates? > I am up to my eyeballs with taxes and new bills from the sale of the > practice and the new house. Let me see what the budget will allow, but I > may not be able to swing it this year. No pressure. Haven't been to one for years, but I promised my wife to take her to Texas (and Hawaii next year). We were supposed to go to Texas 14 years ago....oops, someone made a mistake. Steve >> > > If those are the 'causes' what do you think is the solution? >> >> > > > (1) OCCLUSION....MEANING PTS HAVING GROUP FUNCTION OR BALANCING SIDE >> > > > FUNCTION >> >> > Treatment: put patient into anterior guidance Nope, construct an NTI. >> > > > (2) FIBROYMAGLIA >> >> > Treatment: send to physician who usually uses drugs---usually low >> > dose Elavil. Send them to an drug impaired physician ? >> > > > (3) JOINT PROBLEM >> >> > Treatment: rest. then rest, then send them to other providers. Refer out what you don't know how to treat ? David, you really don't have a clue. Here's a hint quit now to avoid lawsuits later. Gotta go, just ruined another keyboard. This guy is scary >> If those are the 'causes' what do you think is the solution? >> [quoted text clipped - 23 lines] > lower jaw, and she lives with it. She has the popping and a small > lower jaw. Nah, he's just another annoying narcissist. >This guy is scary > ><borat-heath@crap-cast.nut> Give 'em enough rope..... ;-) Steve > Nah, he's just another annoying narcissist. > >>This guy is scary >> >><borat-heath@crap-cast.nut> Wishful thinking ? >Give 'em enough rope..... > [quoted text clipped - 6 lines] >>> >>><borat-heath@crap-cast.nut> Ever notice we see more facial pain (migraine) patients with perfect cuspid rise and perfect tooth alignment than we do with mal-occlusions???? Signature/ Amatus / >> If those are the 'causes' what do you think is the solution? >> [quoted text clipped - 23 lines] > lower jaw, and she lives with it. She has the popping and a small > lower jaw. "Danger Will Robinson!" > In my practice, I see three major causes of TMJ pain, > [quoted text clipped - 4 lines] > > (3) JOINT PROBLEM Yep. And ... yep. > "Danger Will Robinson!" > [quoted text clipped - 6 lines] > > > > (3) JOINT PROBLEM The guy is definately "Lost in Space" > Yep. And ... yep. > [quoted text clipped - 8 lines] >> > >> > (3) JOINT PROBLEM |
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