The TMJ and Neck Connection
Those truly involved in treating TMJ pain and facial pain are very aware that neckaches and headaches are a common complaint and problem with these patients. There are many issues that can cause TMJ dysfunction.
Many of these are occlusal (bite) related. Whether a patient has a deep bite, or overbite, or excessive wear on the teeth, the retrusive positioning of the lower jaw can result in the jaw joints being pushed backward, resulting in displacement of the disc. This is what causes popping of the joints and straining of the muscles of the face.
When these changes are occurring, another issue is occurring that is in the neck. In order to have less strain on the lower jaw muscles that are being retruded, one’s head accommodates to these changes by moving the head forward. A term, we call forward head posture which really places the head forward of its normal posture. This forward head posture places a great deal of strain on neck muscles and trapezius muscles which in turn leads to neck pain, head pain, and even back problems. Finally, this strain and forward head posture can lead to loss of normal curvature (lordosis) in the neck, a common finding in TMJ patients.
This is why it is essential for TMJ examination and treatment needs to include posture and cervical evaluations. It is not just about the teeth. These issues can clearly be visualized in a 3D scan as well as somewhat during clinical evaluation.
Before any treatment is started, it is important to assess the relationship between the jaw (TMJ), neck, and teeth to see what needs to be done to improve and stabilize this relationship. Why would one start treatment in a pathologic position and restore teeth in this same bad position that is causing the problems? This will result in teeth that meet to together with poor joint position and neck pain. When working with TMJ and cervical patients, it is advisable to start with reversible procedures to resolve these issues first.
In addition, it is best to use sophisticated computer equipment and instrumentation with electromyography and jaw tracking to scientifically be able to assess and track and document bite relationships and neck stability. It is also essential to try and have the muscles as relaxed as possible prior to taking bite relationships. This includes relaxing the postural muscles as well. It is possible for teeth to meet in a nice relationship and still have joint and neck pain.
As a final part of the equation, it is also essential to have an airway evaluation. If one cannot breathe through their nose and is a mouthbreather, abnormal bite relationships and narrow arches can develop. An evaluation of the airway, tongue function and lip seal is essential.
With today's technology, most cases can be treated non-surgically and help to change patient’s lives for the long term.
If you have any questions regarding Houston TMJ Treatment or TMJ Pain, please feel free to contact our office, Ronald W. Konig DDS, FAGD, LVIF, FIAPA, 713-668-2289.