hi I'm my name is dr. Adams and I'm a dentist at
Maryland Holistic Dentist in Burtonsville Maryland and I am going to answer
questions about what are the treatments for TMJ I'm gonna review a little bit
because I want to talk about what causes TMJ I have some other videos that really
go in a lot of detail about this but simply TMJ is caused by activation of
the night time clenching reflex and the clenching reflux is a defense mechanism
to clear the tongue of the soft tissues that have collapsed into the airway and
that happens in deep sleep the tongue is a very powerful muscle and when someone
gets into deep sleep the tongue a relaxed and this occurs when there's not
enough space between the jaws for the tongue to to exist and it occurs in
individuals that have small mouths and small nasal passageways there's
literally not enough firm time to fit so the time being about the muscle when it
relaxes will fall back into the airway and the defense mechanism is a body too
for the body to quants to get the tongue up and out of the airway so there in
wise it frames a question what are the treatments for TMJ and I'm going to get
into the treatments for TMJ to work and the treatments for TMJ that manage the
TMJ problem the ones that can correct the problem and the ones that just plain
and simple do not work so focus on the problem that TMJ is caused by a small
small jaws and a tight space where the tongue can't exist the tongue falls back
into the airway what we're talking about our treatments that actually create more
wing in the mouth for the tongue and there's
also the issue of the bite and the jaws are small and the teeth are in tight the
jaws are having to close too far because they're under sized there will be a lot
of tooth clenching and there's been a lot of focus on the bad boy and
certainly one the teeth are tight in their crowded and they don't fit well
because of a small mouth that bad bite really is related to the the undersized
and the under development in the in the mouth so we what we really want to focus
our treatments on things you're gonna create more space in the mouth for the
tongue and the other tissues to stay in the mouth when they belong and not
collapse into the airway and I myself have found this to be a very personal as
well as professional area that means a lot to me when I was a kid I had a lot
of tooth crowding and basically what happened to me is I had four teeth
removed and I had braces which pulled things back and that didn't fast
straighten my teeth but it permanently shrunk the size of my mouth and really
created even less space for my tongue and surprise surprise I've been a
clencher ever since so I do want to say that the number one treatment that I
think will not work at least on its own for treating TMJ is orthodontics
orthodontics are wires they will not create more room in the mouth they will
you know retain bangs and possibly even retract things they will bring this
awful the teeth and the soft tissue if
anything you know further back into the airway there are other modalities that
will create more room in the mouth and they can be used in combination with
orthodontic wires so that's not to say that wires won't work at all but there
are orthopedic treatments out there and this is for adults this is an appliance
called in DNA appliance and basically I know you can't see it very well here but
I've made one of these these for myself and what it will do is it will create
more width and more depth to the mouth it takes anywhere from one to two years
to to do and it's seen on schedule much like orthodontics but instead of moving
teeth it actually increases groves bone and creates more room in the mouth for
the tongue and the soft tissues it also establishes more height to the jaw so
you're not closing your jaws down so far and I really is a perfect treatment for
TMJ also this appliance if you look at it really closely it has a split down
the middle and it's shaped like a why it also looks somewhat like a retainer
so it does a very good job of keeping the front teeth straight as it creates
more round and the other thing that it does is it has an area for the lower
teeth to plate upon so it has a mechanism where you can open and balance
a budget as you're making them the mouth bigger and wider so this really is an
ideal treatment this is a treatment that will simply put will open and create
more room in the mouth and it will in fact make the airway larger because
it'll grow the jaw bones out and forward and moving all the substitution out of
the airway it also increased the diameter of all the wall about including
the bone tissue in the airway it also will balance the bite you you
know we have complete ability to change the body this things are getting bigger
and opening up so simply put this device bounces by you it opens the airway and
if this treatment is handled the right way it can actually correct TMJ and it
actually if it opens the airway up enough can in many cases correct
obstructive sleep apnea and sleep disorders there's another appliance that
has been out since the 1980s it's a springy little wire and I use
this a lot for kids and basically what it does see these little loops right
here these little loops can be kind of opened up in and bent you know the
dentist will you know let's dentists orthodontists people will bend wires and
we can put pressure and move teeth in this case it goes in the mouth these
little loops go over top of the lower molars and it all kind of do this so
basically we'll give like a gentle outward pressure and instantly not as
soon as I put this in my mouth I really feel like there's something something in
there I'm going to play with it so my tongue pushes upon this AOF appliance
which stands for advanced weight wire functional I'm not really sure what the
advanced means but it is a white wire which supplies a light force and it
utilizes functional forces to do its movement to some extent and that
functional horse that it uses to apply pressure and stimulate the movement and
growth of bone is that and the tongue is really important and I
find it song to be a really really interesting thing that song when the
kids develop in will put pressure on the upper and lower jaws when it's moving
properly you know it pushes out stimulates it and a lot of people have
what's referred to as a tied tongue and I know the tongue does a lot of things
but being a dentist the main thing that I really like to see the tongue do is
not be tied so it can stimulate and push on the bone as people talk to do
different things and and and the tongue movement really has almost everything to
do with creating the puck proper proportions and size of the upper and
lower jaw and when the tongue is not doing its job that is when the tongue is
tied we can see a lot of problems so the two conditions where people end up with
TMJ that I that I really think are occurred the most often they're just
genetics which is a strong predictor if you see parents and grandparents a small
Mouse and crowded teeth and then you see these you know genetics is a strong one
and where you see tongues that are tied that you know that they're tied down to
structures they shouldn't be attached to some people at the tone can't come out
and can't swing can't come out and swing side to side or not that probably you
know definitely had some of those problems myself so don't look scary over
a couple of treatments that I think might man it's a problem
these orthopedic appliances secrete more room can actually correct the problem
appliances that can manage the problem and I've used a lot of these appliances
in the past I've been a TMJ dentist for over 12 years and what we would do is we
would make white splints or night guards and basically what the with the bite
splints and light guards will do is it's a piece of plastic you put in your mouth
and you can adjust the bite on it and get the jaw into a more comfortable
position you can position the jaw a little more forward to get the airway
opened up a little bit and for many people it's long as they're wearing this
appliance at nighttime it can make them feel anywhere from I'd say thirty to
seventy percent better with respect to TMJ pain and symptoms and this DNA
'pliance has only been out for the last five years so you know
surprise surprise I've had a lot of experience doing night guards and life
splints because that's really about all that was available for people that
wanted TMJ treatment other than surgery a lot of times you know surgery can be
done surgery can be done to you can you know break and reset the jaws into a
into a more open position to get changes in size and shape of the jaws that's
certainly been done to treat TMJ conditions
you know it's surgery and the results aren't always you know what's it what
you think they're gonna be they don't always turn out great and I've always
wanted that surgical decision to people of it you know everything else has been
tried and you know the person's really having a lot of difficulty that they
can't you know just just not going to be able to deal with the you know so you
know the nightguard is a good management appliance certainly the DNA and the a LF
appliance you're gonna take more time and the treatment it's gonna cost more
money than a night guard a lot of times I'll have people come in and they'll say
well I can't really I don't really have a time the money to do the the
corrective therapy can I do a night guard and we will do a night guard
things that you really don't want to do you don't want to do an over-the-counter
a night guard there's really no ability whatsoever to adjust the bite on that
yourself no way anybody do you get any more balance on on a night guard
you're just gonna put some in your mouth you're gonna be punching on more and
you're probably gonna feel worse about the only thing that that's gonna do is
it's going to be provided like a physical barrier for wear and tear on
your teeth and it probably cost more and there Hetal hurt even more
the nti appliance MTI appliance is a little piece of plastic that gets kind
of put in between the front teeth and it will cause a little bit of separation
and it's y'all we kind of come forward and that I can find a more comfortable
position I really love that appliance for short time short term treatment of
acute TMJ symptoms if people come in and they're really really fired up and
complaining about a lot of pain and you want to do something quick and fast it's
simple it's relatively inexpensive throwing into your eye in there and get
it adjusted and I'm the only problem with this is you really open up the
front teeth you separate the back teeth and you know you have somebody doing
that every night you can start getting the back teeth moving around it's really
not alarm to a long-term solution but if you know the appliance certainly has its
place so there you have it I hope that helps you help provide a little bit of
clarity to what the treatments are for TMJ I think that for a proper TMJ
treatment people need a sleep assessment some physical therapy you need their
airway opened up and their plate balanced give us a call we're located in
Rockville Maryland thanks again and have a good day bye