CranioMandibular Rehab, Inc.

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Questions Answered by :
Ole T. Jensen, D.D.S., M.S., P.C. 

 

Frequently asked questions

Will splint therapy work for me?

Should I consider another surgery?

How can I find a qualified doctor in my area?

Where can I get more information about TMJ/TMD?

I hear clicking and popping in my jaw; what does that mean?

Will surgery stop my headaches?

 


Will splint therapy work for me?

Headache, earache, neck ache, even eye pain improves with bite splint therapy.  How is that possible?

Well, it turns out that chronic muscle tightness leads to lactic acid buildup and fatigue within the muscles.  The muscles become tender to the touch.  Also the areas where muscles attach to bone (origins) become inflamed.  Also, ligaments, which are fibrous attachments between bones, become over-stretched and damaged by chronic muscle contraction.  Muscle spasm pain from the jaw refers to the neck, the ear, the eye and the sinuses.  A common presenting finding might be headache in the temple areas.  Though not a migraine headache, it can nonetheless be very painful.

What the bite splint does is stop a muscle contraction before it starts especially if one of the underlying causes is clenching of the teeth.  The splint fits on top of the lower teeth and prevents a full force clenching bite force.  Muscles are more relaxed and they are “reminded” not to clench when the splint is present.  Less muscle contraction leads to less pain, most frequently manifest as less frequent headaches.
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Should I consider another surgery?

With regards to failed surgery, TMJ surgery is similar to knee or back surgery.  There is a degree of unpredictability of healing and a certain failure rate from surgery – in some cases as high as 25%.  Both patient and surgeon should be reluctant to proceed with a second surgery unless there is some outstanding finding that suggests a second surgery will be helpful.  In some individuals a repeat surgery does not help and can worsen the condition.  A conservative protocol that suggests surgery, almost as a last resort, is appropriate.  For example very young and very elderly patients should be treated non-invasively if possible.  Having said all this, when surgery fails, favorable results are possible from a second surgery, though the prognosis is much more guarded.

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How can I find a qualified doctor in my area?

All Oral & Maxillofacial Surgeons are qualified to perform TMJ surgery.  Some will do more of these procedures than others.  It is always best to get a referral from your dentist or physician as a start.  Another referral source is the School of Dentistry at the University of Colorado or from local Dental or Medical Societies; Hospital referral sources are also available.

Consultation and 2nd opinions are important for the purpose of deciding which surgeon to choose.  In the end, look for a confident surgeon, some one experienced and actually doing a considerable number of the type of surgery you need.  Get all the information you can then trust yourself to make the best choice for your situation.

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Where can I find more information about TMJ/TMD?

Press button for links to TMJ/TMD websites. 
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I hear clicking and popping in my jaw; what does that mean?

The jaw joint has cartilage between the bones.  The joint is not exactly a ball and socket joint.  It has a “dislocating” function.  As we open our mouths about half way, the jaw starts to “dislocate” out of the socket.  In the normal situation, this is a noiseless process, the cartilage in between the bones providing a smooth gliding surface.

The cartilage is suspended perfectly between the bones by ligaments – like a hammock suspended between two trees.  The cartilage has a smooth gliding function but also serves to cushion or absorb shock between the bones.  One can easily imagine that there are several possible types of cartilage malfunction.  These malfunctions are generally manifested as popping and clicking of the jaw on open and closing the mouth.
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Will surgery stop my headaches?

Surgery frequently improves headaches.  Restoration of normal function improves muscle function and decreases headaches.

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Revised: 08/23/06 .