New therapy allows predictable resolution of TMJ, Fibromyalgia and other related conditions

Townsend Letter for Doctors and Patients, June, 2005 by Farrand C. Robson

Introduction

There is confusion and a lack of clarity surrounding TMJ problems. What causes these problems? How do you diagnosis it? What can you do about it? Why do people with Fibromyalgia, Chronic Fatigue and other conditions also have TMJ problems?

The serious nature of this condition is clear. TMJ related pain is one of the most common chronic pain conditions today. By themselves the muscular head, neck and facial pain can be disabling. Generalized nervous system sensitization, on edge feelings, body aches and sleep disturbance make these symptoms even more significant. (1)

TM joint changes, as well as dental bite concerns, are often present along with the jaw related pain and other symptoms of TMJ problems. This does not mean that the changes that can be found are the cause of the symptoms. Joint and bite issues have been evaluated as possibly causing TMJ problems but are not well correlated with the symptoms that define this condition. (2) They may well be the result of the elevated muscle contraction present. (3)

It is apparent that dysfunction in this unique multifunctional jaw system has full body consequences and does not primarily originate from any known pathologic conditions in the chewing muscles or temporomandibular joints. (1,3) The jaws work in balance with other body systems and if the cause of TMJ problems goes untreated, the underlying biology may continue with potentially serious consequences.

Purpose

This paper presents new information about the origin and treatment of TMJ problems and the linkage of oral dysfunction to many systemic concerns. It is based upon the anatomy and neurophysiology that allows normal function to take place. Current dental TMJ treatment is not based upon testable concepts of underlying cause or of the biologic complexities and systemic relationships involved.

The Full Body Nature of TMJ Problems

TMJ problems are muscle pain symptoms and their cause cannot be established from examination, laboratory tests or radiographs. There are many conditions, like TMJ, that are named based only on a particular group of symptoms. (3) Fibromyalgia, Chronic Fatigue, Irritable Bowel, Migraine, Restless Legs and primary dysmenorrhea are such conditions. Like TMJ problems, these conditions occur in combination with posture breakdown and fight or flight feelings. (1)

The Journal of the American Dental Association has recognized that TMJ and Fibromyalgia (FM) are closely related. (4,5) Hadenberg-Magnusson report that not only do the vast majority of Fibromyalgia patients also have TMJ problems but also the intensity of pain of the two conditions relate well to the other. (6) Buchwald and others relate TMJ problems to Fibromyalgia and other conditions as well. (7) The National Institutes of Health also notes the relationship to other conditions. (3)

The broad nature of TMJ-related symptoms suggest that they may be a part of a greater condition. This view was suggested in 1993 by Dr. S.R. Block who reported "the condition of chronic generalized musculoskeletal pain probably is only one part of an even more generalized condition that includes IBS, chronic headaches, regional migratory numbness, TMJ syndrome, and a whole host of other somatic pain syndromes." (8)

Many investigators have noted the common features in this group which The National Heart Lung and Blood Institute calls "TMJ Related" conditions. These conditions all include postural breakdown, (9) sleep disturbance and on edge feelings, as well as head and neck pain. These are the typical TMJ symptoms. The origin of TMJ problems and these other conditions may be the same.

Oral Systemic Balance

Our discoveries in the understanding of TMJ problems has led to new treatment designs that in the experience of this clinician are far more effective and far reaching than ever before. The new therapeutic process not only provides relief of TMJ symptoms but at the same time the symptoms of other conditions tend to resolve or markedly reduce.

This system is the Oral Systemic Balance Therapeutic System[c]. It is directed at the management of TMJ related pain and muscular head, neck, facial and jaw pain. Dentists trained and correctly following the protocols are obtaining consistent, predictable success. We are continuing to look for qualified practitioners, dentists and physicians, in order to make this new science broadly available.

Sleep Disordered Breathing (SDB), TMJ and "TMJ Related" Conditions

There has been the awareness that TMJ problems and sleep related concerns, such as Obstructive Sleep Apnea (OSA), have much in common. This relationship was suggested in 1990 in a study from the University of Medicine and Dentistry of New Jersey when it was reported that "An association exists between bruxism, tension headache, and sleep disorders, particularly sleep apnea, in the craniomandibular dysfunction patient." (10) OSA is not classified as a Sleep Disordered Breathing (SDB) related condition.

The National Heart, Lung and Blood Institute (NHLBI) considers SDB, TMJ and TMJ related conditions to likely be the result of impaired muscular control of the throat with respiration, swallowing and increased upper airway resistance resulting from structural and neuromuscular conditions. They further note that the muscles of mastication and the tongue play a role in swallowing and breathing and that their integration is tightly linked to blood pressure regulation. (1)