TMJD treatment, dentists, and massage

I was contacted by a “digital media intern” who was working for a Houston office, MedCenter TMJ, asking me if I would write a blog post with links to that company. Here goes! (I don’t always or even often do this, by the way.)

Houston dentists offer advanced treatment for TMJD disorder

First of all, I am impressed that a couple of highly trained and educated dentists in Houston are specializing in treating TMJ disorder.

  • Dr. Auvenshine is a DDS and a PhD who has taught at the college level and founded the TMJ and Facial Pain Clinic at Louisiana State University. He’s been practicing in Houston since 1978 specializing in those issues. He currently teaches at the University of Texas Health Science Center and the VA Hospital in Houston, and he gives lectures around the world. He is working with the American Dental Association to get TMJD treatment recognized as a specialty. Here’s his page, with a video: http://www.medcentertmj.com/about-us/dr-auvenshine/
  • Dr. Nathan Pettit is a summa cum laude DDM with advanced training. He too is devoted to craniomandibular and TMJ disorders. He studied with Dr. Auvenshine for three years before joining his practice. Here’s his page with a video: http://www.medcentertmj.com/about-us/dr-pettit/

I looked at their treatment page: http://www.medcentertmj.com/tmj-treatments/. They  “provide therapy to help remove unhealthy pressure from the jaw joint and encourage muscle relaxation”. They make custom-fitted orthotic appliances that they recommend using full-time for six months, and “a program of specific stretches, exercises, and massages is given to optimize muscle and joint health.”

Actually, I would love to learn more about what they do! I wish they would invite me for a visit. I bet we could learn from each other.

Finally, they have a blog (http://www.medcentertmj.com/news-events/) with posts on all kinds of interesting topics, which I intend to read as I have time, relating to hormones, tension headaches, foods, essential oils, stress awareness, overcoming bad habits, and more.

In fact, although these two dentists are highly educated and of course extremely geeky about anatomy as well as offering effective and compassionate treatment, it’s great to know they are aware of the soft side of treatment, because there is definitely a gentle, compassionate, caring, nurturing side that can be integrated into TMJD treatment far beyond what most dentists now offer.

I like that Dr. Auvenshine and Pettit’s website acknowledges that TMJD problems are orthopedic problems requiring long-term management similar to a bad back or a bum knee. I don’t disagree with that, but I don’t believe it’s always the case. Many of my clients have benefitted from a few sessions and gotten over their jaw issues, and some come back only after visits to their regular dentists.

However, I have encountered one client with protracted jaw issues that haven’t been responsive to my treatment. She probably needs a custom-fitted appliance. Now I have a place I feel comfortable referring her, MedCenter TMJ.

What I’ve learned about TMJD and dentists from my clients

People with TMJD often have pain when opening their mouths wide. Sometimes their upper and lower teeth don’t fit together well, or their jaw is misaligned with one-sided symptoms. They may have problems biting, chewing, yawning, or laughing. They may experience near-constant pain from tension in the jaw muscles. They may experience clicking, popping, or grinding in their jaw joints. Headaches and stiffness in the upper body, especially the neck, are common. Vertigo and tinnitus may be related. Sometimes insomnia adds to the misery.

Many TMJD sufferers postpone going to the dentist because it freakin’ hurts to open their mouths wide enough for dental work. That’s not good for their dental health.

From what I hear from my TMJD clients, their dentists don’t do anything for their jaw issues except prescribe night guards. Night guards protect the teeth when someone clenches and grinds at night. They keep them from damaging their teeth, and indeed people can grind their molars smooth or crack them or grow more jaw bone from TMJD. Night guards are preventive, not corrective. They are only worn at night and aren’t designed to help reposition the jaw joints.

Beyond night guards, most dentists seem to have no idea that manual therapy can give the TMJD sufferers among their patients some relief. It’s as if they get very little training in dental school, and it’s only about night guards. TMJD is in some other realm that they are not responsible for. It’s puzzling to me.

I advocate for TMJD sufferers who need dental work to do the following:

  1. Tell the dentist they have TMJD.
  2. Ask the dentist if they can accommodate TMJD sufferers with pre-visit self-care suggestions, shorter visits, frequent breaks, heat, massage, etc.
  3. If the dentist does not do this, tell that dentist they can refer their TMJD patients to me (if in the Austin area) for help. Or…find a dentist who does. Sadly, at present, I do not know of one single Austin dentist who accommodates people with TMJD.
  4. If you know of a dentist who does accommodate people with TMJD, please let me know. I will refer people to them.

Austin area dentists: I will be more than happy to explain what I do over the phone or in person or even do a demo in your office on one of your patients or staff with TMJD.

 

How I work on people with TMJD

Frankly, most people love getting massages and hate going to the dentist. That would bother me if I were a dentist. I’d want to learn how to make it more pleasant.

Without going into too much detail about how I work, I have my clients fill out an intake form, interview them, and get them on my table under the covers with aromatherapy and the table warmer on if they prefer. I offer music or nature sounds, and this helps draw their attention externally, which provides an alternative to focusing on their discomfort.

I do manual therapy on their neck, external jaw muscles, face, and head muscles to release tension. I release trigger points and do myofascial release.

I then begin working inside the mouth, wearing gloves or finger cots, to release the internal jaw muscles.

This usually takes some getting used to, because most people have never been touched in these sensitive places and it can feel invasive even though they’ve sought treatment. I go slowly and recommend a minimum of three sessions, but sometimes it takes six or more to get lasting results.

I can provide suggestions for breath work, visualizations and affirmations to help clients focus on surrendering to facilitate and speed their own healing.

Being worked on inside their mouths is the most difficult part of the treatment. It’s just weird the first time. They know in advance that some discomfort may occur, and together we’ll work to keep it manageable. I let my clients know they have control and that I will remove my fingers from their mouths at their signal. I watch and listen for signs of distress or fatigue. They know when they need a break or have had enough.

In later sessions, I add some gentle external and internal craniosacral therapy. I look at their body’s structure to see if anything could be contributing to their jaw issues  and make recommendations.

TMJD is often accompanied by psychological issues. Usually something happened that led to its onset. Parents divorcing and fighting constantly, sexual abuse, parental neglect, a bad marriage that took time to get out of can all contribute to developing TMJD.

I let my TMJ clients know that if memories or emotions arise during treatment, it’s part of their healing. I can give them some guidance using my NLP training, and I can also refer them to psychotherapists if desired. There’s really not a good reason for continuing to suffer.

Some research points to mild sleep apnea causing TMJD symptoms, as if clenching or grinding will keep the airway open, so not all TMJD may have a psychological component.

Please keep in mind that TMJD work is a specialty in the field of massage. Most massage therapists don’t have any training in intraoral work or craniosacral therapy. I studied with craniosacral therapist and teacher Ryan Hallford of Southlake and have been doing TMJD sessions for three years now, and I plan to continue training in craniosacral therapy.

Note: The jaw joint is the temporomandibular joint (TMJ). TMJ refers to a joint, not a problem with the joint. If there’s a problem with the TMJ, we call it temporomandibular joint disorder or temporomandibular disorder, abbreviated as TMJD or TMD.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s