Surgery and “Disk Removal” for TMJ?

Every so often, I get questions from people about TMJ and surgery, be it a disk removal or grinding of the teeth or what have you. I am not a medical doctor and I cannot give medical advice. But what I can do is review the research on TMJ surgery, consult with experts, and make a recommendation – almost always – that if your doctor or dentist is recommending surgery – get a second or even a third opinion. Research institutions recommend getting the most conservative and reversible treatment available (i.e. not surgery):

“Because more studies are needed on the safety and effectiveness of most treatments for jaw joint and muscle disorders, experts strongly recommend using the most conservative, reversible treatments possible. Conservative treatments do not invade the tissues of the face, jaw, or joint, or involve surgery. Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth. Even when TMJ disorders have become persistent, most patients still do not need aggressive types of treatment.”

The National Institute of Dental and Craniofacial Research (NIDCR), one of the National Institutes of Health (NIH) that leads the federal research effort on temporomandibular joint and muscle disorders (TMJ) and is a good resource for more information:
http://www.nidcr.nih.gov/oralhealth/Topics/TMJ/TMJDisorders.htm

And, of course, I can recommend my gentle, safe and effective Feldenkrais-based sensory-motor sessions for relieving and eliminating TMJ pain: http://feldenkraistmj.com/

Diet, Gingivitis and TMJ Symptoms

I have not been updating the blog too much these days, but just wanted to let you know that I (Ryan Nagy) am still here and the TMJ series is still going strong.

I also want to relay to a very strange experience that I had last year but that I am only now writing about. I started to get TMJ symptoms again, though the symptoms were very mild, just a bit of tightness and pain in the jaw. I did my TMJ series and the tightness went away.

But it came back just a few days later.

I was also having some issues with fatigue. I would get drop dead tired around 6 or 7 pm and could hardly work or go out. I decided to go to a nutritionist thinking that my jaw symptoms and fatigue might be related. The nutritionist did not see a connection between my symptoms, but she did make some simple dietary suggestions. She noticed that I was eating lots of carb and few fresh vegetables and recommended that I limit my carbs and also increase my vegetable intake.

That actually made a big difference…but only for a few weeks. I went right back to getting deeply tired in the early evening. At this point, I noticed that it wasn’t that my jaws and muscles were hurting as much as it was my gums were very tender. So I went to a dentist.

Guess what? I had advanced stage gingivitis. For some reason, my gums were not bleeding very much as they normally do during gingivitis and for this reason I did not notice the condition. After a good teeth-cleaning from the dentist and also removing the damaged portions of my gums, I noticed a HUGE improvement in my energy level. Apparently, my body had spent so much energy fighting the gum infection that it made me tired by the end of the day. And the jaw tightness and pain disappeared completely.

I am not exactly sure why the gingivitis made my jaw and muscles hurt. Perhaps I was clenching my teeth or perhaps the stress of fighting off the infection made the muscles tighten…or…I do not know. But I am happy to report that I have had no more TMJ systems. And of course, my health has improved.

I share this with you as a reminder to me and to you that we are complex beings and need to look at TMJ and health and life in general from many different angles.

Be well!

Ryan

TMJ Specialists: Who Do People See For TMJ?

I’m in the process of pulling together my pdf’s and research articles on TMJ in preparation for writing a book on the subject of “curing” TMJ. I put the word cure in quotes as very often TMJ does not seem to be a disease as much as a process. People often have processes of clenching their jaws and overusing their muscles that lead to painful symptoms. When you get rid of those painful habits, very often the pain simply melts away. Is that a cure? Or is it simply using the power of your brain to change your body?

Anyway, according to a survey by Robert B. Goldstein, Ph.D. 87% of TMJ sufferers see a medical doctor for help. However, 67% of people also see a so-called “alternative” practitioner, meaning some people see both a doctor and some type of other practitioner.

What type of alternative practitioners do people see? According to Goldstein, the people in his survey used the following types of practitioner:

Chiropractor
TMJ Dentist
Massage Therapist
Physical or Occupational Therapist
Acupuncturist
Other Alternative Practitioner
Nutritionist
Podiatrist
Spiritual Healer
Naturopath

This makes me wonder. In terms of writing a book to educate people on non-intrusive and effective ways to heal TMJ, where should I focus my effort? Should I write a book for the public and reach out directly to TMJ sufferers? Or should I write a book that reaches directly to the providers of TMJ care? It’s an interesting question as I wonder whether or not surgeons, dentists or doctors would be willing to try a simple and direct approach. Undoubtedly some will. But what about those who would feel threatened by a simple solution? For example, if you livelihood depended on doing expensive TMJ surgeries or selling TMJ devices…would you be open to an approach that did not require those? I’m not accusing doctors or dentists of anything, I am just wondering about basic human psychology. If a simple process, a sensory-motor re-education process like that found in my TMJ series can cure TMJ pain would it actually be adopted by medical professionals?

TMJ Clicking Sounds: What Should You Do If You Hear Clicking in Your Jaw or TMJ?

I noticed that quite a few people are searching for “TMJ Clicking” or “TMJ Clicking Sounds” on google. I have also noticed that there are people giving potentially misleading advice on this topic. Some medical professionals have written that clicking sounds are a “symptom of TMJ and that clicking sounds may lead to pain if “left untreated.” Well, I will say as always, that I am not a doctor” nor medical profesional and cannot give advice in that regard. But it could be prudent to note that the National Institute of Health (NIH) has stated emphantically:

“There is no scientific proof that clicking sounds in the jaw joint lead to serious problems. In fact, jaw clicking is common in the general population. Jaw noises alone, without pain or limited jaw movement, do not indicate a TMJ disorder and do not warrant treatment.

So, what should you do if you have clicking sounds in your Jaw or TMJ? Consult your doctor or dentist to be sure. But remember that many people have clicking sounds in their jaw and they do not have pain. Be conservative in your approach to TMJ and get a second opinion (and perhaps even a third) if someone wants to operate or give you a dental device or any other expensive, invasive treatment.

cheers! And good luck – Ryan

My apologies. I noticed that this blog post has very similar content to the one that I wrote below! I have no explanation other than it has been many months since I wrote the prior blog post. And, I suppose this idea of “clicking sounds” and their supposed relationship to TMJ is highly annoying to me.

TMJ Symptoms: Is “Jaw Clicking” a Symptom of TMJ?

I’ve noticed that quite a few people go online and search for information on jaw clicking and popping and whether it is an indicator of a problem with the TMJ. The short answer may surprise you. That answer is “No”.

Jaw clicking and popping is not an indicator of TMJ/TMD problems. Many people have jaws that click and pop and they do not have jaw pain nor TMJ.

The National Institute of Health made this clear in a recent research summary of TMJ:

“There is no scientific proof that clicking sounds in the jaw joint lead to serious problems. In fact, jaw clicking is common in the general population. Jaw noises alone, without pain or limited jaw movement, do not indicate a TMJ disorder and do not warrant treatment.” The NIH on TMJ

Did you get that? Jaw clicking is common and is not an indicator of a problem. What is a problem is that most people will not get an opportunity to read what the NIH has written. Do a Google search for “tmj clicking sounds” and what you will find is people telling you that clicking is a problem. You will find passages such as this:

“One of the most common signs of a TMJ problem is a temporomandibular joint which is making noise such as clicking, popping or grating sounds.” Or: “Clicking, popping, or snapping in the jaw joint is the most common symptom of TMJ. There may or may not be pain in the jaw when the clicking or popping sound is heard. The clicking sound may even be so loud that others can hear it when you chew or speak.”

(heavy sigh). I took the two passages above from the websites of dentists who are treating TMJ. Treating TMJ with what? Expensive devices? Invasive surgery? I’m not sure that I want to know. As I have noted before there are strong doubts as to the efficacy of TMJ dentists and surgery of any type. See: TMJ Dentists and TMJ Surgery Alternatives.

TMJ Pain And Surgery: The Mayo Clinic Gets it Wrong

I just read a short article on the Mayo Clinic website regarding TMJ pain and how to get rid of it. The article stated in part:

“In most cases, the pain and discomfort associated with TMJ disorders can be alleviated with self-managed care or nonsurgical treatments. Severe TMJ disorders may need to be treated with dental or surgical interventions.”

While I appreciate the fact that the Mayo Clinic gives a nod to self-care for TMJ, I am stunned that they would assert that surgery “may” be needed. I am not aware of any research demonstrating the effectiveness of surgery for TMJ problems. And I am not alone – as I will show there is no research that demonstrates the reliability of surgery for TMJ.

When I checked the Mayo clinic’s cited research, one stood out in particular: TMJ. American Academy of Otolaryngology: Head and Neck Surgery. The academy represents head and neck surgery specialists in the U.S. Perhaps it should come as no surprise that the organization sees a need for surgery? Here’s what the surgeons wrote:

“Other treatments for advanced cases may include fabrication of an occlusal splint to prevent wear and tear on the joint, improving the alignment of the upper and lower teeth, and surgery. After diagnosis, your otolaryngologist may suggest further consultation with your dentist and oral surgeon to facilitate effective management of TMJ pain.”

They are saying that some TMJ sufferers may need dental implants and surgery. Ok. But where is their evidence for the use of those techniques? None was provided. No research was cited in the Academy’s article nor on their website. Interesting.

I decided to take a look at the other articles cited by the Mayo Clinic, in particular the American National Institute of Health (NIH). Here’s what the NIH has to say about TMJ treatments:

“There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Nor are there standards to identify people who would most likely benefit from surgery.”

There are no long-term clinical trials to support the effectiveness of surgery for TMJ pain. If that is the case why does the Mayo Clinic say that surgery may be necessary? Why? As for why you should NOT get surgery, think about what the NIH says about it:

“Surgical replacement of jaw joints with artificial implants may cause severe pain and permanent jaw damage. Some of these devices may fail to function properly or may break apart in the jaw over time. If you have already had temporomandibular joint surgery, be very cautious about considering additional operations. Persons undergoing multiple surgeries on the jaw joint generally have a poor outlook for normal, pain-free joint function.”

That’s pretty scary isn’t it? A person with TMJ problems who gets multiple surgeries has a “poor outlook for pain-free joint function.” Sounds like a surgery “cure” could be much worse than the initial problem.

In short, the Mayo Clinic is wrong. There is no published evidence that surgery is a useful treatment for TMJ pain.

If you or someone you love is experiencing TMJ pain you may want to consider something that does work, my natural TMJ relief series. Do I have research supporting it’s effectiveness? No. Though, I do have PhD work in research psychology, I am not currently conducting research in TMJ treatments. However, my programs do meet the guidelines suggested by the NIH and the NIDH. And most importantly, I offer a guarantee – If they don’t work, contact me and get your money back.

TMJ Surgery Alternatives: Are There Better Alternatives to TMJ Relief Than Surgery?

TMJ Surgery Alternatives

To be perfectly blunt, nearly anything is preferable for your TMJ pain than surgery. As I have written before and will write again, most reputable and reliable research organizations recommend surgery only as a last resort. According to the National Institute of Dental and Craniofacial Research (NIDCR):

“Avoid treatments resulting in permanent changes in the bite or jaw, including crown and bridge work to balance the bite, orthodontics to change the bite, grinding down teeth to bring the bite into balance, and repositioning splints. Avoid surgery, where possible, and if considering surgery, get medical opinions to fully understand the potential risks.

And the NIH or the “National Institute of Health” in the United States writes:

“Conservative and reversible treatments for TMJ should always precede permanent changes to a patient’s teeth or surgery.”

If you are interested in learning more about TMJ surgery alternatives and trying something that can eliminate your pain without drugs, surgery or medication, take a look at the “Feldenkrais TMJ Cure.” On these audio downloads that even a child can use, I lead you through a series of gentle sensory-motor re-education sessions that directly address the functioning of your TMJ and related joints and muscles, eliminating pain and strain. Take a look: Feldenkrais TMJ Cure

Feldenkrais and TMJ on the Internet

I’ve noticed that more people are writing about the use of Feldenkrais for eliminating TMJ pain. Here’s a short blog post on the “Inside Awareness website: TMJ: Why Feldenkrais?

Feldenkrias TMJ Classes

Judy Katz is teaching some classes in Canada at Selkirk College: TMJ Health: A Restorative Feldenkrais Workshop. There is a practitioner in Australia with some classes coming up: Townsville (Pimlico) – Easier TMJ and mouth functioning.

I don’t have a list of ongong TMJ classes. But if you want to attend a live one, search for: “feldenkrais tmj workshop” or feldenkrais tmj classes” on google and see what comes up.

Feldenkrais TMJ mp3 downloads

Feel free to try my TMJ mp3 downloads. If they do not work for you, you can get your money back – no questions asks. (The reason that I can make that offer is that the symptom reduction and elimination begins to happen almost immediately). This stuff works: Feldenkrais TMJ Relief.

Treating TMJ: “Less Is Best”

Yet another article from the National Library of Medicine urging people to do LESS when treating TMJ:

What Can I Do?

Until there is scientific evidence for making sound treatment decisions, NIDCR suggests people:

Eat soft foods, use ice packs, and avoid wide yawning, gum chewing, and other extreme jaw movements. Short-term use of over-the-counter or prescription pain medicines may also provide relief.

Avoid treatments resulting in permanent changes in the bite or jaw, including crown and bridge work to balance the bite, orthodontics to change the bite, grinding down teeth to bring the bite into balance, and repositioning splints.
Avoid surgery, where possible, and if considering surgery, get medical opinions to fully understand the potential risks.”

What can you do right now? For a mere $27 you can start using my Eliminate TMJ Pain NOW program and begin making steps to getting relief from TMJ pain and symptoms. My sessions are gentle and easy and many people report feeing relief from the very first session.

Give is a shot. I (Ryan Nagy) stand behind what I sell and if for some reason it does not work for you or you want your money back for any reason – just contact me on my personal email that I provide with each order.

Feldenkrais TMJ Pain Relief

By the way – Here’s a quick TMJ tip for you. Don’t lean on your jaw! Many people, myself included, have developed a habit of resting their head on one hand while working on the computer, reading, or doing other tasks! You need to stop doing that. It puts unnecessary strain on your TMJ and related muscles.

TMJ and Dentists: Are Dental Devices a Cure for TMJ?

TMJ Dentists: Picture of Braces

Have you considered finding a dentist to help your eliminate your TMJ? Have you wondered if a dental device could cure your TMJ symptoms? Temporomandibular disorders (TMD) – sometimes called “TMJ” for short – are thought to occur because of problems with the jaw, jaw joint, and surrounding facial muscles that help move the jaw. Because of the jaw/pain connection people sometimes turn to a dentist or oral surgeon to help get rid of their symptons.

There are all kinds of dental braces and devices that have been created to attempt a cure. In addition some people undergo corrective dental treatments such as replacing missing teeth and using crowns or bridges. Why? Some people believe that these techniques “balance” the surfaces of your teeth or that they can correct a bite problem and cure your TMJ.

But What Does The Research Say?

They hypothesis above are plausible but there is not much evidence to support dentistry nor orthodontics as a cure for TMJ. As an example, consider Layton, and McDonald from the Department of Orthodontics at the Leeds Dental Institute who did a comprehensive review of dental research. They found nearly 300 studies of which only 55 were peer-reviewed articles. But upon further analysis only four studies were directly applicable dental and orthodontic techniques for TMJ. Only four!

The researchers concluded that “There are insufficient research data on which to base our clinical practice on the relationship of active orthodontic intervention and TMD.”

How about that? As of yet there in no reliable data that shows that dentistry or orthodontics are an effective treatment for TMJ. Given how expensive these dental treatments can be it might be best to avoid them and try other alternatives.

While I cannot point to specific research on the effectiveness of my Eliminate TMJ Pain Now program, I can tell you that it fits within the recommend best practices as set forth by WebMD and the The National Institute of Dental and Craniofacial Research (NIDCR). Simple self-care practices such as relaxation techniques, stress reduction, and biofeedback are often effective in easing TMJ symptoms. Give it a try and if it does not help you, simply contact me for a full-refund:

Eliminate TMJ Pain Now

If you have questions, leave a comment and I will do my best to answer you. Or send me an email direct: ryan *AT* feldenkraistmj.com