Getting to the Source of TMJ Dysfunction for Effective Relief from Pain and Other Symptoms

We all have temporomandibular joints. Chances are, we don’t think about them until there is “dysfunction.” With one joint on either side of the face, they connect the lower jaw to the skull and support essential functions such as chewing food and swallowing. So, when the TMJs (or structures around them) are dysfunctional, all sorts of problems can arise–headaches, jaw pain, tinnitus, persistently “clogged” ears, and even a tendency for sleep apnea. Like a kink impedes water flow through a hose, dysfunctional tissues can partially block airflow through the airway.  

Fortunately, Dr. Al A. Fallah relieves San Diego, California, area patients with many treatment options. But they all start with Dr. Fallah pinpointing the source of TMJ symptoms. We are happy to share some of those potential causes with you. Often, these conditions are interconnected. So, patients frequently relate to many of the factors listed below.

• Malposition of the jaw (“bad bite”) – Here, we are referring to the relationship between the upper and lower jaws; for instance, the lower jaw may be too far back (“overbite”) or too far forward (“underbite”). This imbalance between the jaws can place stress on the jaw, head, and neck muscles. It also puts undue pressure on the cranial bones behind the neck and the teeth. Similarly, patients may grind their teeth chronically due to these imbalances. Jaw malposition can arise from chronic allergies, inadequate breastfeeding, early childhood behaviors, and even trauma at birth.

• Malposition of the teeth – Here, we are talking about the position of the teeth. We compare this situation to an annoying pebble in your shoe. If you are forced to walk on that pebble, day in and day out, your gait is altered. You may suddenly experience pain in the knee or hip because the stone has effectively thrown off your posture. You can even experience pain in distant areas of the body (such as the head or jaw). Poorly-positioned teeth resemble pebbles; even the tiniest discrepancies can hamper healthy posture. Other teeth may compensate for this imbalance by using forces they were not designed to withstand. This process leads to additional problems, weakening the teeth and eroding the gums. It can also lead to one or more teeth dying and hence end in root canals or extractions over long periods of low-grade chronic bite trauma. 

• “Ascending” Factors – There are two types of TMJ-related pain causality: “ascending” and “descending.” The former kind of stressors is associated with structural imbalances. When headaches or other symptoms are worse at the end of the day, this is a telltale sign of ascending stressors. A good structural therapist, such as an osteopath, Chiropractor, craniosacral therapist, or physical therapist, has mastered the art of neuromuscular health and can address these imbalances adequately.

• “Descending” Factors – Conversely, descending “top-down” pain may be rooted in poor bite, traumatic jaw positioning, infections in the jaw bone (“cavitations”), an asymptotic dead tooth, deteriorated TMJoints, head trauma, and cervical (neck) imbalances. Patients who experience more severe pain upon waking or at the start of the day may suffer mostly from descending factors. Unlike an acute infection that hurts, a dead tooth is a “trickle” infection that chronically and innocuously releases toxins. We use a low-radiation CT scan to detect hidden infections. This advanced technology accurately renders 3-dimensional images of the entire head to identify abnormal areas. PCR DNA testing may confirm the results from the CT scan by further identifying the presence of specific pathogens.

• Chronic stress – When the sympathetic (“fight or flight”) nervous system is chronically “on,” and one never calms down, the stress hormone cortisol is secreted. Prolonged exposure to perceived stressors affects every function of the body. For this reason, stress management can help to ease TMD symptoms. Stress can also adversely affect tissue PH levels adjacent to our living cells. Cells that are more toxic or “acidic” cannot work or detox well. In turn, patients may have lower thresholds for pain. 

Treatment or relief must address the root cause. Depending on what we find at Al A. Fallah, DDS, addressing the root cause is our priority. For example, oral appliances may be customized to keep the airway open when a patient is suffering from sleep apnea. At the same time, such custom devices may support optimal positioning of the jaws to achieve a healthy balance or relationship between the upper and lower jaw. Orthodontic treatment such as Invisalign® may be prescribed following the use of a DNA appliance to expand or bring the jaw into proper position. Eliminating hidden jaw infections can often result in quick resolution of long-lasting pain issues.

As needed, we can use advanced diagnostics to find hidden infections. Or, even among those patients with “ascending” pain, we can work with physical therapists and other medical practitioners to support lasting correction and a healthy posture. 

Ozone Therapy for TMJDs: A Case Study

Dr. Fallah has conducted extensive research and acquired considerable clinical experience using ozone therapy in dentistry. Ozone presents a powerful therapeutic agent. Oxygen’s antimicrobial and natural healing properties have many applications when administered safely at our practice. In fact, Dr. Fallah trusts the safety and effectiveness of dental ozone that he has used to treat many family members’ oral conditions. Regarding TMJ Dysfunction, Dr. Fallah’s successful use of dental ozone is well-documented, and the results are often dramatic.

For example, he successfully addressed all the causative factors responsible for a patient’s TMD. In this case, pathogenic microorganisms played a contributing role. Partly, the patient had persistent pain in teeth previously treated with root canals. She had also been diagnosed with trigeminal neuralgia and peripheral neuropathy. The patient’s immune system activated when medical-grade ozone was delivered at low doses. As a result, her activated immune system produced cytokines, small proteins vital to cell signaling. Notably, these substances communicated with other immune cells. They triggered a cascade of immune system-wide changes, promoting sustained mobilization of the immune system.

Additionally, Dr. Fallah further resolved other causative factors, such as occlusion and neuromuscular disturbances. Partly, the patient was fitted with an oral appliance (neuromuscular orthotic) to support lasting health and function. Dr. Fallah has developed his own techniques to precisely design, fabricate, and place these appliances. Prolozone Therapy®, a homeopathic/oxygen technique, was also applied to the left temporomandibular joint to stimulate repair, reduce pain, and aid in proper function.

Within one week, we had achieved a significantly improved range of motion. Improvements were quantified or supported by evaluating the patient with the K7 Evaluation System. By using these neuromuscular diagnostic scans, we confirmed that:

• Swelling had subsided
• No signs of infection were present
• Jaw movement had dramatically improved

Continued therapy involved chiropractic adjustment and ultra-low-frequency TENS treatment to reduce tension and relieve pain in the jaw and neck muscles. Restorative treatments also helped to achieve a healthy, balanced bite. The patient’s improvements have been so transformative that she has been able to reduce the “wear time” of her neuromuscular orthotic. She no longer wears an orthotic during the day but consistently wears her appliance at night. She is also diligent about visiting us regularly for hygiene appointments, so we can ensure that everything looks and feels great.

As your home for exceptional dentistry, the office of Dr. Al A. Fallah is here to help you lead a healthier, more fulfilling life. We have a long track record of doing so for many other individuals–now it’s your turn! Call us at (760) 730-1600 with any questions about TMJ problems or other concerning symptoms, and schedule an appointment at our office in Carlsbad.