TMJ Disorders and Treatment, with Dr. Catherine McGregor of the TMJ & Sleep Therapy Centre in Ontario, Canada
TMJ refers to the anatomical temporomandibular joint and it is the relationship between your lower jaw that moves and the temporal bone of your skull, according to Dr. Catherine McGregor of the TMJ and Sleep Therapy Centre in Ontario, Canada. Ideally, she says, these two anatomical parts are functioning in harmony and there is good disc space between the jaw joint that moves and the head that is stationary.
There can be a variety of problems with this unique joint, as this is the only joint that has one bone and two actual joints. There can be an extracapsular problem, where there is muscle dysfunction or an intracapsular problem, where the disc is out of position, says Dr. McGregor and this type of patient may present with muscle and facial pain, severe headaches, limitation of jaw opening, jaw locking and a clicking and popping noise.
At the TMJ & Sleep Therapy Centre, Dr. McGregor uses a very conservative treatment when a patient presents with an intracapsular TMJ problem. Using a two orthotic decompression therapy, two different orthotics are used - one for daytime function and one for nighttime rest.
In treating a patient with a TMJ problem with decompression therapy, the first appliance is worn during the daytime, to help decompress the jaw while in function. Dr. McGregor says this is the most important part of treatment and is an orthopedic correction, which puts the joint in the right position so that the ligaments, tendons and muscles can all heal around the joint. To help protect this joint at night while it's healing, Dr. McGregor uses a night orthotic that allows the jaw to rest but not go back and compress the area that's being healed in the daytime.
Success of treatment depends on proper diagnosis and that's where Dr. McGregor puts all of her energy. At the TMJ & Sleep Therapy Centre, they prioritize a person's symptoms to make sure they diagnose the cause of the problem. Success also depends on the person's ability to heal, as well, she adds.
After 10-12 weeks of orthotic treatment, Dr. McGregor performs an MMI exam, or Maximum Medical Improvement, and about 75% of her patients can successfully wean off of their orthotics. The other 25% may need to maintain orthotic treatment and go into some sort of phase two treatment, which can involve some orthodontics.
Dr. Catherine McGregor is a dentist with Lyndhurst Dental in Lyndhurst Ontario Canada and the TMJ and Sleep Therapy Centre of Eastern Ontario. Dr. McGregor is also a leading sleep expert with Sleep Better TV.