How to Treat TMJ
Hi, my name is Dr. Troy Giles. I am a doctor of Chiropractic and a Natural Internist and I wanted to tell you a little bit about today about treating TMJ and issues of the actual temporal mandibular joint and how that plays affect with chiropractic, why it’s so important to be able to be worked together. Many times as you are working with TMJ you are getting a mouth guard, of which I will show you here in a minute. Your dentist puts in a mouth guard for you at night, which is appropriate. First thing you need to find is a bio-dentist, a natural dentist. If there is one in your area, ask around. Ask for referrals. The one we use here in Bountiful, Utah is Dr. Judson Wall. He is a great doctor and does a great job with the TMJ. But, most generally the TMJ is back and jammed up into the joint. So the jaw comes up and jams up into the joint and it works because we are chewing gum or we are chewing, we’re stressed during the day. Many times as we are working, we are clenching our jaw and it just puts a lot of pressure on to that joint. So it just jams it up. So part of the therapy is to draw it back down and out a little bit to give there some space and basically decompress that joint. If you want to get a referral from somebody in your area, I would call Dr. Wall. Look him up on Google, Judson Wall, in Bountiful, Utah and he can either help you here or know somebody maybe in your area. But, what I do as a chiropractor is work with that pain in the jaw, but I do a mouth guard in the evening. This is called Smart Guard. This is a great guard that we use. What it does is we heat it up to, basically, just boiling. Put it in boiling water for about 5 minutes and it becomes very pliable. Then we have the patient douse their mouth with cold water and then we will push it up against the top teeth and mold it so that it comes across the teeth. It doesn’t have to be all pretty and it doesn’t have to be specifically set. It just has to be in a position where it feels comfortable for you at nighttime while you sleep. A mouth guard does this…take your hands right now, put them up here right in front of your ears and then bite down, just softly bite. Okay, now what you can do is you can feel, now bring it from the TMJ right here, down to part of the masseter. This is a masseter muscle. Put them right here and close your teeth and bite. Now watch my hands. See how they move? That is because the contraction of the muscle is pushing my hand away. That is what you’re seeing. Because my back teeth, my grinders, my grinders, talk to Dr. Wall, he’ll tell which ones these are. They are your chewers. When they are together, it causes a lot of pressure under the TMJ. By putting a mouth guard in, it is going to hold the teeth apart so that you can’t get those teeth in the back to contract or to touch together. Now watch this. If you touch your teeth like this, okay, that is what this guard is doing, is helping to make it to where there is a space between those two teeth. It does not allow your teeth in the back to contract or to touch. So, like this, okay? Now when I bite down there is no movement here. That is a great way to explain to you what is happening at nighttime as you are sleeping, if you’re stressed, or if you are thinking about what is going on during the day and it’s contracting, you are contracting that and jamming the temporal mandibular joint and just smashing and pressing it. So we want to try to draw it down and out. So the first thing we do is wear the mouth guard. You can call here to the office. We can get one for you. You can call us and we will tell you exactly how you can form it at your own home even, or wherever you are around the world, and they are 50.00. They are not much at all. So they go on, and you can just press them right against your teeth and that is a very easy, an easy fix there. Next, what we want to do is adjust the jaw. We will adjust it, using either the Pro Adjuster, which basically, this is a little tapping unit that when we tap, we can tap it very small, very tiny, and it is just a little tap. So it is actually pushing, let me put it up high at 35 so you can see what it is doing. It is actually pushing. You see that tapping away. That is 35 pounds per square inch. If I turn it down to 10, it is just barely. But we are able to put on a smaller tool and actually get in to that TMJ and do some adjusting of the joint. It helps draw it down and out, come down and out. We also can manually adjust the jaw with the patient laying down on their back, we just take the jaw and just a little bit of a tip forward, we can bring that out and forward. Now there is a very important part of what is happening with the joint. The TMJ is right here. The atlas is here. You have the TMJ and you have the hyoid bone. So there is a triangle right there. We find that generally speaking most people with TMJ have their head forward. Okay? That will add to your weight bearing. Let’s just look at this really quick. This x-ray, of this patient, is anterior. Her head is forward. So if you look right here, this is C2. It should be over the top of C7. But if you look, I am just going to use this as a straight edge, if I bring it down, she is this far forward. Okay? This point here should be back here. So as her head is forward, like this, she looks down at the ground and instead of looking at the ground, she does this, and that compression right here starts to put pressure back here on the atlas and occiput junction, which then can affect the hyoid bone and then goes up to the TMJ. So there is a triangle right there. So part of what we want to do is we want to help the head come back so that it opens up the atlas occiput junction and takes pressure off of the, off of the internal musculature that comes to the TMJ. So, literally the head is forward, down, so you don’t walk around like this, you do this and that compression, right back here, that needs to be released. So part of the therapy is to lay the patient down, on their back, on the bed and then just hang their head over the bed, which will actually allow and stretch the anterior ligaments of the vertebrae. Also, what we do is we can put a wedge like this, actually like this on the edge of the bed, or a rolled up towel works as well, and this now becomes a fulcrum, so that my head, you don’t want this on your neck, you want your head way over, and that is going to get the neck to start to really help the head come backwards and reverse or diminish that anterior weight bearing, the forward weight bearing. We want to bring it back like this. So bringing the head back like this is going to change that triangle between the hyoid bone, the occiput atlas and the TMJ. So that triangle right here. So by bringing that head back up, it is going to take the pressure off that. So we want to make sure we are adjusting there as well. We also want to look at the internal workings of the system. If the patient has parasites, which is very, very common, with TMJ, parasites cause you to be irritated at night while you sleep. You will end up grinding your teeth, because the parasites are at motion. They are moving and it feels irritating to you so your body goes into a clenching mode and you start to clench a lot more. So I want to make sure that we are looking at you in the triangle of health, which is structure, emotion, and physiology. Structurally, I have discussed that. Now, get the head back, take the pressure off the joint. With emotions, emotions play at nighttime as well. So if you are emotionally stressed, you are going to be biting down and then if you have physiology issues, where the organs aren’t working correctly or you have layers of infection, we want to get those as well. So those three concepts are very vital in working with the TMJ. That is quite interesting. I know you probably have never thought of that, just I got a lot of pain in my joint, and my jaw clicks all the time. Why? Why is a jaw jammed up in there. So dentists can help to draw that down through various things that they can work with you, working on the teeth. Dr. Wall, again, is tremendous, drawing that down and out. But again, helping you to do this with your neck is vital as well. So I hope that has been beneficial for you. If you have any questions or you would like to order any of the supplementation that we have, or any of the Smart Guard, feel free to call, contact the office. You can look on our website as well. We have these for sale there. You can get it off of the website.