No subject in dentistry is shrouded in more controversy than TMJ therapy. There are many "experts", but little agreement as to diagnosis and treatment.
The TMJ is the joint upon which the jaw hinges when you open and close your mouth. You have one on each side of your head, and it is located about one inch in front of your ear.
Muscle Disorders By far the most common TMJ problems are caused by muscle spasm, which in turn are caused by a lack of harmony in the muscles which move the joint on either side. Some muscle disorders cause only pain, while others can cause physical damage to the parts of the joint. One common cause of muscle disorders is a misalignment of the bite.
Internal Derangements Internal derangements are when internal parts of the joint are misaligned or malformed. These problems can be a result of muscle disorders, trauma, or arthritis-related disorders.
Tumors Thankfully rare, some TMJ problems can be caused by tumors in or around the joint. These are often difficult to diagnose, as different types of tumors show up differently in different types of radiographs.
Facial Pain Not all facial pains are caused by TMJ type problems. Some other types of pain can be caused by neurological disorders and vascular disorders.
Controversy arises because there are many different therapies for TMJ problems, each of which has some louder proponents who claim to have the "only" rational therapy.
Drs. Groh and Souviron treat TMJ patients according to careful diagnosis and analysis of signs and symptoms. We strongly believe in reversible therapies whenever possible, and commit to irreversible treatments (reconstruction, equilibration or reshaping of teeth, etc.) only after their effectiveness has been proven by reversible means. We have the most modern instrumentation to diagnose muscle disorders. We also have limits set by our own integrity and discuss clearly with patients when their symptomatology is beyond that which is treatable by proven means. We have a strong network of consulting doctors and therapists, and have seen success in treating TMJ problems far and above that of most practices.
Finally, we urge any patient for whom TMJ surgery has been recommended to get a competent second opinion prior to committing to surgery. While surgery can be a successful treatment modality in some cases, it is only indicated for a small minority of patients and should be confirmed beforehand as the right treatment pathway.
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Last modified: November 29, 1998
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