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This topic contains 6 replies, has 4 voices, and was last updated by   Jamie Hansen June 6, 2019 at 8:20 am.

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    Jamie Hansen

      Hi Everyone,

      I wanted to know if there are specific ID protocols for TMJ?
      Being a neck/upper back body region specialist, I have seen an influx of pt. with sever TMJ pain. One pt in particular his ranges are close to full with minor to no neck pain but is still mentioning his TMJ pain (achy/throbbing).

      I have treated TMJ prior with great results but I wanted to know if there are ID protocols.

      Thanks and have a great weekend!



      Andrew Wengert

        I asked this exact question on the forum a few years back.
        The take home points I remember from the thread were:
        1)Check and restore C-Spine function as it is a major player in TMJ function.
        2)By the time the TMJ is symptomatic there is usually too much degeneration and instability in the joint for adhesion in the muscles of mastication to be a priority.


        Jamie Hansen

          Thank you Andrew,
          have you been able to address TMJ issues after the C-SPINE has cleared out?


          William Brady, DC

            The ID system does not directly address TMJ for the following reasons:
            1. The most common cause is stress related clenching. Stress management for these patients is a better fit.
            2. The diagnosis usually involves joint damage and teeth damage. Not good fits for our skill set.
            3. There is very little relevant adhesion or weakness, but there is high load (see number 1 above).

            Of course these patients can and will benefit from improved cervical spine function. It just tends to be second, third or fourth on the diagnostic list. If the other factors are being addresses then go ahead and treat the cervical spine.



            Jamie Hansen

              Thanks Dr Brady,
              The above does make sense to me, my questions arise more when treating medial pterygoid (however you choose to treat it) in my case I prefer intra-orally, I find that patients receive a great deal of relief post treatment (pt state there jaw feels looser, and this is usually sustained in follow up visits).
              I understand that if the stress component is not addressed, grinding/clenching will continue but there has not been cases when there is adhesion in the medial pterygoid?( i am stressing on this muscle bc when assessing the jaw and there is lateral deviation, this muscle has always been involved.) I personally have not had cases where ppl have had D/X joint damage to the TMJ and come looking for help bc their DDS usually want sell them a mandibular decide to help their bite, but the joint its self is usually healthy. Regarding the teeth damage only have seen this is they are chronic grinders.
              My last question if I am able to clear out their neck issues to the point where there scores are pass or near pass, but the jaw pain persists, there is no definitive ID protocols for the muscles of mastication?

              If I am being redundant i apologize, im just trying to get a deeper understand on why.
              Thank you.


              Michael Danenberg

                I see quite a few TMJ patients. Dr. Brady is correct, as usual, that grinding is a huge part of the problem. I have found if you can find a dentist that can take a mold for a dual arch deprogrammer it will help. Great Lakes Lab makes it. Most of the issue is when they clench and laterally deviate the jaw with the back teeth touching, it will cause the pterygoid muscles to go into spasm. If the deviation is to the Left when opening the jaw, it is usually the ipsilateral lateral pterygoid and contralateral medial pterygoid. Treating these inta-orally will help correcting the occlusion. The bite has to be addressed though. I do use MAR on the masseters and Temporalis.


                Jamie Hansen

                  Thank you so much Michael!

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