TMD can occur from a myriad of sources such as: direct trauma or a blow to the jaw; auto accidents and a related “Jaw Lash” injury; excessive clenching or grinding (Bruxing ) of the teeth. Sudden loss of teeth, recent dental treatment with the mouth held open for prolonged periods, recent changes in occlusion from extractions, crowns, fillings or orthodontic work. These rapid changes overwhelm the jaws natural ability to adapt over time to slow changes in dentition of the shape of the teeth.
Dr. Dreyer performs pre-operative assessments of TMD patients who are sufficiently affected that they will require some form of surgical intervention and provides both pre-operative treatment for these cases as well as treatment immediately post-operatively. Often treatment is provided the day of outpatient arthroscopic surgical intervention.
What is TMJ Syndrome/TMD.
TMJ Syndrome is a very complex aggregation of various symptoms which can include the following: jaw joint pain, clicking, popping or grinding in the jaw joint, limited mouth opening, locking of the jaw either open or closed, stuffiness, fullness or ringing in the ears, headache, eye pain, pain in the neck, shoulder, upper back or arm. It is extremely common for an injury to the TMJ to go undiagnosed and untreated, as frequently, the individual symptoms listed above are being treated via Chiropractic or Physical Therapy and the condition is missed. Often times the first discovery of an injury to the TMJ, is when it is too late and symptoms have progressed to a severe and occasionally irreversible level. Many patients are being treated for an ear infection that they don’t actually have, when they should have their TMJ properly evaluated to assess its involvement.
Appropriate treatment of the TMJ, begins with a thorough history and examination. Then depending on the level of severity, appropriate conservative care is then instituted. This may include any or all of the following: Passive Physiotherapuetic modalities, like Ice, Moist Heat, Ultrasound, Diathermy, Infra-red, Micro-Amperage Electrical Stimulation. Plus Manual Mobilization of the Jaw Joint and referral for a Dental evaluation for the purposes of bite analysis and construction of a TMJ Splint or Night Guard. Extensive home care instructions for diet and activity restrictions are given and prove to be critically important. What is probably the most important thing to remember, is that many cases of TMJ Syndrome/TMD can be treated successfully without any aggressive therapeutic intervention, such as have the teeth ground down or rebuilding the bite or doing tooth extractions or undergoing surgery for dental implants. These can be important steps that may be needed later in the cycle of care, but they need to be held in reserve, as they are permanent in nature and as such are irreversible.
Dr. Steven Dreyer has been actively treating TMJ
(Temporomandbular Joint) Syndrome or as it is now referred to TMD (Temporomadibular Dysfunction) since 1990. In 1990, Dr. Dreyer received extensive training in TMJ evaluation and management under the tutelage of Dr. Dennis Steigerwald, lecturer and author of the TMJ – A Multi-Disciplinary Approach to Management. Dr. Dreyer was an active participant in Multi-Disciplinary study group meetings at both Mission Hospital and Scripp’s Medical Center in San Diego and founded the ITA (Inter Disciplinary TMJ Association in Orange County. These study groups were founded by Oro-maxillolofacial Surgeons, General and Reconstructive Dentists, Prostadontists, Chiropractors and Physical Therapists, who were passionately interested in the furthering their knowledge about the treatment and management of TMD