For further guidance, check out this educational book on TMD

In November “Take a Bite Out of Pain: A Journey to Overcoming Temporomandibular Joint Dysfunction (TMD)” was released and available for purchase. It is exciting to have both a book on TMD and sleep apnea for further outreach and education on topics that are often overlooked. This new educational book serves many purposes. It can be put on display at your office for your patients or it can be gifted to a friend or family member that might be suffering from pain.

This educational book is now available for purchase at Lulu.com, Amazon and Barnes & Noble. Pick your favorite website to go to and purchase it!

What can you expect from the book?

I wrote this book in collaboration with Sara Berg, my writer. As many of you know, she has been writing for me for almost five years now and this is our second book together. We decided to write about pain and TMD to better educate patients on these symptoms and what to do. As dentists, we are in a unique position to help our patients feel better, so why not continue to provide them with the resources they need to better understand their condition?

To help you get a better understanding of what the book is about, here is a brief description:

“Pain should never be ignored. Whether it is pain in your jaw, or what seems like a headache, don’t ignore the discomfort. Ignoring pain would be a waste of time, leading to further complications with your health.

Search for the underlying cause of your pain with help from qualified dentists that treat such cases. Finding the source of your nagging pain will help you continue on with your daily activities—hopefully eliminating any discomfort present.

Don’t just “put up with” pain—seek proper treatment. Pain is a complex and complicated symptom tuned by your brain, as it triggers every painful sensation. Are you just going to sit there and wish the pain away? No, absolutely not.

Educate yourself on the cause or causes, and treatment options. Pain isn’t a singular problem, it can be so much more.”
I look forward to hearing your thoughts and I hope that you utilize this book to help your patients before, during or after their visits to your dental office!

Long-term treatment for adolescents with TMJ pain

I want to take a moment to discuss a study I was looking at the other day. This study looked at the long-term treatment outcome for adolescents with temporomandibular joint (TMJ) pain. I find this interesting because it is a subject that doesn’t always get a lot of attention.

What the study says

In this study, their waim was to evaluate long-term, self-perceived outcomes in adulthood for individuals treated as adolescents for TMD. To find this they looked at two previous randomized controlled trials.

There were 116 participants with 81 percent female and were treated for frequent TMD pain in previous years. The treatment for these individuals consisted of an oral appliance or relaxation training. For those that participated, they answered a questionnaire based on their experience of “frequency and intensity of TMD pain impaired chewing capacity and daily social activities, help-seeking behavior and treatment, general health, other pain and depressive symptoms,” according to the study.

Older participants reported lower levels of frequency and intensity of TMD pain, impairment and depressive symptoms. They also reported better general health. Females, which were the majority of the participants, reported more frequent and more intense pain associated with the TMJ. They also reported greater impairment and more often reported other pain compared to males.

What did we learn from this?

From this study we understand that adolescents treated with oral appliance therapy showed a somewhat better sustained improvement over the extended follow-up period than those treated with relaxation therapy. This highlights the need to pay closer attention to these groups. By looking closer at this information we can extend or create different treatment plans to improve patient outcomes.

Keep an eye out for adolescent patients that might be experiencing TMJ pain and think about the long-term goals. By helping this patient population, we can better equip them for adulthood.

Pay attention to dental side effects during long-term oral appliance therapy

We understand how successful treatment of obstructive sleep apnea (OSA) can be. However, we need to pay attention to the potential side effects from long-term oral appliance use. If we are aware of these side effects, we can help educate our patients and prevent them from occurring and interrupting care.

What do we do as dentists to help?

I have read several studies that looked at the predictors of dental changes associated with long-term treatment with oral appliances in patients with OSA. From these studies I have found that yes, long-term use can lead to dental complications if we do not educate our patients.

Before you fit your patient for an oral appliance, ask them if they are willing to take at least two-minutes out of their morning to perform exercises. That’s all it takes. Just two minutes (maybe even less) a day to prevent further complications. And, of course, if they do notice any shifts in their teeth, it is important for them to keep you up-to-date. You can provide an adjustment to their treatment or offer other solutions to improve this change.

When you are fitting your patients for their oral appliance, let them know that it is important to perform daily exercises after removal of the device. By performing jaw exercises, it can help prevent the patient’s mouth from becoming stiff or sore. It can also help to prevent lock-jaw and other complications.

It is our duty as dentists to take care of our patients and that means proper education for daily exercises after removing the oral appliance each morning.

What are you doing to help your patients through the oral appliance process? Are you having them perform exercises? If so, what kind? I am interested in learning what everyone is doing to help their patients each step of this journey.

The mechanisms of craniofacial pain

A recent journal looked at the mechanisms of craniofacial pain. The researchers worked to highlight peripheral and central adaptations that might promote chronification of pain in craniofacial pain states, including migraines and temporomandibular disorders (TMD). Pain is a common symptom that is associated with disorders of the craniofacial tissues, such as the teeth and their supporting structure, the temporomandibular joint (TMJ) and the muscles of the head.

Most acute craniofacial pain conditions are easily recognized and well managed. However, others, especially those that are chronic such as migraines and TMD, present clinical challenges for dentists and physicians. While the mechanisms of chronic craniofacial pain in patients remains limited, both clinical and preclinical investigations suggest changes in afferent inputs to the brain occur in chronic pain. This results in amplification of nociception, which promotes and sustains chronic craniofacial pain states.

Through an increased understanding of the physiological and pathological processing of nociception in the trigeminal system, we can learn about new perspectives for the mechanistic understanding of acute craniofacial pain conditions. This also helps with the peripheral and central adaptations that are related to chronic pain. We can offer improvements in treatment for chronic and acute craniofacial pain conditions.

What are your thoughts on this? Does this information help improve treatment options for your patients?