Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

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An estimated 20 million Americans with temporomandibular joint syndrome, mostly women, have a wide array of distressing symptoms, including pain in the jaw muscles or in front of the ear, clicking or popping sounds in the joint, locking, difficulty chewing or talking, dizziness, headaches, neck pain and even backaches. Thirty-two billion dollars annually is spent in this country seeking relief. About 40% of Americans have some form of temporomandibular disorder that includes TMJ. Only 5-10% require treatment by a dentist. At least 7% of patients treated still have pain, leaving us to believe dental treatment is ineffective.‍

Treatments

1. ‍‍For a period of one month use the jaw as little as possible. That means chew only soft foods, never chew gum, and do not grind granola with the teeth (blend any hard foods so that pressure on the temporomandibular joints will be avoided).
2. When the head rests on the pillow, if sleeping on the side, care should be used not to put pressure on the jaw. Lying for long periods of time on one side can strain the joints of the jaw. Using a properly positioned scarf either around the neck so high that it props the jaw shut, or slung under the chin and tied on top of the head, may be helpful.
3. When chewing, allow no motion that causes pain or popping of the jaws. If a side-to-side motion causes pain, do only up and down movements. If up and down movements cause pain, do only a sliding, grinding, or side-to-side movement. Sometimes jutting the jaw forward a bit can be helpful. In some people, all food must be pureed or ground, then taken into the mouth in small bites and swished to thoroughly mix with saliva.
4. A naturopath believes TMJ and bruxism are symptoms of intestinal parasites. He recommends taking five to six tablespoons of pumpkin seeds chewed well three times a day for four weeks to get rid of worms.

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‍Case History‍

One patient named Paula was fitted with braces in 1978, to close a gap in her front teeth. Over time, she developed painful clicking in the jaw and severe headaches. She was diagnosed with TMJ. Over the next 20 years, she had two jaw implants and now, at the age of 40, is unable to wrinkle her forehead or raise her eyebrows. One eye closes with difficulty, and her smile is lopsided. Sometimes she has severe pain.

Paula had a variety of unsuccessful therapies—splint therapy, biofeedback, surgery to repair dislocated right and left discs, psychiatric assistance, and replacement of the right disc with a Teflon coated device. The FDA declared these devices unsafe in 1989. Paula's Teflon disintegrated into a fine powder and lodged in the surrounding tissue and bone. She then had a balancing left jaw procedure and five more operations to put muscle grafts from her temple and clean out mysterious growths caused by the Teflon powder. Eventually, she had all metal joints used to replace her jaw joints. She still needs nightly treatments with painkillers and anti-inflammatory drugs and mouth stretching devices. Her bills have topped two hundred thousand dollars. If a person has Teflon implants, they should be removed before they disintegrate. Broken silicone implants should also be removed (American Health. Vol. 12, Nov. 1993, p.60).