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TMJ Centre Melbourne - Facial Pain & TMJ Therapy

Do Headaches occur with TMJ ?

Unfortunately most dentists and GPs have been trained to think that the only headaches that can occur as part of TMJ / TMD is temple headaches due to clenching. The Temporalis muscles (located in the temple regions) are recruited during clenching and so the assumption is that these are the only headaches that can be attributed to TMJ/ TMD. This however is far from true. TMJ/ TMD can also mimic sinus type headaches, particularly the maxillary sinuses (in the cheek area). They can also mimic tension type headaches affecting the temple and occipital regions ( back of head) and migraine.

Population studies have shown TMJ/TMD is more common in those with chronic daily headaches, tension type headaches and migraine.* According to Dr Noshi Metha a leader in the treatment of craniofacial pain, up to 85% of headaches can be associated to muscular dysfunction that create trigger points and cause referred pain. A major cause of the muscular dysfunction can be TMJ/ TMD as well as cranial and cervical (neck) dysfunction.
A study by former board members of the American Academy of Craniofacial Pain found occipital (back of head) headaches in 94% of subjects and temple headaches in 92% of their TMD patients. Furthermore in the same study demonstrated that treatment of TMJ/TMD lead to improvement in the occipital, frontal and temple headaches in nearly all patients . Regarding occipital headaches, following 3 months of treatment 66% of subjects reported complete elimination of the headaches and 33% reported improvement.
The same study above showed that pain behind the eye is also improved with TMD treatment, showing elimination of pain in 68% of subjects and improvement in 30%.

A randomised, double blind placebo controlled study ( therefore scientifically excellent) has shown that when it comes to this that suffer with Migraine and TMD, treatment of TMD using splints and medication together provided the best treatment outcome. It is well known that many migraine suffered also have signs of TMD.

1)Headache and Symptoms of Temporomandibular Disorder: An Epidemiological Study. Headache 2010;50:231-241

2) Anterior Repositioning Appliance Therapy for TMJ Disorders: Specific Symptoms Relieved and Relationship to Disk Status on MRI. J Craniomandibular Practice, 2005

3)Treatment of Comorbid Migraine and Temporo- mandibular Disorders: A Factorial, Double-Blind, Randomized, Placebo-Controlled Study. Journal of Orofacial Pain. Volume 27, Number 4, 2013
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Upper Airway Resistance Syndrome

You have to suffer from snoring, choking, gasping and stop breathing to suffer from the damaging effects of sleep apnoea ? don’t you ????…… WRONG

Today we reviewed a client of our following a sleep study which was begrudgingly carried out as they said, “ But I don’t snore, choke or wake gasping" but they always woke up tired, unrefreshed, often exhausted. Blood tests game back normal and the client just assumed it was poor sleep due to worrying about life stresses and relied on medication. Incredibly the sleep study showed they woke (micro arousals) more than 30 times every hour.

What this client was suffering from is called upper airway resistance syndrome. (UARS). UARS is part of the spectrum of sleep disordered breathing (SDB), most recognise the other end which is termed sleep apnoea.

Incredibly in UARS there is only a slight closure of the airway which increases resistance to airflow and reflex mechanisms form receptors in the upper airway ultimately cause the brain to wake (micro arousals) which lead to poor sleep and ultimately exhaustion. UARS typically affects thin patients and as mentioned before there is very little or no snoring. Many UARS patients report fatigue and insomnia.

UARS like sleep apnoea also puts your body into fight or flight mode (sympathetic overdrive) every time there is a micro arousal which ultimately affects your organs and the musculoskeletal system. UARS has been linked to chronic pain and fibromyalgia. The constant fight / flight response causes the muscles in the body to be constantly tense and this leads to pain. Poor sleep due to micro arousals also means your body does not get a chance to rest or heal, therefore leading to more pain.

Fortunately most UARS cases can be successfully treated with mandibular advancement splints, which are much easier to tolerate than CPAP machines. It is also important to establish correct breathing patterns and eliminate any obstructions of the nose.

So if you are feeling fatigued, have chronic pain there may be a simple reason.

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You've been told you need jaw surgery....

As with other joints in the body surgery is a treatment of last resort when alternative treatment has proved ineffective. Surgery should really be restricted for those who are born with or develop jaw malformations and patients with true arthritis where the head of the jaw has loose fragments of bone or severely broken down condyle and may need reshaping or replacement.

According to the American Academy of Craniofacial Pain and the American Academy of Orofacial Pain 95% of patients suffering from TMJ/ TMD should be treated non surgically. In our office even patients with degenerating jaw joints have become pain free with NON SURGICAL treatment.

TMJ/ TMD often has more than one symptom, and usually occurs due to many underlying causes happening at the same time, such as a combination of dislocated jaw joints, breathing dysfunction, dysfunction in the spine / cranium, stress, poor sleep, anxiety, stress, sleep disordered breathing, clenching / grinding, poor nutrition, generalised inflammation due to poor diet. Thats why a holistic approach is so fundamental to treating TMJ/TMD.

For more information on holistic relief from TMJ/ TMD see or call us on 03 94174038
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Our clients often ask us about exercise while they are in pain and the answer is always the same. For those with chronic pain walking is simply the best form of exercise. Not just because it is less traumatic to your joints and muscles causing less breakdown, it has also been shown to help the brain heal and importantly calm the nervous system.

Running while good at burning calories, places you brain and body in fight / flight mode (sympathetic overdrive) which is not conducive to healing. Walking like meditation and correct breathing places your body in a healing mode by putting your body in parasympathetic mode (rest/heal/digest). 

Our bodies should be running on parasympathetic mode most of the time but with life's pressures, stress, poor diet, dysfunctional breathing, pain, poor sleep many of us walk around in sympatheic mode all the time. So an easy way to get back to parasympathetic mode and reduce pain is to go walking. Ideally at least 3 times a week gradually increasing the time. This is a great way to loose body weight and calm the mind. 

Walking also stimulates brain and body connection which stimulates neuronal synapses and plasticity and importantly neurogenesis (growth and development of brain tissue). Ultimately meaning your brain says well tuned. A healthy brain means less pain and healthy well run body for everything is run by the brain !

Many studies have shown the benefits walking which include the following;  learning and memory, protection from neurodegeneration and alleviation of depression, particularly in elderly populations.

Dr M Shah
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Using the latest in CAD CAM design, TMJ Centre Melbourne is now able to provide custom made bite plates / orthotics to the  correct neuromuscluar bite within 3 hours so that you can begin your healing journey as soon as possible. Currently to our knowledge we are the only practice in Australia to offer such incredible service to our clients. Being able to mill the orthotics using cutting edge technology the orthotics are strong, light, accurate and very comfortable.

For rapid TMJ relief call us on 03 94174038.
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TMJ and Face Pain

Did you know that TMJ the more common name for TMD temporomandibular dysfunction is very commonly associated with face pain, in particular TMJ symptoms often mimic sinus type headaches? With true sinus headaches  there is usually a discharge from the nose and additionally the pain becomes much worse as you bend your head downwards. Many of our clients have been to see ENTs (Ear, Nose and Throat specialists) and come away frustrated as the ENT has found the sinuses clear with no obvious cause for the face pain. Some have even had repeated rounds of antibiotics or sinus surgery to no avail. The jaw muscles running along the cheeks  in conjunction with the with the jaw joints themselves  will cause referred pain along the cheek line, mimicking maxillary sinus pain or  face pain along the cheek line. These jaw muscles also refer pain to the lower teeth and may result in unnecessary root canal treatment.

The temporal muscles running along the side of the head around the temple region are powerful jaw muscles used during chewing, clenching and grinding. These muscles will also refer pain to the temple, mimicking tension type headaches. The temporal muscles will also refer pain to the teeth, and cheek regions.

When there is inflammation in the jaw joints, your body will adopt a forward head posture as a way of reducing the pressure on the jaw joints. In other words your body tries to get away from the pain. For every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds. This places considerable strain on the neck muscles which connect at the back of the head. When these muscles become too strained they can cause tension type headaches at the back of the head, and referred pain to the front of the head, mimicking frontal sinus pain, pain in the ears, pain the face and also cause eye pain.

Additionally long term TMJ can cause the cranium (bones around the brain and face) to become jammed which can then cause face pain and headaches. This “locking” of the cranium is known as cranial dysfunction.

So if you have face and head pain that is not going away it's important to have a comprehensive evaluation for possible jaw and cranium dysfunction. Please note the strained ligaments in the face also cause face pain as well as postural compensations due to issues in other areas of the body, but that's to be discussed another time!

Contact us on 03 9417 4038 for an appointment if you have any ongoing issues with face pain

#Face pain
#TMJ pain
#Jaw pain
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