Temporomandibular Joint Disorder (TMD)
A collective term used to describe a group of medical disorders causing TMJ pain and dysfunction, and is estimated by The National Institute of Dental and Craniofacial Research of the National Institutes of Health to affect 10.8 million people in the United States at any given time.
When normal relationships between the condyle, the disc, the fossa, and the eminence are altered or distracted for whatever reason, the result is called “Internal derangement of the TMJ”. Internal derangement includes disc displacements, clicking, popping, stretched or torn ligaments, perforated discs, infection/ inflammation of the capsule or tissues, and adhesions of the cartilage to the socket of the jawbone. Joint noises, especially clicking, popping and crepitus (grinding sound in the joint) are indicators of internal derangements.
When pain and dysfunction develop in the surrounding muscles and tissue, this is called “Myalgia/Myofascial pain dysfunction syndrome”. This is usually due to persistent contraction of the chewing muscles as they attempt to keep from excessive movement.
Symptoms of TMD/TMJ
Some of the Symptoms that commonly associated with TMD include pain at the TMJ, generalized orofacial pain, chronic headaches, and neck pain, earaches and ringing in the ear, dizziness and vision problems, jaw dysfunction including limited movement or locking of the jaw, painful clicking or popping sounds with opening or closing of the mouth, and difficulty chewing.
Headaches
Headaches are the number one cause of pain in the United States and there are numerous medications and treatment modalities for headaches. However, millions of people still suffer from various types of headaches every day. When neck and jaw muscles become dysfunctional or tight due to injury, dental distress, chronic stressful situations, abnormal habitual positioning, or whatever the cause is, this compresses the occipital and trigeminal nerves, both of which are distributed to the head, neck, face, jaw, and teeth. The occipital nerve is the most common nerve to cause headaches. It is connected to the trigeminal nervous system, which in turn directly innervates the TMJ and teeth.
One of the most common causes of dental distress is a bad bite. Bad bites induce TMJ dysfunction which in turn compress nerves within the joint space, making neck muscles tighter, resulting in headaches. Another known cause of headaches is viral/bacterial infection, heavy metal deposits, and nutritional imbalance. The Resultant Force Vector Technique provides the unique ability to reduce abnormal muscle tension and to restore balance within the body by correcting bite and establishing physiological functions.
Most headaches can be treated effectively by utilizing intra-oral appliances, eliminating infection and heavy metal deposits, and maintaining a proper airway during sleep at night.
If you suffer from weekly or daily headaches, are taking medications, injections or various treatments, it might be worthwhile to get a second opinion by Dr. Uparika Sharma. There is no need to continue living in constant frequent pain from headaches when in most cases, headaches can be treated fairly easily.
Musculoskeletal Disorder
Our body is the ultimate living machine. But it needs a well-maintained bone structure, muscle tone, nutrition, and emotional environment to function and perform properly.
The musculoskeletal system is the master system in our body. It controls posture, breathing, gait, and body movement. It is the system that allows you to enjoy golf, dancing, sports, working out, and sexual performance. If you have a TMJ-musculoskeletal disorder you may experience fatigue easily, loss of balance, unstable gait, curved posture, a hunched back, tilted neck, discomfort standing/sitting, muscle pain on the neck/shoulder/low back, shortness of breath, difficulty taking deep breaths, limited range of movement, chronic fatigue, and indigestion, etc.
If you are experiencing such chronic symptoms as described above, and have tried various treatment modalities without satisfying results, you should seriously consider having a TMJ/Bite evaluation. Most musculoskeletal originating pain can be eliminated or reduced faster than by taking pills or exercising.
Fibromyalgia (FM)
This is one of the most prevalent rheumatic disorders affecting women between the ages of 25 and 55. Most FM patients complain of generalized pain that is difficult to pinpoint which leads to the statement: “It hurts all over” (11 out of 18 pain points).
Hundreds of prominent researchers and clinicians have spent their time, effort, and millions of dollars (maybe multi-billions around the world), to find the cause of FM and pain mechanisms. So far, they have recognized the following as possible causes of fibromyalgia: physical trauma, chronic pain conditions, arthritis, chronic mechanical stress, psychological distress, significant emotional stress, repetitive environmental stimuli, genetically decreased threshold, mechanical stress in the spine, automobile accident, infection, sleep deprivation, insomnia, psychosocial factors, stress, depression, anxiety, childhood trauma, irritable bowel syndrome, headaches (migraine, tension-type), restless legs syndrome, periodic limb movement disorder, temporomandibular pain and dysfunction, myofascial pain syndrome, primary dysmenorrhea, chronic fatigue syndrome, female urethral syndrome, neuroendocrine dysfunction, nutritional deficiencies, hormone imbalances, chronic enzyme deficiency, central sensitization (sensitive central nervous system caused by continuous irritation of chemical, heat, touch, etc), and much more.
Fibromyalgia experts have recommended the following treatment/management modalities: exercise, muscle strengthening, aerobic fitness, pool exercise, spa therapy, ultrasound therapy, cardiovascular program, mineral bath, acupuncture, massage, nutritional supplement, chiropractic therapy, physical therapy, pain pills, muscle relaxants, and sleeping pills.
Fibromyalgia is not an intractable or incurable disease. It is a symptom of the broken circuit in the Autonomic Nervous System (ANS) inside your body and can be cured by simply resetting it again.The Resultant Force Vector Technique is the key to the treatment of fibromyalgia.
Trigeminal Neuralgia
Trigeminal neuralgia is also referred to as tic douloureux, which means unbearable, painful twitch. The symptoms of trigeminal neuralgia include a very sharp, short, electric-type pain. Pain is triggered by touching a specific area of the skin by washing, shaving, applying makeup, brushing the teeth, kissing, or even by cold air.
Because of the complexity of treatment modalities and the unpredictable treatment outcome, not many healthcare practitioners are willing to challenge this unusual symptom, and only a few highly educated and trained individuals or hospital-level of program-ready facilities are available for this treatment. Commonly, drugs such as Neurontin, Tegretol, or injections are used to quiet nerves. Occasionally, very aggressive treatment modalities are implied, such as brain surgery, to separate blood vessels from nerves to relieve pressure on the trigeminal nerve.
The main nerves distributed in the face and the jaw are the Trigeminal nerve and the Facial nerve. Branches of the trigeminal nerve are directly related to TEETH and TMJ. Because trigeminal neuralgia is caused by irritated and triggered trigeminal nerves, and malocclusion and TMJ disorder are the main nerve distressing factors.
The resultant Force Vector Technique is the key knowledge and technique for the treatment of trigeminal neuralgia and Dr. Uparika Sharma has treated many trigeminal neuralgia patients successfully without medication or surgery. If you are suffering from Trigeminal neuralgia, have attempted various treatment modalities and, surgery is the only option left it will be worthy to have a second opinion by Dr. Uparika Sharma.
Whiplash
Whiplash trauma involves a rapid displacement of the TM joint, neck, and upper shoulder girdle as the result of a vehicular collision or other jarring events (such as a fall). Neck pain is the most commonly reported symptom, headache is the second. It is not uncommon for pain and dysfunction to appear several days, weeks, months, or even years after the injury.
There are various effective treatment modalities such as chiropractic therapy, physical therapy, massage therapy, acupuncture therapy, etc. However, if symptoms remain after a certain number of months of therapy, the internal force vector of the incident may be perpetuated into the TMJ and alter the occlusion relationship. This remains a focus of dysfunction of the altered mandibular-cervical relationship, which changes the tone of the masticatory muscles. Until the altered TMJ-Bite relationship is corrected, some degree of symptoms may persist despite various treatment modalities.
Dr. Uparika Sharma is Certified in “Soft Tissue Injuries Resulting from Motor Vehicle Accident: Biomechanics, Diagnosis and Testimony Preparation” from the American Academy of Craniofacial Pain and is qualified to be an expert witness if legal issues are involved.
Chronic Fatigue/Lack Of Energy
Many people blame their age. Aging may be one of the factors, but some multi-factors cause chronic fatigue. Improper nutrition, continuous unresolved stress, structural imbalance, including TMJ imbalance, and chronic illness such as; diabetes, cancer, allergies, hypoglycemia, hypothyroid, poor circulation, and taking multiple drugs, all have to be considered as well. Maintaining a peak energy level requires multidisciplinary attention.
Balancing the body structure and establishing proper body chemistry is the most effective proven chronic fatigue syndrome treatment modality. If you have Dental Distress Syndrome, which perpetuates into TMJ, further influencing masticatio this can cause inadequate absorption/assimilation.
Dr. Sharma has extensive education and training in nutrition, food supplement, toxic element evaluation, oriental medicine, sleep medicine, compatible dental material in addition to holistic dentistry.
Important Symptoms Before TMJ Surgery
Many years ago, various surgical methods and techniques were developed for TMJ treatment. It was one of the most popular treatment modalities for patients whose symptoms could not be relieved by splint therapy or other conservative treatments. However, despite some experiencing symptomatic relief, the majority of patients suffered more after surgery. Surgical procedures are irreversible and if a patient experiences post-surgical pain, there is nothing much he/she can do except to go back and medicate to control the pain. Because of the severity of the pain and the side effects of the drugs, both patients and doctors struggle.
These days, better non-surgical techniques and drugs are utilized, and both surgeons and non-surgeons consider surgery as the last treatment modality option. Dr. Wesley Shankland, past President of the American Academy of Craniofacial Pain recommends, in his book, three criteria be satisfied before TM Joint surgery is attempted. These criteria are:
All conservative treatments were a failure. If splint therapy is a failure once, it should be repeated, with a different splint design, or by a different doctor.
There has to be a demonstrable physical or structural explanation for the patient’s complaints. A physical problem can be seen with an MRI, x-rays, or dye injections into the joint. Make certain that this is not an exploratory surgery or that the surgeon “thinks” surgery will help. Patients must be suffering so much that they must take strong pain medication, greatly altering their lifestyle. In other words, the patient must be desperate and at the “end of their rope” before surgery is attempted.
Do not permit the doctor to proceed with any invasive or irreversible procedure too soon. Instead, insist on a referral to other practitioners who are trained to analyze symptoms, observe signs, and are adept at placing these findings into comprehensive packages. By doing so, a correct diagnosis can be performed and a treatment determined which will include a conservative non-invasive modality.
Categories of Post Surgical Symptoms
Post-surgical symptoms are categorized into “chronic pain symptoms” and must be treated/managed accordingly because of irreversible structural changes. If you have already undergone a surgical procedure, and are experiencing prolonged post-surgical symptoms that now require prolonged medication/therapy, and were told to live with it, Dr. Uparika Sharma may be able to identify the possibility of reducing the pain level through his unique examination and assessment method.
Dr. Sharma has not referred any patients for surgery for many years and is currently treating patients who have already had surgery, or have post-surgery complications, such as continuous pain, limited mouth opening, and limited range of motion.
Other Symptoms of TMJ/TMD
TMJ disorders are frequently unexplained, misdiagnosed, and mimic many other symptoms. Because of this, healthcare practitioners call it “The Great Imposter”. Chronic fatigue/lack of energy, stiff neck, dizziness, ringing in the ear, lightheadedness, blurred vision, pain behind the eye, muscle twitching, numbness or tingling, swallowing difficulty, attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), seizure, inability to fall into a deep sleep, snoring, difficulty breathing, constant changing of position while sleeping, nasal stiffness, allergies, unstable walking, falling often, head forward posture, unparallel shoulder height, un-corrected scoliosis, pain in the hip/leg/foot/heel, restless leg syndrome, carpal tunnel syndrome, Parkinson’s Disease, irritable bowels, may all be a part of TMJ disorder symptoms.
Some may consider these symptoms as a field outside of dentistry. However, the fact is, that many patients experience relief or reduction of these symptoms in both intensity and/or duration after TMJ/Craniofacial treatment.