Standardizing TMJ Education Improves Diagnosis and Patient Outcomes

Key Quotes

"The overwhelming majority of people popping clicking locking of the jaw the majority of those issues at some point are related to that cartilage pad not being in the proper position which affects the movement of the joint and you know and then symptoms that are associated with that."

Dr. Justin Richer explains that most temporomandibular joint (TMJ) issues stem from the cartilage pad within the jaw joint being out of its correct position. This misalignment directly impacts the joint's movement and leads to associated symptoms.

"The teeth ultimately are the support system to the joint so like let's just say like you don't have any teeth on half of your mouth so you're going to chew on the left side of your mouth and you're going to probably develop a habit with the way that your jaw wants to rotate and shift to be able to function to talk to be able to chew you know to be able to say how great your podcast is your jaw joint is moving around every every time that you know we're speaking or eating or functioning and so um if you're unsupported on one side you start to develop habits with the way that you move your jaw to be able to function and then that can that can weaken the structure."

Dr. Richer highlights the crucial role of teeth in supporting the jaw joint. He illustrates that missing teeth on one side can lead to compensatory chewing habits, causing the jaw to rotate and shift. This imbalanced function, according to Dr. Richer, can weaken the jaw's structural integrity over time.

"My TMJ exam is longer and more detailed than anything else that I do and most including most surgeries that I do and part of that reason is is you really have to listen as a provider and so like you know do they have locking of the jaw do they have dislocating of the jaw like you know maybe just one side of their jaw is having a problem and the other one's moving fine maybe the jaw deflects a little bit you know or doesn't doesn't move so well on one side but you start by listening and then you know you compare you know what they're saying to what you're seeing on an exam and then we take an x ray we see if you know there's changes in the bone you can get MRIs of the jaw joint just like same way you get MRIs in a knee and so like you know those are those are forms of assessment."

Dr. Richer describes his comprehensive approach to diagnosing TMJ disorders, emphasizing the importance of active listening to the patient's symptoms. He explains that this detailed examination includes assessing for jaw locking or dislocation, observing jaw deflection, and comparing patient reports with physical findings. Dr. Richer also notes the use of X-rays and MRIs to identify bone changes and assess the jaw joint's condition.

"MRI proves it you look at an image and you're like well cartilage is supposed to be here but it's actually there and you can't MRI doesn't lie so you know once you see it you know it I look at the health of the bone and um and the position of the bones and so if there's not a lot of space in there normal space for the cartilage to be sitting in then the cartilage is probably isn't sitting in the right spot."

Dr. Richer states that MRIs provide definitive evidence for TMJ diagnosis by clearly showing the position of the cartilage within the jaw joint. He explains that an MRI reveals if the cartilage is displaced from its normal location, indicating a problem. Dr. Richer also mentions that he examines the bone's health and alignment, noting that a lack of normal space for the cartilage suggests it is not positioned correctly.

"Treatment ranges from things as simple as occlusal appliances so like a thick Invisalign retainer that sits on the teeth and just takes some of the pressure off the joints kind of like a knee brace you know would be on like an injury but you also have like minimally invasive like procedures like um this procedure called arthrocentesis which really is just um using some needle holes to inject water through the jaw joint get rid of inflammation get rid of some byproducts that that are in there."

Dr. Richer outlines a spectrum of treatments for TMJ disorders, starting with simple occlusal appliances, which he likens to a knee brace for the jaw, to alleviate joint pressure. He also describes minimally invasive procedures like arthrocentesis, a process involving injecting water into the jaw joint to reduce inflammation and clear out byproducts. Dr. Richer indicates these are among the less invasive options available.

"If as a dental community if we all can get on the same page on what the problem is and how to go about treating it wow sky's the limit."

Dr. Richer expresses optimism about the future of TMJ treatment within the dental community. He believes that achieving a consensus on understanding and addressing TMJ disorders would unlock significant potential for improved patient outcomes. Dr. Richer suggests that unified knowledge and consistent treatment approaches could lead to widespread advancements in the field.