Is Important to highlight that the nerves and conditions described in all TMJ associated syndromes have the origin at the level of the spine, hence, neck evaluation and treatment should be incorporated when dealing with patients with any TMJ complaint.
The evolutionary importance of the mouth is represented with a vast structural musculoskeletal support system controlled by a fine elaborate neurological connection with a widespread of network withing the central nervous system, this explain the variety of health conditions that are likened with TMJ issues.
Neurological syndromes associated with TMJ dysfucntion.
Tension Headaches: Is generally caused by an increase hypertonicity of the muscles of mastication, the masseter and temporalis muscles. The maintained tightness in these muscles create a pattern of refer pain and trigger point activities that evolves into tension headaches.
Cluster Headaches; Is considered one of the most painful conditions. The symptoms usually locate around the forehead and eyes and is described as sharp and extremely debilitating disorder. Chronic TMJ dysfunctions may alter the central neurological connections and create several patterns of referred pain as seen in this type of HA.
Migrane: There are several factors that influence the development of migraines, TMJ dysfunction is a common precursor as per the significant central neurological connection is has with other bodily function structures resulting in the development of this type of headache
Bell’s Palsy: This condition causes a paralysis of certain muscles of the face. There are two areas of the nervous system that influence this disorder, the peripheral part of the nervous system may be associated with TMJ conditions as per the close relationship is has with the facial nerve.
Trigeminal neuralgia Affects the trigeminal ganglion and corresponding branches casing significant pain in the areas of the face supplied by this nerve. Due to the close peripheral and central neurological relationship the jaw, TMJ dysfunction is generally a predisposing factor for the development of trigeminal neuralgia. Acute Herpes Zoster, is an associated neurological disorder caused by an infectious trigeminal ganglion and nerve.
The spine biomechanical chain must be evaluated as part of the TMJ neurological analyses as per the neurological and mechanical influences of the spine.
Clinical assessment of the spine and TMJ.
Clinical assessment to identify the key joint dysfunctions of the jaw and the associated muscles compromised.
Anterior – Posterior (AP) X-ray cervical/Jaw view is essential to check the patterns of TMJ misalignment
Important exam to verify the level of narrowing of the nerve passage and the exact point of irritation
Rule out any other condition; There are rare disorders that may create similar patterns of dysfunction, is advisable to rule out these conditions prior to the start of the treatment.
Restore the biomechanical alignment of TMJ
Neuromobilization techniques may be used once the direct compression of the nerve is reduced.
Specific therapeutic essential oils are applied to reduce nerve inflammation and enhance healing.
Depending on the level of nerve compromised and chronicity of the misalignment a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this deformity.