TMJ Problems Can Be Treated Without Surgery

Jim/Dr. Kennedy, thank you so much for this piece about TMJ dysfunction.

I had a question for Dr Kennedy about off the shelf oral appliances.  I see one advertised late at night that is obviously aimed at those who are not sleeping because of their bed partner's snoring, perhaps, or their own.... Who knows. So this was a question about both appliances to the position the jaw to reduce snoring but as you will see, he addresses TMJ in his response:   

Mardy,

 

The (brand removed) appliance for snoring is not very good. Like OTC appliances for TMJ, they may help some cases and make a lot of others worse. I do not like any one size fits all appliances. The worst thing about them is that people try them and they don’t work for them so they give up on appliance treatment for their Sleep Apnea or TMJ altogether.  

 

Also these OTC appliances do not last very long. We have some temporary appliances at the office that can be boiled and fit to a person in the office, but these do not allow for much adjustment. There is no replacement for a proper diagnosis and a custom made appliance.

 

Thanks for the question!

 

Jim

 

I'm the first to admit that I was unaware of all of the symptoms of TMJ dysfunction in the past; the  went off for me the day Dr Kennedy and a local PT co-presented at a CME/Continuing Medical Education at our regional medical center.  In all fairness, the second chiropractor I went to in my life, at age 30, had found something needing to be adjusted from time to time with my TMJ, but the timing of that was just after I'd been deluged with the chronic fatigue syndrome and all the 'wild' stuff' this D.C. tested for anddid in treatment. For instance, it was where I first experienced AK, applied kinesiology for 'muscle testing'.  

As time went on, pretty much everything he had said from the very start was proven out in conventional ways.  So I must admit that there was something related to my body that I'd gotten one provider's input on which didn't 'stick' to my overall list of concerns because for some of us, sometimes and maybe all the times, you have to hear things a few times before it 'sticks'.  Sometimes for people who were skeptical about a type of provider, they need to displace their old thinking and get an open mind and then allow things to deepen related to their trust in the approach. Think about how many times we've gone to the allopathic providers and been helped in our lives; a lot, typically. We know that it can save lives, and maybe have experienced it ourselves. So we don't have to 'give that ALL up', just open our minds to integrating different things. 

When I had a hysterectomy/surgery with intubation at the end of 2006, I had problems start up the next week related to hearing and it affected my balance/stability, and went to a PT coworker when I was in the office to push some paperwork around for the doctors to give orders or clarification on orders.  They worked on me and things got better and perhaps they also said 'yeah, you seem like you might have some TMJ problems', but I don't recall thinking 'wow, I have TMJDysfunction! But from my perspective, with chronic illness you end up in a swarm of providers and appointments at some points in time, and when that dust settles, and in my case, I was feeling SO much BETTER finally, you just 'get back to normal', and 'normal' to me means NOT having a lot of appointments about your wellness/illness! And I just didn't pursue at that time, treatment about TMJ.

So the  had basically half gone off about my having TMJ dyfunction, but I didn't seek a consult with Dr Kennedy at that time, which makes me, on one hand, want to , looking back on it.  Another factor I want to really highlight is that while I had my opinion forming about there being some issues you might be the ideal provider for me to consult with, without the providers working with me thinking to bring you up, I didn't give enough credence to WHAT I KNEW or WHAT I FELT. And I also didn't bring it up and say 'what do you think about me having an evaluation by Jim Kennedy?"

I can explain how that can happen, because I'm as guilty of it in the past, at least!  An example: When I was the OT in the PT clinic in the Primary Care Parterners building here in Grand Junction (CO, USA) my office was across the lobby from where Dr. April Schulte-Barclay, DAOM subleased space from EMPI, back before she grew and moved to the location she is at currently just up 12th from your office.  (Dr. Schulte-Barclay also provides educational content to Lumigrate).  Many upper extremity conditions can be very much alleviated by acupuncture, but I had few people who were interested in hearing about that optional, private-pay treatment as many of them were coming on workers' compensation insurance or on their insurance, and it was not very often the patient we had were interested in pursuing such things. As time went on I 'learned' to not make the suggestions because 'I was just wasting my breath'. So, again, I really suggest people realize that part of being a proactive patient is to take the initiative to ask your providers for their opinions about other providers or types of providers, and then keep in mind it is their 'opinion' (key word).  

That's why I currently work with Lumigrate's providers to keep us remembering each other, whether that be in posts on Facebook for people locally or nationally and beyond to see (or other social media they might use), or for those living locally doing a FUN gathering to get people together.  BUT I MAINTAIN THAT THE BEST WAY FOR MEDICAL CONSUMERS TO GET TO THE PROVIDERS AND GET THE INTERVENTIONS THAT WILL HELP THEM IS TO EDUCATE THEMSELVES, BECOME EMPOWERED TO FIGURE OUT THE SYSTEM THEY'RE OPERATING IN AND LOOK TO OTHER SYSTEMS TO ALSO GET HEALTH CARE IN AND PERSIST UNTIL THEY GET THE RESULTS THEY BELIEVE/'FEEL' THEY CAN HAVE.  

MUCH THAT YOU WILL WANT AND NEED IS NOT PAID FOR BY PROGRAMS YOU NORMALLY TURN TO, SO THINK OUTSIDE THE BOX, FIND SOLUTIONS ONE WAY OR THE OTHER.  In the case, above, perhaps try something you can afford and get an idea of it, and then SET A GOAL OF SOMETHING MORE IDEAL, AND THEN WORK TO FIND SHORT TERM STEPS TO ACHIEVING IT. IDEALLY, you will have more things work than not, your health will slowly or rapidly change in the direction of your goals/desires/intentions.  

Eventually I heard Dr Kennedy speak AGAIN at a CME (on pediatric sleep apnea - I've written about it in the sleep/apnea forum) and this time you showed a photograph of a young girl's neck/positioning and the  went off again! This time  -- it just resonated this THIS is my next step. I've had a head forward posture and I've always had a pronounced windpipe, and the girl in the photo had those features. I'd just never thought about the head and mouth position related to 'compensating' and getting more air for people who have sinus problems or irregularites of the structures of the head and neck that have to do with breathing.  Then THAT made sense related to fibromyalgia! I just was a very quiet, light sleeper with apnea and not the typical one.

The oral appliances you recommended and created have been really helpful to me related to protecting my teeth at night if I clench, as well, something I was aware I was doing but UNaware was potentially harmful to my teeth as I didn't know they could fracture. It was one of those things that, in the end, I thought 'I didn't know what I didn't know!' 

To give an idea of costs: $95 initial evaluation charge (at the time of this writing and per my understanding), and you are VERY KNOWLEDGEABLE about various aspects of holistic health care, which has only enriched my overall 'team approach' to my health care. It seems like the appliances and treatments vary in cost a great deal, so I will simply encourage everyone to make an appointment with you or a dentist in their area who specialists in holistic dentistry.

Going to your website is also a very helpful step for people to get an idea of what to look for in someone near to them geographically.  Like most of our providers, you provide links to national organizations, as well as The Cranial Academy's website, which is in your signature area, below, as a resource for people to follow out to for further information or finding a provider "like you" in their area possibly. 

Thank you for going the "different route" with your career, and I'm very grateful you moved from the Front Range of Colorado to Grand Junction, as I did.  I'm glad that eventually I found out about you, OVER AND OVER, until the moment: the voice in my head said just go have a consult and see if I have issues he can address.  

As I say, "Live and Learn! Learn and Live Better!!" ~~ Mardy

Note: It turned out that my reporting of symptoms at my monthly visits to Dr Kennedy lead to his becoming a very integrated part of my "YOU" team of providers, making very good suggestions about future treatments and testings, and I ended the year 2012 in a much better place with my health than I went into the year with.  It's a lot of layers of 'onion peeling', so to speak, and a process that after 20 years now has me rather anxious to be done with someday. It's kind of like having braces, but for 20 years -- GRINS.  

Toward the end of the year he made a jaw positioner for sleep apnea after having done CT scan of my head. This was the 'next step' with an ENT in town when I had recurrent sinus infections after moving here, but my thought process was that if I didn't have them before and I had the same sinuses, surgery was a band-aid for symptom remediation and NOT getting to the underlying CAUSE.  So I went the direction of working on my gut health with a local naturopath and a local chiropractor along with many other things. Had amalgam fillings replaced, for instance.  

I noticed immediately with the initial TMJ appliance, drainage from my sinus' as I was driving home and my sleep changed immediately, for the better one night then not the next. So in January of 2012 I awoke one morning with a stiff neck and vaguely recalled having been struggling to breathe and in a neck extended position sometime in the middle of the night. I'd gone back onto muscle relaxants which helped me fall asleep -- well, Dr Kennedy said matter of factly 'well that's your problem right there, it's shutting down your throat more".  

And you know, when he saw the results of the head/neck CT scan, there's a narrowing in my throat. So I worked AGAIN on my positioning in bed and even found some interesting information about the didgeredoo being used to treat sleep apnea.  I haven't gotten one yet, as it is not the custom for women to play them, and I don't want to disrepect their sacred customs, but I'm working on my unique 'surrogate' breathing exercise technique, and find the TMJ positioner surprisingly 'enjoyable' to wear because it just makes me FEEL BETTER breathing.  

I thought back to learning to SCUBA dive and how AWESOME it was to have that air pushing into your lungs! And I wonder if I might be one who does well with a CPAP or similar. I'll be working on that in this NEW year of 2013, and updating my journey here for those who wish to follow it. I hope it assists you in finding someone like Dr Kennedy if you're not so fortunate to live in or near Western Colorado. Thank you again to Dr Kennedy for his time in adding education at Lumigrate.com.  We got off to a good start with our collaborations in 2012 and I look forward to MORE in 2013 ~~ Mardy

I wanted to add this great resource here, they have nice videos about the TMJ and explain well how their products can be an aid or tool in reducing the side-effects of the underlying problems. www.pressurepositive.com/TMJ-Pain-Solutions-Myofree-TMJ-Cervicogenic-Headache-.aspx [10]

I want to remind people that everything is mind, body, and spirit and there are many contributing causes to most problems. Continue to study about diets that can cause or solve muscle issues, supplementation of nutrition or other herbs and homeopathic remedies, modalities, exercise and hydration. Meditation and the mind/body/spirit connection, prayer, and many other things are steps in the right direction that can become journey bringing a better or even ideal quality of life! ~~ Mardy