Treatment of  Temporomandibular Disorders

Dr. Hart's primary teaching experience was as a clinical professor in the Marquette University Dental School's Temporomandibular Disorders Clinic (previously called the "Occlusion Clinic").  Our approach to Temporomandibular Disorders ("TMD", formerly called "TMJ") is extremely conservative and focuses on treatment of your pain with minimal use of medications and extremely rare involvement of surgical procedures.

Headaches from TMD are an extremely common problem. The classic symptoms include the following:

• "Band-like" pain or sensation of muscle stiffness, usually on both sides of the head near the temples, jaw joints, and/or cheeks.   Sometimes additional sites of TMD headache pain are in the region where the back of the neck joins the skull, or the areas muscles that turn your head attach.
• The pain, while persistent and uncomfortable, is almost never intense, and over the counter pain medications (especially ibuprofen ("Advil") are reasonably or totally effective at keeping it under control.
• Tendency of your headaches to occur in the morning or during times of positive or negative emotional stress.
• Accompanying "clicking" and/or pain in the jaw joints.
• The pain is not excruciating, and it does not need narcotic pain killers to treat (this is extremely important).
• The pain is not brought on by foods, is not accompanied by dizziness, sensitivity to light, tingling, or nausea.

Following, for your review, please find excellent summary of other types of headaches that was written by Marilynn Marchione and was published in the December 7, 1998 edition of the Milwaukee Journal Sentinel..  If you have symptoms similar to the following, you should seek care from your medical professional.

Severe attacks that occur over a few days or weeks - clustered in time, not in an area of the head.  They occur more often in fall and spring.  More common in men than women;   more common among smokers.

Symptoms:  Intense burning, piercing, throbbing or constant pain on one side of the head or behind an eye.  Develops swiftly.  Can awaken the sufferer in early morning or during the night.  Usually lasts 30 to 45 minutes but can be as long as a few hours.  Headaches can recur the same day.   Can last weeks or months and then disappear for months or years.

Cause:  Some are due to swelling of blood vessels in the head;  hypothalamus and neurological mechanisms may be involved.  Can be triggered by alcohol, nitroglycerin, histamine or smoking.

Three times more common in women than men.  Most common type of headache occurring in adolescents.

Symptoms:  Intense pain or throbbing lasting from 4 to 72 hours;  blurred or impaired vision;  nausea or vomiting;  sensitivity to light or sound;  tingling numbness in the arms or legs.  Sometimes preceded by an aura, or sense of impending headache.

Cause:  Swelling of blood vessels in the brain.  Can be triggered by hormone fluctuations from menstrual cycles or birth control pills, stress, travel, fatigue, change in sleep patterns, missing or delaying a meal, some medications, bright light, TV or movie viewing, excessive noise, and certain substances or foods, including aged cheese, chocolate, nitrites, MSG, and alcohol.

Chronic headache among people who regularly take headache medications.

Symptoms:  Pain that usually is present on awakening and lasts throughout the day, though it may vary in intensity.  Pain usually is dull and throughout the head, sometimes accompanied by nausea, irritability, restlessness and problems with sleep and memory.

Cause:  Overuse of and dependence on medications that treat headaches.  Many contain caffeine, which relieves pain by constricting swollen blood vessels.  But when it wears off, the vessels can dilate again and cause pain anew.

Headache centered in sinus cavities.

Symptoms:  Constant pain or tenderness over the sinus, a deep dull ache made worse by head movements or straining, especially bending over.   Often accompanied by nasal discharge, ear fullness, facial swelling, fever.

Cause:  Inflammation of lining of sinus cavity, swelling or blockage of sinuses.  Can be caused by infection or allergy.

TMD / TMJ Treatment at our Office:

We perceive ourselves as a team member in the treatment of these disorders.  When you seek TMD care at our office, Dr. Hart performs a comprehensive and detailed TMJ examination, then discusses your symptoms and possible treatment with you.  You can be assured that the approach we take emphasizes conservatism, minimization of cost, and non-intrusiveness.  More often than not, we help you form a team of other dental, medical, and physical therapy professionals who will work together to solve your TMD / TMJ problems.