#118 Fact Checking TMD/TMJ (Part 3) “Talk Therapy”

First, let’s define our terms.  TMD/TMJ is disease with multiple symptoms.  The most common symptoms are headache, earache, jaw pain, neck pain, ringing in the ears, a feeling of fullness in the ears, vertigo, upper back and shoulder pain, arm/hand/finger tingling and numbness and various kinds of jaw locking.  Noise from the jaw joints is a sign of the disease, not a symptom. 

Talk therapy is a method of treating emotional problems usually administered by psychologists and psychiatrists.  However, the psychologists are the most common healthcare providers using talk therapy and do not prescribe mood altering drugs while psychiatrists most often prescribe drugs for emotional problems. 

The question is, how does talk therapy treat the above symptoms?  The answer is “it doesn’t”.  However, I can explain the theory behind this sometimes highly promoted method of treatment.   I am aware of two of at least two of largest dental schools in the country that include psychologists and psychiatrists on their overly expanded team that treat patients with TMD/TMJ.  I’ll discuss the other categories of team members in subsequent articles. 

The logic used to validate “Talk Therapy” for treating TMD/TMJ  follows. 

  1. Bruxism or clenching and grinding of the teeth is one of the three elements that can damage the temporomandibular joint (TMJ).  The other two are acute trauma, and functional malocclusion. 
  1. If bruxism is one of the causes, then anything that limits bruxism should decrease symptoms. 
  1. It is generally accepted that bruxism, clenching and grinding of the teeth, is related to stress and anxiety. 
  1. Therefore, if you can decrease stress and anxiety for the patient the TMJ symptoms should be resolved. 
  1. A properly trained psychologist or psychiatrist can talk with and council a patient about stress and anxiety to the point that they no longer have stress and anxiety. 

That’s the theory supporting this type of treatment. 

The facts are: 

  1. The exact mechanism within the nervous system that converts external stressors and emotional anxiety into bruxism is unknown.   
  1. Everyone on the planet experiences external stressors on a daily basis.  Some people deal with stress and anxiety better than others.    
  1. One’s ability to deal with stressors varies on a day-to-day basis depending on hundreds of factors. 
  1. Talking about one’s stressors and emotional anxiety sometimes makes things better and sometimes worse.  Think about your own personal experiences. 
  1. Talk therapy has no effect on the other two elements that cause TMD/TMJ. 
  1. Talk therapy is a continuous never-ending cycle of support that must be followed consistently to have any effect at all.  Consider the use of the 12-step method for alcoholism which must be applied indefinitely. 
  1. Bruxism is an involuntary mechanism within the body coordinated by the autonomic nervous system which also controls breathing, heart rate, and gastrointestinal function for which we have no control. 
  1. Talk Therapy has no significant effect relieving symptoms of TMD/TMJ 

In my opinion universities that use psychologists and psychiatrists for “talk therapy” to treat TMD/TMJ simply do so to appear more academic, needlessly inflating the number of providers necessary to treat the patient. 

If you are interested in finding out why chronic inflammation of the temporomandibular joint (TMJ) is the common denominator of all the symptoms, ncluding the easiest and best way to relieve chronic inflammation of the TMJ, complete explanations are available at www.urbanektmj.com and within our You Tube channel “TMD Demystified”.