#77 TMD/TMJ and Tardive Dyskinesia

I bet you haven’t heard of Tardive Dyskinesia.  Unless you are a Neurologist or Psychiatrist you probably don’t know about Tardive Dyskinesia. It is kind of a medical secret.  The pharmaceutical industry doesn’t want to talk much about Tardive Dyskinesia. Most general physicians, PCP’s, nurse practitioners, and physician assistants don’t know about Tardive Dyskinesia. Most medical specialists don’t know about Tardive Dyskinesia.   I can promise you, not one in 500 dentists can tell you what Tardive Dyskinesia is, although every practicing dentist in the United States observes patients with Tardive Dyskinesia frequently.

Tardive Dyskinesia (TD) is a movement disorder that causes involuntary repetitive body movements and is commonly seen in patients who are on long- and short-term treatment with neuroleptic drugs.  A neuroleptic drug is any drug that tends to reduce nervous tension by depressing nerve functions. This includes all types of psychiatric drugs and categories. According to a December 16th 2016 article in “Scientific American” 17 percent of Americans fill prescriptions for psychiatric drugs each year.  And this percentage continues to increase each year.   It has been estimated that 20%-50% of patients taking psychiatric drugs develop Tardive Dyskinesia

The most common repetitive motions associated with Tardive Dyskinesia include facial grimacing, sticking out the tongue, smacking of the lips, and jerky, to and fro movement of the lower jaw.

Constant, jerky, to and fro motion of the lower jaw can cause eventual damage to the jaw joints. Damage to the jaw joints leads to chronic inflammation of the temporomandibular joints.  Chronic inflammation within the jaw joints (TMD/TMJ) will lead to any of the disparate symptoms. (Headache, Earache, Jaw Pain, Neck Pain, Tinnitus, Hearing Loss, Vertigo, Shoulder/Arm Pain, Arm/Hand/Finger Tingling and Numbness.)

So, it is a little know fact, somewhat hidden by the pharmaceutical industry, and infrequently discussed when the drugs are prescribed, that taking psychiatric drugs can lead to Tardive Dyskinesia.  Once the repetitive motions occur, decreasing or discontinuing the medication will not decrease or limit the damage to the nervous system.  The repetitive motions continue indefinitely.

Christina M. is an 80-year-old patient of mine who exhibited obvious oral Tardive Dyskinesia after taking prescribed psychiatric medication for 40 years.  The jaw motions were so severe and constant that it interfered with her speech.  She also exhibited many of the usual TMD/TMJ symptoms.  She was aware of the cause of her constant jaw motion and even knew its proper name.  She knew her Tardive Dyskinesia was a permanent disability but came to our practice for relief of the TMD/TMJ symptoms.  Fortunately, after several months of using the Urbanek Device and Protocol her TMD/TMJ symptoms were resolved.  She even shared that with the device in place the dyskinesia feels better.  Christina is only one of many patients we have seen who exhibited TMD/TMJ caused by Tardive Dyskinesia.

According to an article in the “Ochsner Journal 2017, pp162-174” the list of medications that can induce Tardive Dyskinesia include:

Antipsychotic Drugs                                Antimalarials

Anticholinergic Drugs                             Antiparkinson Agents

Antidepressants                                       Anxiolytics

Antiemetics                                                 Mood Stabilizers

Anticonvulsants                                        Stimulants (ADHD Drugs)

Antihistamines                                          Amphetamines

Decongestants                                          Appetite Suppressants

Tardive Dyskinesia is an increasingly common problem and seen frequently by the medical and dental professionals but unrecognized.  Because it can cause pharmaceutical induced TMD/TMJ I bring it to your attention.  It is my chosen responsibility to address all factors related to TMD/TMJ for the benefit of our patients and the general public. Sharing all the information available about TMD/TMJ is what sets our practice apart from other providers.