#87 TMD/TMJ is Not a Psychiatric Disease

TMD/TMJ is not a psychiatric disease. So why are university TMD clinics enlisting psychologists, psychiatrists, and behavioral therapists to consult with patients with the known and disparate symptoms associated with this disease?  Why do some doctors think patients with the disparate symptoms of TMD/TMJ are crazy and occasionally say so?  Why do some doctors treat the symptoms of TMD/TMJ with mood elevators and psychiatric drugs?

The answer is university clinics think the cause of TMD/TMJ is multifactorial, (stems from many causes) and therefore the solution will come from a multi-specialist team approach.  The bigger the team, the better.  The broader the background of the team members, the more likely the cause and solution for the problem will be addressed successfully.  If anxiety can be decreased, clenching and grinding will stop and symptoms is go away. Nothing could be further from the truth.

Following this line of reasoning, if more university departments is better, then involving every university department would be the ideal scene.  Some universities are using this multidisciplinary approach and have established TMD clinics within their dental schools that bring together psychiatrists, psychologists, behavioral therapists, physical therapists, comprehensive care dentists, social workers, Oral and Maxillofacial Surgeons, orthodontists, and anesthesiologists.

No matter how many providers get involved, if they are not aware that all the symptoms of TMD/TMJ are driven by inflammation within the temporomandibular joint, they end up addressing symptoms only and not the cause of the symptoms.

The common denominator of all TMD/TMJ symptoms is chronic inflammation within the temporomandibular joint.  Chronic inflammation within the joint is caused by overuse or abuse of the joint.  Just like the chronic inflammation of a knee, hip, or elbow is caused by overuse or abuse, the TMJ develops chronic inflammation by direct trauma, long term clenching and grinding of the teeth, and teeth and jaws that are not aligned properly.  In fact, TMD/TMJ and “tennis elbow” is the same disease.  The best way to treat tennis elbow is to place the arm in a sling and rest the elbow joint.  When the TMJ becomes inflamed it makes the muscles of the jaws, neck and shoulder hurt. The orthopedic surgeons have known about this mechanism which makes the forearm hurt when the elbow joint becomes inflamed for 60 years.  How come the dentists have not applied this same scientific information to TMD/TMJ. Instead of applying technology to rest the joint, they gather a cadre of specialists who end up making the problem as complicated as possible.

If you are one of the unfortunate people who have suffered from the various symptoms of TMD/TMJ you may have already had the experience of being placed on a mood elevator or psychiatric medication in an attempt to keep you from clenching or grinding your teeth.  Scientists do not know the mechanism within the brain that translates thoughts of anxiety, stress, and worry into clenching and grinding.  Scientists don’t even have a good definition for stress.  But universities are now instituting programs involving psychologists and psychiatrists to treat TMD/TMJ patients using drugs and behavioral modification in order to decrease clenching and grinding.  In doing so, they have totally missed the point.  TMD is no more a psychiatric disease, than tennis elbow is a psychiatric disease.

If the joint is abused and develops chronic inflammation the solution is to rest the joint.  The simplest way to rest the TMJ is to place a small device between the front teeth according to a protocol in order to unload the joint, just like a sling unloads the elbow.  Allowing only the front teeth to touch separates the back teeth. Because 90% of the loads on the TMJ come from the posterior teeth separating the back teeth unloads the TMJ.

When a joint is unloaded, the chronic inflammation subsides, and the symptoms diminish.

The Urbanek Device and Protocol works just like a sling for tennis elbow, or a set of crutches works for chronic inflammation within a damaged knee.

TMD/TMJ is not a psychiatric disease.  It is a disease caused by chronic inflammation and responds to unloading the joint as if the jaw was in a sling or on crutches.