TMJ/TMD Care Example Complex TMD Orthodontic/Both TM Joints Replaced and Jaw Surgery
In addition to treating patients orthodontically, Dr. Garvey also treat patients who have temporo-mandibular dysfunction often called TMD or TMJ. He personally has had this condition for years which gives him first hand experience. Years ago he did his own braces to help improve the function of the bite to improve the TM condition. TMD is multi-factorial and many varied aspects of total health are involved. A comprehensive health history is taken and often TMJ records are needed for an accurate diagnosis and treatment plan. A splint/orthotic is usually fabricated which is a removable hard plastic upper appliance (see Photo of Dr. Garvey/’s splint). This appliance needs to be adjusted sometimes along with PT care to reduce the strain on the jaw joint complex. Usually some minor adjustments in the bite also help in this condition. The idea is to reduce headaches, muscle strain, earaches, and neck aches. Often stress is a major factor, as we all at times grind or clench our teeth usually unconsciously at night. Often depending on the severity of the condition; only splint/bite adjustments, with exercises and a reduction of factors which may strain the bodies structural balance will alleviate symptoms to an acceptable degree. A whiplash or other trauma to the head or neck will precipitate the symptoms. Sometimes full orthdontic care is indicated if the bite is a significant factor in the needed balance for optimal health. A TMJ MRI may be needed.
Should the condition be of such severity that surgery in the jaw joint or in the jaws themselves is reasonable, Dr. Garvey works closely with an experienced team of professionals who are trained in this complex type of care. This is done often in conjunction with full orthodontic treatment. The pictures below gives the progress of a complex case which was treated with full braces and artificial replacement of both jaw joints and the hinge areas of the jaw joint. Jaw surgery was also completed which moved the upper and lower jaw to a more functional balance. This patient was in severe pain prior to the combined care and now is out of pain. Note the functional change in the profile with the reduced over-jet as seen in the facial photos and in the head film x-rays take before and after the treatment.