One of the Top TMJ Specialists,
Your Pain Relief Is Just A Phone Call Away!
Bob Perkins DDS The Best TMJ Doctor & Specialist
Serving Los Angeles and Malibu
What is TMJ? TMJ literally refers to the Temporomandibular Joint. That is the ball and socket joint behind the ear that is involved with opening and closing the jaw. It is common to hear people refer to problems with the jaw and the joint as “TMJ” which is accepted but the more accurate term might be TMD (Temporomandibular Disorder). Typically “TMJ” or TMD refers to problems that arise from an improper or (non physiologic) bite. If a person’s bite is not in the correct place then a patient can have many muscle and jaw joint symptoms in the area as well as other symptoms would seem non related but are such as: ear congestion, ringing of the ear, and dizziness. Typically, a patient with TMJ will have a bite that requires their jaw to be positioned to far back. Oftentimes a TMJ patient will have an overbite which is a reflection of this retruded lower jaw position. The “bite” determines where the jaw position will be even when a person is not eating so it is important that the bite (the position where the upper and lower teeth come together) be one where the muscles don’t have to overwork in order to access it.
Imagine walking where you raise your knees up to your waist with every step. Imagine the extra work your muscles in that area would undergo if you did this instead of a normal, less stressful, walking style. These muscles would soon become fatigued. You might have a number of symptoms that would arise from this chronic overworking of the muscles. Your hips might hurt, knees, etc.. Well, TMJ is similar in that when you have TMJ your muscles are typically working too hard in order to bring your teeth together. This chronic overworking can cause debilitating symptoms.
Our protocol is to diagnosis this dysfunctional bite and establish a new bite position on a trial basis to see if we can get ALL the symptoms to subside in a very timely manner. We can change a patient’s bite non invasively and totally reversibly with the goal being to allow the lower jaw to achieve a position with respect to the upper jaw where the muscles no longer have to overwork, the joint doesn’t have to experience compression….and relaxation and relief could be the lasting result. We hope and expect to relieve all symptoms within 4 weeks but we often get results within the first 24 hours. If we relief the symptoms with the “trial” bite we can then make that bite permanent.
The following are symptoms associated with “TMJ”. Some patients will only have (1) of these symptoms and others will have all of them. TMJ tends to get worse, not better because it is a structural problem that needs to be remedied by a correcting of the structure.
- Headaches or Migraines
- Ear pain or Ear congestion
- Facial Pain
- TMJ pain or TMJ clicking
- Neck Pain*
- Limited Opening
- Ringing of the ears
“TMJ” is often associated with one or more of the following other symptoms:
- Sleep disorders including sleep apnea
- Retruded lower jaw (weak chin)
- Compressed lower face
In many cases a patient with TMJ will have their pain issues resolved as well as their sleep issues, and issues with facial balance. “Form follows Function”. If one system of out of balance it can create imbalances in other systems.
Connection between TMJ and other Health and Behavioral Issues
TMJ problems very often affect women much more than men. They also affect those who have a retruded lower jaw and an “overbite” much more than those whose jaws are developed more forward. Though not true in all cases it is very likely that a TMJ patient will have a retruded lower jaw. There is a certain facial profile that is common for TMJ patients. It is also true that people with retruded lower jaws will have a much higher likelihood of having sleep issues associated with an obstructed airway. With a visit to our office we will screen patients for airway and sleep issues at the same time we are diagnosing TMJ disorders. It is also very common for patients (young patients especially) to have a retruded lower jaw, sleep issues and behavioral issues such as anxiety and depression.
The anxiety and depression are closely linked to the obstructed nighttime breathing.
Below is a link to information linking behavioral issues with obstructed breathing.
When a patient presents with a retruded lower jaw it is a health issue. Oftentimes the jaw is retruded because of blockage of the upper airway and chronic mouth breathing. Chronic mouth breathing is a very big issue that can lead to tooth crowding, narrow upper arch, TMJ, obstructed sleep issues, and behavioral issues. It needs to be taken seriously. Below is a link to a TED talk that draws a link between jaw relationships (bite), sleeping disorders, and behavioral issues.
Related videos and media
Temporomandibular joint disorders affect the jaw joint and chewing muscles that can cause discomfort or pain in the jaw.
If you were ever involved in an accident that caused an injury to your mouth area, you could experience TMJ later in life.
Dr. Perkins will analyze the bite ratio between the upper and lower levels of the teeth to find the cause of the disorder.
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About TMJ Disorder Specialist
Dr. Bob Perkins
Dr. Bob Perkins, one of the leading Malibu and Los Angeles/Burbank who focuses on Orthodontics and TMJ disorders. He has successfully completed dental training and a notable undergraduate education at USC, University of Southern California. He also attended the Las Vegas Institute for Advanced Dental Studies where he learned about advanced cosmetic dentistry, orthodontics, and TMJ disorders.After more than 20 years of helping patients throughout the Los Angeles and New York areas, Dr. Bob Perkins continues to gain knowledge and success in the field of dentistry. With well over 1,000 hours of dental continuing education and extensive research, he has gained several return and referral patients. Creating and supporting healthy and beautiful smiles is what he is most passionate about. Contact us today to see Dr. Perkins, the top Neuromuscular Dentist in Los Angeles. You can visit one of our practices in Malibu or West Hollywood/Los Angeles.
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Dr. Perkins offers a treatment based on Neuromuscular Dentistry. Neuromuscular Dentistry dictates that a person’s “bite” should be in a place where the muscles that support the jaws are relaxed and not under any undo stress in order to function in the “bite”. So often with TMJ the lower jaw is forced to retrude in order for the teeth to come together. Muscles have to strain and overwork in order to find the existing, pathological bite. This chronic overworking of the muscles and joint bring about pain and tightening. Neuromuscular Dentistry finds a new bite position where the muscles and joint in the head and neck area are NOT forced not overwork. The process of finding this new bite position is totally reversible and non invasive. A new bite can be established in the proper Neuromuscular position and the muscles can calm down overnight. In a high percentage of the cases treated the patient will notice virtually a total resolution of their symptoms. These symptoms can include: HEADACHES, ringing of the ear, neck pain, clicking of the joint, ear congestion, and many other symptoms.
In addition, when a patient has TMJ disorders it is often reflected in the proportion of their face. A typical TMJ patient will often have a lower jaw that is set back (retruded). The lower face will oftentimes be short (compressed). Finding the correct bite that works best for pain relief will invariably bring about a more proportional and often younger looking face. Skin will flatten out as it gets more support from the new position of the lower jaw. The visual changes can be quite profound.
No permanent changes are made to the patients bite unless and until the temporary changes have proven to bring about the desired results. This process of finding the correct bite via the temporary process takes no more than 4 weeks. After this time a patient will be presented with the treatment plan to move forward and make the changes (and the results) permanent. Once the changes are permanent the patient will not have any relapse of the symptoms. It is like changing lanes with your car from a lane that was full of debris into a lane that is clear and unobstructed.
In closing, chronic TMJ/TMD problems very rarely resolve on their own and they can be quite debilitating and degenerative
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