In layman’s terms, the goals are often as follows, but they may go beyond this as well:

• Enlarge the jaw by moving the teeth such that the jaw is ideally sized for your tongue.
• Posture the lower jaw forward to its ideal position of relaxation.  * See Note.
• Reshaping or rebuilding your teeth to achieve a correct bite

Note: Your jaw is the only double-hinged joint in the body — i.e. not only can it open and close, but it can be postured forward and back.  It is quite common for it to be postured too far back. Very rarely is the lower jaw postured too far forward.

The following table describes common orthodontic techniques for achieving facial balance in order to help adults with TMJ. Just as with any major medical procedure, I cannot over emphasize the importance of getting multiple opinions before proceeding with an orthodontia procedure.  This is not medical advice or a recommendation of treatment. It is merely intended to inform you of what options are out there.

Technique	Description
Advanced Light-wire Functionals (ALFs)	Uses low-force removable custom-made wire appliances to move the teeth from behind. This could be called a "finesse" technique. Braces used afterward.
Functional Jaw Orthopedics (FJO)	Commonly called European-style orthodontics, this technique uses removable custom-made plastic appliances. Provides a high-level of control. Braces used afterward.
Orthotropics	Uses custom-made removable plastic appliances. Capable of maximum forward growth of the maxilla (upper jaw bone), however this is not a low-force technique. Braces used afterward.

Here are some basic things to understand about magnesium:

• Key sources of magnesium include: Green vegetables, nuts and seeds, oat bran, wheat bran, brown rice, and certain fish — such as halibut, tuna, and pollock

• As stated on jigsawhealth.com, “magnesium is involved in over 325 biochemical reactions. Some of the early symptoms of magnesium deficiency include body aches, muscle twitches, leg cramps, fatigue, headaches and migraines, severe PMS, chronic constipation, insulin resistance, and more”.

• magnesium is a natural muscle relaxant, arguably mother nature’s best, and is absolutely essential for healthy muscle function

• The ratio of calcium to magnesium that you consume in your diet should be in a ratio of 2 to 1 (i.e. twice as much calcium as magnesium).

• Calcium is a natural muscle contractor.  However, calcium must be present for magnesium to be well absorbed.

• The American diet is often very high in calcium (sometimes at a ratio of 5 to 1, instead of the ideal 2 to 1), because we consume a lot of milk, cheese, and other dairy products.

Specialists in TMJ who are keenly aware of the role of nutrition pay very close attention to a person’s calcium and magnesium intake, and often recommended magnesium supplementation to help relax the muscles, not just in the jaw but throughout the body.  This is very helpful with TMJ muscle disorder.  Calcium supplementation may also be recommended, or combined in a single product, but remember that calcium is a natural muscle contractor, so too much calcium will counteract the muscle relaxant effect of magnesium.

So, you want to know what I take?

I take two products:

• Jigsaw Magnesium with SRT. I like it so much I wrote a product review about it.  The key ingredient is magnesium malate, which is a highly absorbable form of magnesium.  I also like this product because it is a sustained release formula.

• DermaMag. This product comes as a spray or liquid which is highly absorbed when applied to the skin. I apply this directly to my jaw muscles (following the recommended dosage). Oh baby, just what the doctor ordered!

Website: http://pb-ebr.eznetpublish.ihealthspot.com/

Dr. Max Ebrahimian DDS and his associate and daughter Dr. Ariana Ebrahimian DDS would be ideal doctors to seek immediately if you have TMJ symptoms. Many of your needs: diagnosis, stabilization of the jaw, management of pain and inflammation, and structural correction with orthodontics, can be taken care of at one place. It is quite unusual and very advantageous to find an orthodontist doing Biobloc Orthotropics™ and structural correction of TMJ with functional orthopedics, who also does neuromuscular dentistry. He also works in conjunction with cranial osteopaths and sacro-occipital chiropractors, which is what I like to see.  Some TMJ specialists are not pro-active in integrating them into overall holistic therapy.

Important Note: It is wise to get multiple opinions before proceeding with an orthodontia procedure for TMJ. There are multiple approaches, and rtho: is one such approach.   Functional Jaw Orthopedics and  Advanced Lightwire Functionals are several others.

Type of specialist: orthodontist, neuromuscular dentist

Techniques: Functional Orthopedics

Common symptoms in the jaw and mouth:

• joint pain, on one or both sides of the head
• jaw muscle pain and stiffness, on one or both sides of the head
• clicking and popping sounds from the jaw joint
• difficulty opening the jaw
• bruxism (teeth grinding and teeth clenching)
• sensitive teeth

The following list of symptoms (from http://www.healthcentral.com/chronic-pain/tmj-38544-5.html) is one of the more comprehensive and accurate list of symptoms I have seen:

Eye Pain and Eye Problems:

• Bloodshot eyes
• Blurring of vision
• Eye pain above, below and behind eye
• Pressure behind eyes
• Light sensitivity
• Watering of the eyes

Head Pain, Headache Problems, Facial Pain:

• Migraines
• Forehead pain
• Cluster headaches
• “Sinus Type” headache
• Hair and/or scalp painful or sensitive to touch
• Headaches at the back of the head, with or without shooting pain

Teeth and Gum Problems:

• Clenching during the day or at night
• Grinding teeth at night (bruxism)
• Tooth pain
• Sensitive teeth

Mouth, Face, Cheek, and Chin Problems:

• Discomfort or pain to any of these areas
• Pain in cheek muscles
• Uncontrollable tongue movements

Jaw and Jaw Joint Problems

• Limited opening
• Inability to open the jaw smoothly or evenly
• Jaw deviates to one side when opening
• Inability to find the correct bite with teeth
• Clicking or popping jaw joints
• Uncontrollable jaw movements

Ear Pain, Ear Problems:

• Hissing, buzzing, ringing, or roaring sounds
• Diminished hearing
• Clogged, “stuffy”, itchy ears
• Feeling of fullness
• Ear pain without infection
• Balance problems, vertigo, dizziness

Throat Problems:

• Swallowing difficulties
• Tightness of throat
• Sore throat with no infection
• Voice fluctuations
• Laryngitis
• Tongue Pain

Neck and Shoulder Problems:

• Neck pain
• Tired, sore neck problems
• Shoulder aches
• Back pain (upper and lower)
• Arm and finger tingling, numbness, and/or pain
• Stiffness

It is very important to keep in mind that everyone is different.  Please see a physician to receive a thorough examination and diagnosis before jumping to any conclusions about your health.

“The most common cause of facial pain is temporomandibular joint and muscle disorder (TMJD), which causes recurrent or chronic pain and dysfunction in the jaw joint and its associated muscles and supporting tissues. TMJD is the second most commonly occurring musculoskeletal condition resulting in pain and disability (after chronic low back pain), affecting approximately 5 to 12% of the population, with an annual cost estimated at $4 billion. About half to two-thirds of those with TMJ disorders will seek treatment. Among these, approximately 15% will develop chronic TMJD.”.

Frequently people with this disorder experience pain and stiffness or locking up in the jaw muscles as a sudden event, which can be triggered by multiple causes, but commonly it is preceded by chronic teeth clenching (see bruxism or teeth clenching syndrome) usually at night during sleep. Inflammation and swelling in the myofascial tissue that supports the jaw muscle is typical.

Appropriate TMJ specialists (TMJ dentists, neuromuscular dentists, and TMJ orthodontists are all qualified) should be consulted immediately in such an event. It is wise to seek multiple opinions as fast as possible, as there are different treatment paradigms and considerable variance in specific therapies used. Keep in mind this is a specialty within dentistry which is relatively new (most understanding has come in the last 10 years), so techniques and therapies are still evolving. If not handled properly with appropriate therapy expediently, the myofascial tissue can bind down over a period of weeks or months resulting in difficulty opening the jaw and limited range of motion. Lockdown of the jaw is more rare and the most serious symptom, as well as the most distressing — again, appropriate TMJ specialists should be consulted immediately .

But don’t be fooled into thinking TMJ symptoms are as straightforward as this. Nothing could be farther from the truth. If not diagnosed and treated, the underlying causes of TMJ, which are almost always include structural problems in the jaw and the bite, get worse, often slowly over many years (even decades). In such cases, a variety of serious medical conditions are likely to result, and these medical conditions extend far beyond the jaw — the entire muscular and skeletal system is affected, not to mention your mind (more on this later). In order to understand TMJ, you must truly understand the functional model of the human body — everything is interconnected and works together to function as a whole. An imbalance in a critical part of the muscular and skeletal system (arguably, nothing is more critical than the jaw — it’s where you breathe, eat, and talk, and it’s in your head!) must be counterbalanced elsewhere, and muscular tension, pain and dysfunction, and postural problems are the result. When you see TMJ specialists you’ll find they understand this principle at a very deep level — this is a core principle in all recent education they receive in TMJ.

In the next section, TMJ symptoms will be covered in detail.

Wow, this is intense!  How about some good news to cheer you up?

With prompt and optimal treatment starting quickly after the onset of symptoms, TMJ is reversible in most cases and can at least be made manageable in almost all cases. For those of you who already have chronic TMJ, don’t despair — tremendous strides have been made by TMJ specialists in recent years and treatment options have improved considerably.

Website: http://www.bodymindandsmiles.com/

The best way I can commend Dr. Johnson is as follows: I know a patient whose husband is in the TMJ business  and she switched between multiple TMJ orthodontists during her treatment, before she settled on him. Dealing with TMJ as an orthodontist requires particular sensitivity to the needs of the patient, and you will find great variance in how well orthodontists accomplish this. Dr. Johnson is excellent. He also excels at understanding the relationship of the entire muscular and skeletal system to the function of the jaw.  He treats TMJ with Functional Jaw Orthopedics, which effectively and efficiently move the upper and lower jaw into better facial balance. A huge asset of working with Dr. Johnson is he is a pioneer in the Dental-Chiropractic Co-Treatment Paradigm — this means he will work as a team with a TMJ chiropractor to oversee and manage progress in bringing your entire muscular and skeletal system (including your jaw) back into ideal balance. Dr. Johnson also specializes in sleep therapy, snoring, and obstructive sleep apnea.

Important Note: It is wise to get multiple opinions before proceeding with an orthodontia procedure for TMJ. There are multiple approaches, and Functional Jaw Orthopedics is one such approach.   Orthotropics and  Advanced Lightwire Functionals are several others.

Type of specialist: orthodontist, holistic dentist

Techniques: Functional Jaw Orthopedics, Functional Orthopedics

Website: http://www.tmjandsleeptherapycentre.com/index/

Dr. Shirazi is the orthodontist many, possibly most, people needing help with TMJ and obstructive sleep apnea get referred to in this part of the greater LA area (i.e. West San Fernando Valley, Conejo Valley, Simi Valley, to Ventura).  If his location is convenient, I would definitely say do a consultation with him.  He does orthodontic treatment with Advanced Lightwire Functionals and Damon braces, which are both state-of-the-art low force techniques for achieving facial balance, he has excellent therapy options for managing inflammation and pain (especially iontophoresis, ultrasound, and laser therapy), his practice is very much integrated with holistic dentistry, and he also has a specialization in sleep and obstructive sleep apnea.

The following page on his website gives an excellent overview of his orthodontia techniques:

http://www.tmjandsleeptherapycentre.com/orthodontics/

Extras: he uses a CT scan machine for 3-D imaging of your jaw (which many orthodontists don’t have, because it’s a very expensive investment),  to accurately measure facial balance, jaw function, and monitor teeth movement during orthodontics

Important Note: It is wise to get multiple opinions before proceeding with an orthodontia procedure for TMJ. There are multiple approaches, and Advanced Lightwire Functionals is one such approach.   Orthotropics and Functional Jaw Orthopedics are several others.

Type of specialist: orthodontist, holistic dentist

Techniques: Advanced Lightwire Functionals, Damon braces, Functional Orthopedics

My 2¢:
I received tremendous help from a chiropractor who specializes in TMJ, craniosacral therapy (CST) / TMJ cranial therapy, and sacral occipital technique (SOT).  Specifically, the orthodontic treatment I received created a lot of tension in my head, neck, jaw, shoulders, and back, and relieving this tension on a weekly or biweekly basis was absolutely essential — otherwise, the tight tissue in my jaw muscles (characteristic of TMJ muscle disorder) could have stayed this way permanently.

References:

[1] http://www.holisticdentist.com/services/tmj-cranial-therapy.html

Reference:
DeJarnette MB. Sacro Occipital Technic of Chiropractic. Nebraska City, Nbraska, 1952.

Removable or fixed appliances are used to address malocclusions which have a skeletal basis. Newer materials and designs, along with the latest research in jaw orthopedics, have opened up even more promising pathways to treat young children.

Light, consistent forces applied through fixed or removable orthopedic appliances will influence the growth of the developing facial and jaw bones in a young child, just when they have the potential for rapid change and growth. 90% of the facial skeletal growth occurs before the age of 8. Boys keep growing until the age of 18, whereas girls grow until age 15. However, growth continues in various forms until the age of 30, and bone remodeling never ceases, being responsible for lifelong alterations of the facial and jawbones due to functional influences.”

Early treatment in a growing child using functional orthopedics and jaw expansion helps in:

1. Non-extraction orthodontics: creating the foundation for all the teeth to fit comfortably without resorting to extractions later on.
2. creating a convex, attractive profile with proper lip support.
3. A broad, attractive and spectacular smile.
4. Proper space for the tongue.
5. Less chance for relapse.”

References:

[1] http://www.sarkissiandds.com/articles/1007.html, Dr. Sarkissian DDS