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  1. #1
    drkeller is offline Newbie 510 points
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    TMJ Pain patients

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    Im curious, does chiropractic training include the stomatognathic system.
    I hear that chiro treat TMJ disorders. Is that accurate?

    when would it be appropriate to send a head and neck pain patient to a dentist that specializes with TMD?

    what is the established the criteria that is taught?

    I always keep a good chiro on hand because as you all know treatment of pain and dysfunction in the head, neck and jaw is multifactorial.
    Fellow in the American Academy of Craniofacial Pain

  2. #2
    AgActual's Avatar
    AgActual is offline Member 525 points
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    Im curious, does chiropractic training include the stomatognathic system.
    Yup, every system in the body is covered in the first 4 semester in the basic science phase. Of course which systems are covered in depth is dependent on how relevant they are to everyday chiropractic practice. At my school, there is a class in head and neck anatomy during the second semester but is a relatively small three credits. So a chiro student would know about the jaw and whatnot but really it is only covered for a few weeks, at most.

    I hear that chiro treat TMJ disorders. Is that accurate?
    From what i have heard, yes. Of course the question is, are they properly trained to diagnose and treat TMJ, and my answer would be "almost certainly not". I can't imagine most do. Who would develop TMJ and think "i have to call my chiropractor"?

    when would it be appropriate to send a head and neck pain patient to a dentist that specializes with TMD?
    Well keep in mind that most chiros only do work on the back of the neck, around the cervical spine and don't concern themselves too much with the front or the area around the jaw. Of course you could manipulate the jaw but you would have to be deranged to try it. Although from what I have heard about this is that most chiropractors attempting to treat jaw problems methods that are more useless, such as an activator, meditation, and biofeedback, as opposed to dangerous.

    The thing in, any pain or dysfunction that will cause TMJ or TMD probably is going to have no relevance in chiropractic practice, since it will be so far removed from the pain typically encountered in the cervical spine region. Anyone presenting with problems looking more like mouth or jaw problems will have pain too atypical to be in the cervical region and would be referred out (assuming you go to a competent chiropractor)

    what is the established the criteria that is taught?
    Probably none. At least not at the schools. Those pesky weekend seminars perhaps, but i highly doubt these chiro schools are spending any tangible amount of time on jaw treatments. While most of these schools do have courses dedicated to treatment of the head and neck, it is likely that those classes are focusing 99% of their energy on cervical spine problems and not structures of the face.
    Last edited by AgActual; 10-19-2010 at 05:56 PM.

  3. #3
    ChiroPhysician is offline Newbie 510 points
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    I agree with Ag on this one. Very minimal time is spent on treatment and dx of TMJ. I vaguely remember using measuring sticks to determine lateral to medial deviations from center line points, as well as, opening and closing of the jaw. I wouldn't feel comfortable in the dx of a patient now unless I reviewed some of the material, but a patient that has been dx for TMJ is a little different. Trigger point therapy, muscle stim. and TMJ manipulation are all feasible. The manipulation uses the premise of trying to reset the disc between the mandible and temporal bones. Trigger point therapy is done from inside and outside of the mouth which is pretty painful (temporary) for the patient.

    I have treated 2-3 TMJ patients all with good outcomes.

    I guess it depends on how comfortable the chiro is in treating TMJ.
    Last edited by ChiroPhysician; 10-21-2010 at 02:51 PM.

  4. #4
    drkeller is offline Newbie 510 points
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    Quote Originally Posted by ChiroPhysician View Post
    I agree with Ag on this one. Very minimal time is spent on treatment and dx of TMJ. I vaguely remember using measuring sticks to determine lateral to medial deviations from center line points, as well as, opening and closing of the jaw. I wouldn't feel comfortable in the dx of a patient now unless I reviewed some of the material, but a patient that has been dx for TMJ is a little different. Trigger point therapy, muscle stim. and TMJ manipulation are all feasible. The manipulation uses the premise of trying to reset the disc between the mandible and temporal bones. Trigger point therapy is done from inside and outside of the mouth which is pretty painful (temporary) for the patient.

    I have treated 2-3 TMJ patients all with good outcomes.

    I guess it depends on how comfortable the chiro is in treating TMJ
    Let me follow up.

    You have treated 2-3 patients with TMJ. What was the diagnosis(s)? FYI: TMJ is not a diagnosis its just a catch all term. If you dont feel comfortable making the diagnosis which is fair, then who did for the 2-3 patients you treated.

    Lastly, i understand the concept that chiro uses manipulation to get the disc repositioned between the condylar head and fossa, but how do you keep it there? Please look at this video on you tube and type in Pathology: Anterior DDR It will help with what i am asking you.
    Fellow in the American Academy of Craniofacial Pain

  5. #5
    drkeller is offline Newbie 510 points
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    Quote Originally Posted by ChiroPhysician View Post
    I agree with Ag on this one. Very minimal time is spent on treatment and dx of TMJ. I vaguely remember using measuring sticks to determine lateral to medial deviations from center line points, as well as, opening and closing of the jaw. I wouldn't feel comfortable in the dx of a patient now unless I reviewed some of the material, but a patient that has been dx for TMJ is a little different. Trigger point therapy, muscle stim. and TMJ manipulation are all feasible. The manipulation uses the premise of trying to reset the disc between the mandible and temporal bones. Trigger point therapy is done from inside and outside of the mouth which is pretty painful (temporary) for the patient.

    I have treated 2-3 TMJ patients all with good outcomes.

    I guess it depends on how comfortable the chiro is in treating TMJ
    Let me follow up.

    You have treated 2-3 patients with TMJ. What was the diagnosis(s)? FYI: TMJ is not a diagnosis its just a catch all term. If you dont feel comfortable making the diagnosis which is fair, then who did for the 2-3 patients you treated.

    Lastly, i understand the concept that chiro uses manipulation to get the disc repositioned between the condylar head and fossa, but how do you keep it there? Please go to youtube and type in Pathology: Anterior DDR. It will help with what i am asking you.
    Fellow in the American Academy of Craniofacial Pain

  6. #6
    AgActual's Avatar
    AgActual is offline Member 525 points
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    I have a bit more information on this issue. I went to National's clinic a few days ago to get treatment for a stiff neck and one of the rehab chiropractors asked if i also have TMJ. I guess some neck problems and TMJ often go togeather. I do, so i decided to accept treatment, since i remembered this thread, because i wanted to see what their plan was.

    I can't get too techincal since i was just laying there and i am unsure what the offical treatment protocol was but it involved me laying on my back while one of the interns put pressure on both sides of my jaw in various postions, while i opened and closed my mouth. It was fairly gentle and lasted about 20 minutes.

    I'm not sure what they were attempting to do but what i do know is that the popping i have had in my jaw for years has suddenly stopped. I have been fairly skeptical of a chiropractor's ability to fix TMJ but from one one experience it seemed to do something. Take that to mean what you will but I do wonder what several more treatment sessions would do. I will get back to you guys and let you know if i have actually been cured, somehow.

  7. #7
    deandrade is offline Newbie 510 points
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    Jaw pain and jaw problems are the hallmarks of TMJ disorder.Sensitivity to heat and cold. Loosened teeth, fractures, and a debilitating headache. All this can occur while TMJ problem.I dealt with this problem and i visit Las Vagus Dental Implants and really they are commendable.

  8. #8
    adamcollin is offline Junior Member 513 points
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    Chiropractic does help to treat TMJ. The technique involved relieving tension and dysfunction in the spine, which it reduces the pressure on various nerves (including the one associated with TMJ).
    Corrective Chiropractic & Wellness

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