The temporomandibular joint (TMJ or TM Joint) and the trigeminal nerves are some of the most important structures of the face. When the TMJ is out of alignment or compromised in other ways, it can affect many other areas of the head and neck. Because the trigeminal nerve, which innervates the TMJ, also innervates so much of the face and neck, pain all over the head and face may result when there is any sort of disorder in this important structure.
This is, by far, the most active joint in the body, usually involved in over 2,000 swallowing actions per day, every day of your life. The TMJ is instrumental in a number of other facial functions, including:
It is the only joint structure in the body with two sides that affect each other. It is often considered to be the last vertebrae because of the enormous effect the lower jaw has as a counterbalance to the head. This means that if one side of the jaw is knocked out of alignment, it puts the mandible out of balance, which can cause numerous problems to the head and face. It has been shown in research that the condyles of the mandible almost exactly duplicate the condyles of the atlas that articulate with the skull.
Most disorders of the TMJ are caused by repetitive motion injuries causing stress or fatigue of the masticatory and cranio-vertebral muscles. The joint itself is also susceptible to diseases of the joint like arthritis and other degenerative joint diseases. These muscles exert up to 200 pounds of pressure several times a day, which is a lot of work for any muscle.
When one looks at the entire nervous system, you find that only about 20% of the input to the brain comes from the spinal column.
The other 80% comes from twelve sets of cranial nerves that control taste, smell, hearing, vision and eye movement, inner ear proprioceptive function and autonomic control of the organs and blood vessels of the body.
70% of that 80% (cranial nerves) or more than half of the total input to our brain comes from the trigeminal nerve. With so much neural input it must go to some very important structures. So what is innervated by the trigeminal nerve?
- The teeth
- The periodontal ligament, the joint that connects the teeth to the jaws
- The muscles that move the jaw
- The muscle that tenses the ear drum
- The muscle that opens and closes the eustachian tubes
- The lining of the sinuses
- Some of the innervation to the tongue
- The jaw joints or TM Joints
- The control of the blood flow to the anterior 2/3 of the brain via the dura mater
Understanding the Trigeminal Nerve
If one looks at the nervous system and compares it using an analogy to electrical wiring in a house, it is easier to understand these complex mechanisms. When you blow a fuse or circuit breaker it is usually the overloaded circuit that blows i.e. you plug in the toaster and the microwave at the same time and you blow a fuse. Everything on that circuit no longer works correctly. If you unplug either the toaster or the microwave all other symptoms function normally. So it is with the trigeminal nerve; it is the largest fuse to our brain carrying over 50% of the total input to our brain when it blows we get migraines, tension headaches, TMJ pain, ear aches, stuffy ears, and more.
If we unplug some of the input via neuromuscular dentistry then the entire system functions normally and healing results.
The TMJ is closely associated with the trigeminal nerve, which innervates approximately 40 percent of the head and face. This nerve has three branches and is involved with the following functions:
- Chewing functions of upper and lower jaw
The pain associated with TMJ is transmitted through the nerve structures and can result in referred pain in other parts of the head and neck. Some of the symptoms of temporomandibular joint disorder (TMD) include:
- Clicking or popping jaw or TM Joint
- Crepitus or grinding noises like broken glass in the TM Joints
- Headaches including migraines
- Neck pain
Many of these symptoms are directly related to the connection of the body part to the trigeminal nerve.
Impact of TMD
Many consider TMD to be a slow developing disorder, unless there is some sort of trauma involved, and people are not even aware that their pain is associated with TMD. They simply experience a myriad of seemingly unrelated episodes of pain and discomfort. In actuality, we suffer from the problem but are able to control the symptoms by making continual adaptations. Patients often seek treatment when their adaptive abilities are exhausted.
Just because there is not severe pain does not mean that our neuromuscular status and TM joint dysfunction are not adversely affecting our lives. It may just mean that we are attributing signs and symptoms to something other than our jaw function. It is amazing how many people never really feel good but do not look for treatment until they feel bad. Patients can often not remember the last time they woke up in the morning feeling great.
As TMD progresses, however, the pain and discomfort usually gets more unbearable. Since the condition is hard to diagnose, many patients are brushed off when they consult a dentist. It is important to find a qualified neuromuscular dentist to diagnose and treat TMD.
The neuromuscular dentist is always striving to improve the quality of his/her patients’ lives. Find out how Dr. Ira L. Shapira can help you by calling 1-800-865-6468 to schedule a TMD/TMJ consultation at Think Better Life.