It never ceases to amaze me how my TMJ (Temporal Mandibular Joint) experience comes in handy on a daily basis. About half of my practice is devoted to TMJ treatment so I am always thinking about solving TMJ problems or managing bruxing (grinding of teeth) habits. Patients frequently come in with broken and cracked teeth, and maybe some irregular, strange pain that comes and goes on its own whims. Well, knowing how the TMJ joint works with all the muscles, discs, etc., I can use this knowledge to help determine if those phantom pain symptoms are for an undiagnosed TMJ.
Sometimes a tooth will break because of TMJ, yet anyone might think it was caused by something completely different. The knowledge is best practically utilized in how I repair teeth. Through experience of solving TMJ problems, I know how teeth are supposed to hit when you bite down. This is extremely valuable, because if I were to place a crown or filling in the mouth and it did not hit the opposing tooth correctly, I could have inadvertently caused a TMJ problem for the patient. Yes, you heard right. In my opinion, small mistakes in general dentistry gradually snowball into large TMJ problems.
There is a principle called the DUML rule that I follow religiously. DUML stands for the Distal of Uppers and the Mesial of Lowers. This translates into avoiding bad contact points between teeth that can contribute to TMJ. When I solve TMJ problems, I make sure that I do not have those contacts on the teeth.
These incorrect points are like sitting next to a car booming with ear-grating rap music at an especially long red light. Is there even such a thing as good rap music? I am revealing my age now…
Dr. Sperbeck, West Los Angeles