Welcome to the stanford health library. Thank you for coming here tonight. My name is Michele Jehenson and I work at the orofacial pain at the Stanford Pain Center in Redwood City. So today’s topic is TMJ disorders. TMD, I’m going to speak about the nature of the disorder.
What a tmj disorder really is. I’m going to also talk about who is at risk for TMD. And finally, I will touch on the common treatments that are recognized as evidencebased treatment for TMJ disorders. So, I guess it’s customary to.
Talk about disclosures as to if i’m affiliated with any kind of pharmaceutical company or anything like that. I have no disclosures to be done. So, I wanted to first show you the anatomy of a TMJ. It’s a joint that is very unique in the body. It’s one of a kind.
There is a one disc, and you can picture it as a donut. So, it’s a circular, biconcave, just a donut, just doesn’t have the actual hole in the middle. So it’s kind of like a donut shape, and it separates the jawbone, which you see as the rounded bone in the picture, from the skull.
And particularly, the fossa, the articular fossa, and the eminence that you see to the right of the fossa. So the disc is flexible. It’s fiber cartilage, and it offers a perfect interface between the skull and the jaw. It allows for smoother motion.
The joint is also particular in a sense that not only it allows rotation of the joint, but it allows for forward motion of the jaw. So, if you put your hand like slightly over your, in front of your ear and you open your jaw wide and slow, you can see that initially, it just starts rotating and.
Then you can feel it actually advance forward. And for some people, you can actually feel it coming out slightly, because even though the jaw is seemingly fixed, the suture that is in the front, it allows for certain flexibility in and out of the joint itself. So, what is a TMJ disorder?.
So, a tmj disorder is defined by pain, either at rest or upon function. It is defined by something that is a painful noise. It can also be just a dysfunction, like a limited range of motion, or a jaw deviation such as this, like when you open you go to one side or.
Internal Derangements of the TMJ
Ok we have expert number two. he is a private practice, board certified in sleep medicine and pain management. You all know Mickiewicz and Mickiewicz, take it away. Thank you so much. When Lou approach me a week ago or so it was specifically on internal.
Derangements. so i’m gonna take a little different tack Malick gave us really nice presentation of like the overview of like how you take the patient from point A to point B and I want to get down a little more.
Nittygritty with you guys and my practice it is unique in a lot of ways because it is all i do. I stopped doing restorative dentistry, you know, for a multitude of reasons. I’m incredibly busy with what I do with the orofacial pain.
Practices that i have. sutter, mercy, uc Davis those are my biggest referers for probably a 200mile radius. So I get people from everywhere with and I might the the person of last resort i am the neurological dumping ground.
From all the local neurologists the physical medicine specialist, a lot of the dentists or oral surgeons I mean whoever and the dentists of course. So and I’m there and fairly available email or whatever. My website, I left some referral.
Stuff and my website back there is drmickdds and there’s a ton of information on there, links to you know all sorts of organizations pretty much all the information that I can share here and what’s a little bit different about my approach, I mean it’s.
Pretty much part and parcel of what they teach at UCLA, you know in terms of how we get from point A to point B. You know I’m a UOP boy so you know we have a little different bent on things, but it was a similar background you know I.
Started this 2530 years ago with chase down at UOP and they had a pain and we had all the specialties represented and it was pretty cool but we didn’t have the cool technology we didn’t have people like Rathi have at our.