Cargotts Consulting LLC

One of the most common topics I deal with in my practice is TMJ/TMD, despite the fact that I am not a doctor.  I think that is a function of referrals (from existing clients), but also the fact that an estimated 20-30% of all people suffer from some form of TMD.  I write TMD, which stands for Temporomandibular Disorder, as opposed to TMJ, which stands for Temporomandibular Joint, because although they are used interchangeably in common society, TMD is actually what people are suffering from.  If you’re reading this article, you probably know all of that already, and thus, I will move along to the point of this article, which is to give people some unique views, and information about TMJ/TMD, based on my own experiences, research, and positive outcomes, as well as the experiences of the clients I’ve worked with (and ultimately helped, in terms of relieving their pains associated with TMJ/TMD).  At the end of this article, I provide a free, natural, solution to nighttime clenching, which is a leading cause of TMJ/TMD.

Speak to someone suffering from TMJ/TMD and the first thing you will notice is a sense of frustration.  Why?  Because even after scouring the internet, and seeing the “best” doctors, they can’t come up with a cause for their TMJ/TMD, they don’t understand how all of their symptoms (i.e. jaw pain, ringing in their ears, etc.) are connected, the remedies their dentists and orofacial pain specialists have prescribed (and for which they paid hundreds, if not thousands of dollars out of pocket for), like custom splints, dental nightguards, and other devices, don’t work, their pain often gets worse after using the prescribed devices, and after enduring the pain, day after day, with no end in site, they are just worn out!  Who wouldn’t be frustrated?

So why is there so much mystery and misunderstanding surrounding TMJ/TMD that’s leading to all this frustration?  Because doctors, scientists, and humans in general, like to “categorize” things into neat little boxes.  Our brains understand things better when they are presented in a linear fashion. But in the case of TMJ/TMD, there isn’t one single cause of all the symptoms associated with TMJ/TMD.  There are multiple things that can cause TMJ/TMD.  TMJ/TMD, its causes, and its symptoms, cannot be categorized into one little box.  Each case of TMJ/TMD is unique depending upon the initial cause, the number and types of symptoms, and what “stage” the TMJ/TMD is at.  Common causes of TMJ/TMD include physical injury (i.e. trauma to the face), disease (i.e. arthritis or tumors to the jaw bone), physical development malformations (i.e. severely misaligned teeth or jaw bones), and bruxing/clenching (i.e. grinding your teeth and clenching your teeth).

The biggest misunderstanding, in my opinion, with regard to TMJ/TMD, is the number of cases that are initially related to clenching one’s teeth.  I believe the overwhelming majority of cases in fact, are initially due to clenching (I will explain later what causes the clenching in the first place). However, when you read the entries on most forums dedicated to TMJ/TMD, the most vocal/active participants (and therefore the most numerous) are written by those who suffer from TMJ/TMD as a result of injury and disease.  Grouped into those with injury, I include people who grinded and clenched their teeth so much, and for so long, that they displaced, or dislocated, the disc(s) in their jaw (there is a small, fibrous disc that sits between the condyle and the glenoid fossa a.k.a. the ball and socket of your jaw joint), as well as those people who ground down their teeth to the point where they became misaligned. Many of these people have suffered from TMJ/TMD for years, if not most of their lives, because their cases are the hardest to cure.  ESPECIALLY those who have dislocated their discs due to grinding and clenching.  Besides the complicated nature of the surgery and recovery associated with repairing a disc, the reason why so many surgeries fail to relieve TMJ/TMD over the long run, is because it is not curing, repairing, or solving the grinding/clenching problem (the initial cause of the dislocated disc in the first place).   Additionally, how can one properly recover, and allow their disc, jaw, muscles, etc., to heal after surgery, if they are still clenching/grinding their teeth?  They can’t!  SOOOO… as a result of their large representation in forums, along with their unsuccessful attempts to cure their TMJ/TMD, those suffering as a result of injury and disease, are unknowingly and unintentionally, fostering the common misconception that most cases of TMJ/TMD can’t be cured, and that there is little help for anyone suffering from it.  New forum members leave message boards feeling more frustrated because they couldn’t find the answers they were looking for, and additionally, become more stressed and anxiety ridden after reading about the terrible situations, failed surgeries, uninsured costs, and pain that their fellow TMJ/TMD sufferers have gone through.  As you read on, you’ll soon see why the forum/”internet search” experience, and resultant psychological set-up, are relevant and important.

HANG IN THERE…WE’RE GETTING TO THE MAIN POINT OF THE ARTICLE!

At the risk of being criticized by the professional dental community, as what I am about to write is arguably controversial, I will go ahead and state the following anyway:  It would seem that SOME (not all, to be clear), dentists and specialists are further, indirectly, advancing the idea that TMJ/TMD can’t be cured.  Why?  Because in many cases, they are treating the symptoms of TMJ/TMD, and trying to stop the effects of grinding/clenching of teeth, rather than stopping the grinding and clenching itself.  First, let’s talk about what grinding and clenching do to one’s teeth does.  The enamel on your teeth, under normal circumstances, wears down at the rate of .3 millimeters every 10 ten years.  For someone who grinds their teeth, it is not uncommon for them to experience two millimeters of enamel erosion over the same time period. Additionally, the grinding and clenching can produce up to 250 pounds of force per square inch- enough pressure to crack a walnut! Think about that for a moment and you’ll start to understand why the muscles in your jaw ache, and why you get those terrible migraine headaches.  What else happens?  Eventually your teeth can get so worn down that they become flat and even in length, your teeth could get ground down to the dentin (which makes you sensitive to hot and cold), you could lose teeth, and you can get tiny cracks and broken fillings (leading to nerve damage).  Additionally, over time, one can also wear out and dislocate the discs in their jaw that I mentioned earlier.  Back to the roll of dentists- a typical experience for someone who recently developed symptoms of TMJ/TMD goes something like this…. after a period of time goes by whereby their symptoms do not resolve themselves (the aching jaw and headaches persist), the patient eventually makes an appointment with their dentist, or holds out until their semi-annual check-up, and complains to their dentist then.  He/she will first ask if they’ve been chewing a lot of gum, then take a look inside the patient’s mouth, most likely see some signs of bruxing, and even if they don’t, they will explain to the patient that “they are grinding and/or clenching their teeth.”  The patient will be silently elated that the dentist has found the cause of their symptoms.  The dentist will further state that he/she can “build them a custom dental guard or splint, that will prevent them from grinding their teeth and/or protect them when they clench.”  The patient is even more elated- their dentist has a fix for their “problem!”  Thoughtful dentists (so their patients aren’t shocked when they check-out) will at this point make the patient aware of the cost of a dental guard (which can be $500-$700+), and inform them that it is not covered by insurance.  So now, rather than thinking about “grinding or clenching” and wondering why they are grinding or clenching their teeth in the first place, the patient’s focus has quickly shifted to the $700 cost of the guard,  and the quick decision they have to make while their dentist is essentially hovering over them.  It isn’t until they get home, or weeks later, if ever, that patients start to question why they grind and clench their teeth.  And that’s when they start searching TMJ/TMD forums, message boards, and support groups, and end up more confused, as they read about malocclusions, dislocated discs, and very rarely end up reading about grinding/clenching, and the root cause of grinding/clenching (which we will get too- hang in there).  I’d like to make something clear.  There is absolutely value in using a dental guard (it’s not like the dentists or specialists are pulling off some scam).   Dental guards and splints will protect your teeth from the wear and tear described above, which is very important.  Unfortunately, in many cases, depending upon the material used to make them, and the fit, they can actually lead to more clenching.

Finally, so what is the root cause in most cases of clenching (and therefore the root cause of an overwhelming amount of TMJ/TMD cases), and why aren’t dentists and specialists talking more about it?  It’s not a big secret, and it’s a simple answer: STRESS and ANXIETY!  That’s right… those migraine headaches, that itchy spot on your skin (that sometimes looks like a scratch mark)- it’s eczema, caused by stress.  That ringing in your ear called tinnitus, it’s associated with stress.  The back and neck pains- stress!  Stress and anxiety explain why so many people across the world (remember that 20-30% number) suffer from some form of TMJ/TMD.  Sources of stress and anxiety are all around us- our jobs, kids, marriage, exams, school work, finances, illness (your own or other’s close to you), traffic, inconsiderate neighbors, life decisions (like moving and marriage proposals), etc. Sources of stress and anxiety, at times, seem endless.  Sometimes the stressor(s) is short lived (i.e. you pass your exam or finish that big project at work), in which case your TMJ/TMD resolves itself over a short period of time, and in other cases, the stressor(s) persists, you fail to deal with the stress and anxiety it gives off, you never stop clenching, and your TMJ/TMD never goes away.  That is also why you may experience “flare ups” at seemingly random times.  If you track your stress levels, however, they won’t seem so random anymore.  So the “cure” or remedy for these TMJ/TMD cases is pretty clear- identify, deal directly, and manage stress and anxiety.

Back to dentists and specialists….So why do dentists and specialists often stop at just the dental guard, telling you to avoid chewing gum, and instructing you to eat soft foods?  Why don’t they talk about stress and anxiety, and what’s causing you to clench in the first place?  Why don’t they prescribe an inexpensive over-the-counter dental guard for 30 days and tell you to deal with your stress?  Well for starters, that would be irresponsible.  They can’t rely on the quality/fit of the OTC dental guard, and they definitely can’t be sure that you will eliminate enough stress to stop the clenching.  They at least want to make sure your teeth are protected.  Furthermore, there’s a financial incentive.  Let’s be honest, it wouldn’t be very lucrative to prescribe an OTC dental guard and some yoga!  And there’s money associated with splint adjustments and follow-up appointments.  But really, it’s also a practical matter.  Dentists and specialists don’t have time to start arguing with patients about whether or not they have stress in their lives, or analyze where it is coming from.  They don’t have time to listen, nor do they probably want to hear about all the stresses and issues going on in their patients lives i.e. how they or their husband lost their job, how their marriage is suffering, how their business is failing, etc.  That’s not what they signed up for.  So stress and anxiety are rarely mentioned, and thus, the root cause of the clenching are never dealt with by the patient.  Instead, patients continue using their devices.  Sometimes it helps a little, sometimes not at all, and in some cases (in situations where the device makes them clench even more) their TMJ/TMD symptoms get worse.  For those reading this that have dental guards or splints, pay attention to the first reflex you have when you place the guard, or splint, in your mouth.  Generally, the first thing people do is bite down- especially with larger, bulkier ones.  It actually induces you to clench.  So although your teeth are protected, it becomes clear why dental guards and splints never cure, or solve, the TMJ/TMD problem.

How do you treat or hopefully cure TMJ/TMD associated with clenching your teeth as a result of stress and anxiety?  As I briefly mentioned above, it comes down to identifying the root cause of your stress and anxiety, dealing with it directly (to the best of your ability), managing/coping with stress that you can’t avoid (i.e. traffic and weather- think farmers and fishermen), and altering your overall lifestyle.  It is in these four specific areas that I have had success helping those suffering from TMJ/TMD (after I explain many of the topics I’ve written about above, with the intent of demystifying and adding clarity to their TMJ/TMD problem).  Thanks to this article, that same information is now publicly available, and I hope it will help clarify things for even more people.  Details surrounding the four specific areas I mentioned above are beyond the scope of this article, but I want to share the single, most impactful thing one can do to manage their stress, stop clenching, and ultimately cure their TMJ/TMD.  It is unique meditation method.  When most people hear “meditation” they are put off by thoughts of gurus, swamis, uncomfortable sitting positions, mantras, religions, and weird music.  Well what if I told you there was a meditation method that doesn’t require you to cross your legs, doesn’t require an instructor, doesn’t require an app on your phone, doesn’t require weird music, or repetitive mantras, involves no religion or “mindfulness”,and only requires a minimum of 10 minutes a night to be effective?  A while back I developed this unique technique, out of necessity, to solve my own clenching and TMJ/TMD associated pain.  I eventually starting teaching it to my clients and for many of them, it was the first time they ever saw an improvement after trying everything under the sun to get rid of their pain (including acupuncture, aromatherapy, chiropractors, massage therapy, appliances, guards, etc.).  With the idea that I could help thousands of people, and not just my clients with this technique,  I finally decided to make a free, instructional YouTube video that teaches people this simple, but unique meditation method.  You can find a link to that video here: Simple 10 Min Meditation Method Stops Clenching.  Just 10 minutes a night (though more is better) before bed, will relax your mind and body, lead to a deeper/more restful sleep, and it will stop you from clenching at night.  I’ve literally had clients see results after one night!  The additional benefits of meditation are numerous, and nothing short of remarkable. There’s tons of free literature available that tout the specific benefits of meditation, so I will not get into them here, but I assure you the “hype” and articles purporting the positive effects of meditation are real, and I implore you to try it.  I promise The Cargotts Method will help you reduce, if not totally stop your clenching at night, for those of you who associate your clenching with stress/anxiety.   As a result, you will either have less pain, or even no more pain, and the quality of your life will improve as a result. The YouTube video I made is straightforward, but if you would like individualized instruction, or private coaching to access your performance, you can contact my life strategy practice.  There is nothing more rewarding than helping clients across the globe (via Skype, etc.) and hearing them say “it works”!!!