Oral Surgery/tmj

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Question
I copied the following in case you didn't remember me. We got in early to see the oral surgeon. He said it was muscular. I'm wondering if I should get another opinion. What do you think. He gave her Naprosyn and a muscle relaxant.

QUESTION: does tmj cause dizziness and back pain? I've heard that it can. My daughter has TMJ. She has the dizziness and back pain as well as headaches, neck and cheek pain.

She has tried acupuncture, physical therapy, chiropractic, and wears a bite brace every night.

She's had TMJ for a while but I don't know if the TMJ is responsible for the dizziness, headaches, back and neck pain or not.

ANSWER: Joyce -  TMJ problems can manifest and cause symptoms in other areas due to a couple of different situations.  Inflammation and spasm of one muscle can produce similar situations in other muscles by a system of cascading.  What I mean is that where the muscle in spasm attaches to the bone, there are other muscles and ligaments nearby. These nearby muscles and ligaments can be forced into spasm at the attachment site of the original muscle in spasm.  This process can progress and spread to other areas.  This might be what your daughter is experiencing.  At the TMJ site, the muscles that attach there spread also attach to the neck, chest and shoulder and produce spasms of these other areas.  

Is this what is happening with your daughter?  I don't know, but you should seek an evaluation by a board certified oral and maxillofacial surgeon to evaluation your daughter's situation and determine if the TMJ might be the initiating site or is something else occurring.

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QUESTION: She has an appointment to go next week to see if that's what the problem is. In the meantime I was covering my bases to be sure I knew what I was talking about.

She also has a CPAP machine for sleep apnea.

Back in January, the hosp did a CT of her head and told us the muscles were all bunched up in her head. Is that part of TMJ as well?

ANSWER: Joyce -  the bunching of the muscles in her head could be related to a TMJ problem.  I wish her well and hope the true cause can be determined and corrected.

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QUESTION: We had a chance to see the oral surgeon earlier. He said its all muscular. I'm wondering if we should seek a second opinion. What do you think?

Answer
Joyce - I, of course, cannot be sure, but from the symptoms you describe it can definitely be muscular in origin.   Seeking a second opinion is not a bad idea, but make sure that any oral and maxillofacial surgeon you see is board certified.

A board certified oral and maxillofacial surgeon has undergone a 4 year surgical residency, but as opposed to the non-board certified surgeons, this doctor underwent a test 2-3 years after his residency and has repeated this test every 5 years.  This repeated testing forces the surgeon to remain up on all aspects of surgery and can only take such tests if his practice has included treatment on all types or surgical problems.

So why to use this doctor is the repeated evaluation to insure that this doctor maintains knowledge and skills.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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