TMJ / TMD Case Study

TMJ / TMD Case Study

A Interesting perspective on health from 35 years of Dental Practice

Have you ever wondered why more and more children have crowded teeth and need braces? Why do so many people have their wisdom teeth extracted? Why do so many children have problems concentrating and sleeping well at night and develop attention deficit hyperactivity disorder (ADHD)? Why do people lose their teeth and require implants? Why do so many people suffer from headaches, jaw, neck and back pain? Lately it seems like many older Americans are developing sleep apnea and need a pump called a CPAP to keep them breathing at night. Older Americans are taking medicines to treat problems such as erectile dysfunction, acid reflux, high blood pressure, allergies, and insomnia. Even the Six O’Clock News is full of T.V. commercials for prescription medications. Frankly, we have an epidemic in this country that has gone unrecognized. Medical costs have risen dramatically and steadily over the last 30 years based on the U.S. Bureau of Labor Statistics Consumer Price Index (CPI).

So what is this epidemic? A major portion of this epidemic is abnormal development of the faces! Our faces are not growing properly. Crowded teeth and the lack of room for wisdom teeth are very strong indications of this problem. A few years ago I spoke about Orthodontics and TMJ disorders at an international meeting for facial growth and development. The panel of speakers also included an anthropologist and he compared the faces of modern man with faces from our ancestors. Interestingly, our ancestors had room for all 32 teeth and very little crowding. He also showed that even today cultures that maintained a natural diet have healthier and more attractive faces.

What are we doing about this? Unfortunately not enough! First, we must breast feed our babies for at least 1 year. Second, we must eat healthy food and avoid junk food. Third, health care professionals simply do not diagnose early enough. Braces at age 10 and up and extraction of crowded permanent teeth simply do not address the problem early enough. Braces and extractions can actually mask or worsen facial growth and lead to chronic health problems. Dentists, physicians and parents must recognize abnormal facial growth on 3-5 year old children. Waiting until you see crowded teeth at age 10-12 is too late! Every day I see very young children and adults with abnormal facial growth and some even have straight teeth and a nice bite.

This 13 year old patient had dental crowding. His orthodontist recommended extraction of his permanent lower bicuspids to relieve crowding. The mother was concerned and took her son to another orthodontist. He concurred with the first orthodontist and recommended extraction of his upper permanent bicuspids as well. His crowding worsened and his face appeared dished in. His mother brought him to my office. I expanded the arches, retrained his muscles to allow his face to expand and reopened the space for where the permanent teeth were extracted. Implants and crowns were utilized to replace the extracted permanent teeth. The result was much more esthetically pleasing and healthier as he now has sufficient room for his tongue.

Treatment must involve changing both the form and function. Braces alone change the form. Relapse results when only one is corrected. In defense of the orthodontist, this 13 year old patient was beyond early age correction. This problem should have been recognized and addressed by age 5. Interestingly, his teeth looked fine at age 5. Which is why the mother never knew a problem was forthcoming. 35 years of keen observation and training have taught me how to identify abnormal facial growth at age 3-5. Anais Nin once said, “We don’t see things as they are, we see things as we are!"

The longer abnormal facial growth progresses the more difficult it is to treat, the less successful the result, the more likely the relapse, the more likely other health problems will develop and persist through life and the more expensive the cost to treat. Consequently the epidemic continues and medical costs continue to rise.

Patients suffer from headaches, neck pain, sore jaw muscles, clicking and painful jaw joints, postural problems and poor sleep and insomnia. Clinical depression, anxiety, high blood pressure, obstructive sleep apnea, heart problems and brain damage can all follow abnormal facial growth and development.

Thomas M. Walsh II, D.D.S.