Craniomandibular dysfunction (CMD) - the jaw joint and its pitfalls

CMD and TMJ - What are they?

Craniomandibular dysfunction, or CMD for short, describes one of the most common functional disorders of our time and refers to a functional disorder of the jaw joint. This is often referred to as Temporomandibular Joint Disease, or TMJ. This can affect the opening or closing of the jaw. A cracking sound in the jaw joint may be the first indication of an incorrect load or misalignment in the joint. Muscular tension caused by grinding or simply “biting” or “clenching” the teeth at night can also be a reason for muscular overexertion and, in the long term, lead to overload in the temporomandibular joint.

What symptoms do a disorder of the jaw joint cause?

The symptoms of CMD/TMJ can be very varied. Those affected often report ear pain. In most cases, however, previous ENT examinations did not reveal any abnormal findings in the ear.

But it is not only earaches that can occur. Rather, headaches, tinnitus, hearing loss, dizziness, neck and back pain, even knee pain can be a sign of a functional disorder in the jaw joint.

Those affected often seek advice from dentists, orthopedists, ENT specialists, neurologists, etc. to clarify the cause of their disorders. However, in most cases, no organic causes can be found by the aforementioned specialists. Often, a psychosomatic complaint is diagnosed without considering functional disorders.
Diagnosis of CMD/TMJ

First of all, it is important to evaluate the existing symptoms using conventional medicine. Depending on the symptoms, a wide range of disciplines are involved. These most often include ear, nose, and throat specialists, dentists and orthodontists as well as neurologists and orthopedists. If the causes of an organic disease have been ruled out here based on the range of symptoms, functional complaints also need to be considered.

Depending on the level of knowledge of the individual disciplines, initial functional evaluations are already carried out during the organic examination. In order to gain a deeper insight into the symptoms, additional training in manual medicine and osteopathy is required. These enable the assessment of the function of individual joints, muscles and even the connective tissue such as the so-called fascia. Movement patterns, restrictions in the extent of joint movement, or even pathological muscle tension are revealed by this and can often establish connections between individual symptoms.

Manual medical examinations also include checking so-called bite splints. If a splint is inserted in a jaw that was already “crooked” before the dentist took the impression, it can solidify the issues or, in the worst case, even intensify them.

Therefore, the fit of the splint should always be checked by a manual physician / osteopath after it has been made, and checked by the dentist. If necessary, further adjustments to the splint may be necessary until a static balance is achieved throughout the body.

The causes of sudden hearing loss seem to be multifactorial. Patients often report an occurrence in particularly stressful situations coupled with neck or back pain. But is it the stress? Is it the tension? Or can other causes be found?

One of the most common causes of a one-sided hearing loss is a so-called earwax plug. This can occur spontaneously or, far more often, through the use of ear sticks, and, depending on its severity, can cause hearing loss-like symptoms.

However, if this is not the case, it is important to rule out other causes of unilateral hearing loss. Other causes of sudden hearing loss can be divided into organic, functional and psychological components.

Why can back or knee pain come from the jaw joint?

You are probably thinking: “That’s not possible! Chronic back pain or knee pain originating from the jaw joint – there’s no connection there! They are too far apart for there to be a connection!”

Unfortunately, this is not true. In order to understand the origin of disorders in our body, the following aspects should be considered. Our axial skeleton is an interconnected system of bones and joints. All tissues connected to the axial skeleton (tendons, muscles, fascia, etc.) can influence it or are influenced by it.

Disturbances in the posture of our body can influence the position and mobility of organs in the body cavities and thus affect their function.

Due to these conditions, a disturbance, e.g. a malposition in a joint, inevitably leads to changes in the entire system.

Why can back or knee pain come from the jaw joint?

You are probably thinking: “That’s not possible! Chronic back pain or knee pain originating from the jaw joint – there’s no connection there! They are too far apart for there to be a connection!”

Unfortunately, this is not true. In order to understand the origin of disorders in our body, the following aspects should be considered. Our axial skeleton is an interconnected system of bones and joints. All tissues connected to the axial skeleton (tendons, muscles, fascia, etc.) can influence it or are influenced by it.

Disturbances in the posture of our body can influence the position and mobility of organs in the body cavities and thus affect their function.

Due to these conditions, a disturbance, e.g. a malposition in a joint, inevitably leads to changes in the entire system.

CMD/TMJ - The experiment

I find the following example very nice to illustrate these facts. By the way, you can also try this experiment at home.

Take a towel that is as large as possible – preferably a beach or sauna towel, one that is about as big as you are. With the help of another person, stretch the towel out lengthwise by holding the corners. Note the tension on each side, the feeling of support, the stability and balance of the towel in this state. Now lay this flat on the floor, bed or a couch. Now tie a knot in one of the corners of the towel, so that there is still a small tip of the corner sticking out. Now stretch the towel again by grabbing the corners of the towel again. Take notice of it again. Something has changed – right? Ask the person at the other end of the towel once if anything is different than before. You will notice that even the person at the other end notices a slight change in the balance of tension. You will also be able to see the wrinkles in the towel, which are not limited to the knot in place. Rather, they extend far into the towel.

The towel is, in fact, you. A change at the farthest corner of our body can lead to a change at the other end. In this process, the changes become less overall as the distance increases, but several changes such as muscle tension with joint changes and overuse as well as stress are all “nodes” in our body and affect it. The more disturbances occur, the greater the symptomatology. Thus, symptoms often can only be noticed years after a disorder has occurred because the initial changes were too small. If, however, the initial cause of a complaint is overlooked, this can possibly lead to a lack of improvement despite numerous but merely symptom-oriented therapy approaches.

Since all muscles of the body are connected via joints and tendons, a tension in the jaw joint, for example, can cause a blockage of the cervical vertebrae via a tension in the neck muscles. This in turn can act as a so-called descending chain along the spine into the pelvis and ultimately cause knee and ankle joint strain. The development of such pain rarely occurs spontaneously, but is usually associated with a prolonged overload. However, if the cause of the initial discomfort is found, even if it is far away from the actual point of pain, it may be possible to bring about lasting relief.

Finding these points of origin is the basis of manual medicine / osteopathy and also of applied kinesiology.

What therapy options are available?

The therapy options depend on the symptoms and their causes and can be treated by a variety of approaches. In addition to the classic ENT & dental as well as orthodontic and orthopedic approaches to organic disorders, complementary therapy options include:
Which form of therapy is right for you will be decided in a consultation with the physician treating you. It is important to exclude contraindications for one or the other method and to find the right approach for you individually. In most cases, it is not just one method that has to be the right one. Rather, it can be the combination of the individual therapy methods that makes the difference.

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After the COVID-19 test has been performed, please send it to us by e-mail / the test result by telephone before your visit to the practice.

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Nach durchgeführtem COVID-19-Test lassen Sie uns diesen per e-mail / das Testergebnis per telefonischer Auskunft vor Ihrem Praxisbesuch zukommen.

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oder hatten Sie in den letzten 14 Tagen vor Ihrem geplanten Termin Kontakt zu einer erkrankten Person mit o.g. Beschwerden, verzichten Sie bitte auf eine direkte Vorstellung in unserer Praxis und auf eine Online-Termin-Buchung.

Zur Planung des weiteren Vorgehens in o.g. Fällen stehen wir Ihnen gerne telefonisch oder per Videosprechstunde zur Verfügung.

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INFORMATION

Due to the new regulation of the federal government, it is necessary that you perform a COVID-19 rapid test on the day of your appointment before presentation in my practice. This also includes all accompanying persons (including children). The number of accompanying persons in the practice must be kept to a minimum.

After the COVID-19 test has been performed, please send it to us by e-mail before your visit to the practice.

In case of a positive test result (also within the family / circle of accompanying persons), please refrain from a presentation in our ENT practice and contact us to discuss the best possible procedure for you.

In these cases, however, I am still available to you via video consultation.

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Pain in the fingers, carpus and wrists can have a wide variety of causes. Acute injuries due to compression, contusion or fracture can cause these symptoms. However, chronic inflammatory diseases of the rheumatic type or bacterial infections (including Lyme disease) are other possible causes. If, however, no cause is found in orthodox medicine, hidden inflammatory foci, so-called interference fields, are often possible causes, which can be detected by Applied Kinesiology and treated by means of acupuncture or neural therapy. For supportive pain therapy, the latter therapies are also a possible option.

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This is one of the new popular diseases. Everyone knows the grinding or biting with the teeth, the morning tension in the jaw area in stressful everyday situations. Learn more about the effects of overloading the jaw joint in my blog.

The unconscious release of stress usually takes place at night. Unnoticed it comes to grinding movements of the teeth or to increased biting during sleep. This can lead to an overload of the teeth, the jaw bone and also the temporomandibular joint and sometimes cause symptoms in distant organs or joints, which seem to have no connection with the initial place of origin of the complaints. Learn more about symptoms and treatment options here.

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Headache – one of the most widespread diseases of our society requires detailed clarification to find the cause. These can be of organic origin (e.g. trauma, hemorrhage, stroke, high blood pressure, chronic sinusitis, tumors, etc.) or of a functional or psychological nature (tension, overload, dehydration, etc.).

Therefore, a good interaction of neurology, ear, nose and throat medicine, dentistry, orthopedics and, if necessary, radiology, internal medicine / cardiology or vascular surgery is important for accurate diagnosis. 

Because not all headaches originate from the head. Temporomandibular joint disorders (CMD), cervical vertebrae blockages or even incorrect shoe inserts can lead to complaints in the head area over a longer period of time. So-called interference fields such as undiscovered dental foci or scars along meridians can also be the cause of these complaints. 

The therapy options depend on the corresponding cause. If an organic cause has been ruled out, however, osteopathy / manual medicine and also acupuncture as well as neural therapy can provide support in the therapy. 

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MEHR ERFAHREN:

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Acute hearing loss can have various causes: 1) earwax plug 2) ear canal inflammation 3) sudden hearing loss 4) popping or noise trauma 5) traumatic eardrum injuries and much more.

can not only originate from the ear, e.g. through an inflammation of the ear canal or the middle ear or an injury to the ear canal or the eardrum. They can also occur with TMD symptoms.

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Es ist stressig, der Nacken verspannt und plötzlich tritt es auf. Ein dumpfes Wattegefühl auf dem Ohr und ein Pfeifen. Häufig gibt sich das Bild innerhalb von Sekunden oder Minuten wieder und ist genauso schnell verschwunden, wie es gekommen ist. Doch bleiben die Symptome bestehen, kann es sich um einen sogenannten Hörsturz handeln.  Mehr lesen

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