What is Link between Temporomandibular Joint Disorder and Obstructive Sleep Apnea


hi my name is dr. Gary Adams and I’m a
dentist at Maryland Holistic Dentist in Burtonsville Maryland and earlier I was
answering the question about what causes TMJ and what is TMJ
and I basically stated that TMJ is caused by activation of the night time
clenching reflex due to the tongue and other soft tissues falling back into the
airway and basically how that activates the quantanium reflex which is a de
menthe defense mechanism to protect the airway and nighttime breathing so
getting in this a little bit further the next big question would be what causes
the tongue and other soft tissue to fall back into the throat in the airway and
block breathing and that is a more complicated question basically what
happens is in many individuals their mouths and their nasal passageways are
very small and when these spaces are small the mouth and the nasal
passageways and the throat basically comprise the airway and if they are
small then there’s no surprise that it can be easy for these areas to collapse
and the issues with nighttime breathing but specifically in the case of TMJ and
they time breathing I think the real problem is the size of the jaws and the
size of the mouth itself and what you’ll see is people who when they were
children did not grow to be large enough and you’ll see things like tooth
crowding if you look in the mouth you will see how the there’s not enough room
for the teeth to fit they’re certainly not enough room for the tongue to fit in
between the teeth this is a really big issue all you have to do is look in the
mouth and see it appears that the tongue can fit in
between the teeth and if it can’t the tongue is a very powerful muscle and
what will occur is when we get into deep sleep and all our muscles relax the
tongue being the very power of the muscle will fall back into the throat in
the airway and block the airway and stimulate the clenching reflux and this
can occur hundreds or thousands of times a night and it’s no surprise that we
will see all kinds of disturbances for people who have this problem will see
people not sleeping well you know certainly if it’s the second they get
into deep sleep they climbs and wake themselves off to clear their airway at
a tone and this cycles over and over and over again throughout the night people
are not going to stay but they feel like they got a very good night’s sleep
the second issue we’ll see is we’ll see tons of complaints about TMJ pain and
TMJ pain can be anything from like a nagging annoying tension to outright
debilitating pain or someone is out on disability we can hear complaints of jaw
pain tooth pain and sensitivity we see wear and tear on the teeth we see people
that have crack teeth and had root canals and crowns from this constant
plus her pressure placed upon the teeth at night time if the jaw is over
activated its muscles are over activated it will create lots of tension in the
neck and shoulders back it’ll create sometimes migraine headaches general
body tension eye ear symptoms of fullness and ringing I’ve I’ve really
heard it all and seems like every month or two I hear about a new complaint but
we can generally categorize all these complaints and something
get one or two of these symptoms some people get all the above and some people
just don’t sleep too well it just depends on the person but it really is
all the same problem so the TMJ problems are a real issue we can see major
problems with this condition with what Dante positions of teeth and what I mean
by that is teeth that are too crowded if mouths are small there’s not gonna be
enough room for these teeth to fit when people are clenching and grinding the
teeth or you know it can be getting pushed around the mouth and they’re not
maintained in a stable position so we’ll see teeth it move up and about and
around the mouth and they’re not at all in a stable position due to the constant
force is placed upon them we will also see postural problems when the tension
is great in the jaw area it will draw the head forward and we can see people
changing their overall posture and maintaining a forward head position and
these people will have shoulder pain and neck pain back pain sometimes tingling
in the extremities there’s all kinds of issues that we can see so there you have
it this really goes over what causes TMJ and some of the common symptoms that we
see and people who suffer from TMJ the other thing that I’ll state two is that
the symptoms that somebody has when they have TMJ
is really variable from one person to the next si as I said before some people
will just complain about the sleep you know in fact we may have no complaints
at all 80% of people who clench their teeth at nighttime do not know that they
concert to you this is a well documented fact also if you really want to get
technical I don’t even there that TMJ really should even be a diagnosis
because this clearly is a whole-body problem word involves breathing sleeping neuromuscular dysfunction it’s really a
problem that really starts with an upper airway restriction syndrome and a
sleeping disorder and I believe a TMJ really more or less is a symptom of a
sleep disorder caused by an airway and not being maintained well enough for
proper easy nighttime breathing and when you have tongues and other soft tissues
falling back into the airway what else is the body and I do to try to protect
itself and the clinching is really about all I can do to wake you up so there you
have it is there I also often times get asked the question is there a link
between TMJ and sleep apnea sleep apnea obstructive sleep apnea at least is a
sleeping disorder caused by an airway not staying open there most definitely
is it went between sleep apnea and TMJ in fact 75% of people who have Chifa who
have sleep apnea report TMJ symptoms so there you have it my name is dr. Gary
Adams and again with dentist at natural dentist associates in Rockville Maryland
I’ll be happy to see you any time we maintain a TMJ sleep dentistry clinic in
Rockville North Bethesda Maryland whatever you want to call it we have a
special program where we have a physical therapist we assess sleep we do sleep
tests and they’re read by sleep doctor and we have treatments that will
essentially open the mouth and air creating more room for the tongue and to
balance the budget so feel free to give us a call anytime our office phone
number if you’d like a schedule Constitution is three zero one seven
seven zero two two seven zero thanks and have a good day

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