Does DCS Cause TMD?
For the past two decades, the dental profession has been in a quandary regarding disorders of the TMJ. The National Institutes of Health has had several major conferences on TMD, and just cannot seem to formulate a consensus or even an opinion on its causes or treatment. During these national conferences, the media reports that patients wearing T-shirts with the message, "I Am A TMJ Disaster" are picketing outside.
Why is the dental profession at such an impasse in understanding this problem?
My opinion is that what we have an epidemic on our hands of repetitive motion trauma of the TMJ (not unlike carpal tunnels syndrome) due to DCS.
The reason this is not obvious to a majority of the profession is because the physical signs of DCS are not recognized.
An article on temporomandibular disorders appeared in the Wall Street Journal on August 31, 1993 entitled, "Medical Mess, Implants in Jaw Joint Fails, Leaving Patients in Pain and Disfigured."
The story was about the recall of 25,000 TMJ implants. These implants were small teflon-coated disks that were placed in the TMJs of people having TMD.
The article recounted dozens of horror stories. An oral surgeon, Dr. Stephen Hawkins in Tucson, Arizona, treated one hundred of these patients, twenty of whom he said were suicidal. "They are barely functional, under heavy pain medication and antidepressants. They have had significant damage to the bones and muscles of the face and nerve damage." Another surgeon, Dr. Douglas Morgan in La Crescenta, California, reported that an implant had migrated into the patients brain.
The article reported that the surgeons blamed the product, and the manufacturers of the implant blamed the surgeons.
The patients are the helpless victims in the debate.
So what is going on?
The article gives an important clue:
"The teflon coated implant which was used to replace an oval disk of cartilage that acts as a shock absorber between the temporal and mandibular bones can be irreparably damaged by too much grinding or clenching of the teeth."
What if this was the problem that caused the disc to break down in the first place?
It is an engineering fact, and common sense, that if one compresses one's teeth there is corresponding pressure on the TMJ.
The pressure is easily discernible when you touch the sides of your face just in front of the ear and squeeze your teeth together.
In my practice not one of my patients has active TMJ problems because I do not treat TMJ. I treat DCS to take the pressure off the TMJ!