The best treatment is the conservative approach, says one of the leading specialist on TMJ in Bulgaria and the world
At least one in ten people experience temporomandibular joint (TMJ) disorders during their lifetime. Symptoms usually begin with cracking and clicking of the jaw. This is a serious discomfort in patients' daily lives and should not be ignored. However, treatment is available. The best approach is the conservative treatment, says one of the leading specialists in functional orthodontics and occlusal dentistry in Bulgaria, Dr Manol Ivchev.
Dr Ivchev graduated from the Medical University in Sofia, has 18 years of clinical experience and numerous specializations in Austria, the US, South Korea, Brazil, and Luxembourg. He is also a renowned lecturer and educator in Bulgaria and abroad. Dr Ivchev and his team treat complex orthodontic cases and TMJ disorders at COLDY DENT Functional Atelier dental clinic with state-of-the-art technology.
Dr Ivchev, what are TMJ disorders?
Very little is known about these disorders. They are characterized by cracking, clicking of the jaw, and pain in the muscles in this area. However, very often these fade with time. The patient might think that the problem has disappeared, but this is an illusion – the cracking actually decreases because the disc of the joint gets thinner and alleviates the tension when the bone goes over it. And then, seemingly out of the blue, the jaw can literally lock itself, preventing the patient from opening or closing their mouth. Or there may be serious pain.
Many people, and sometimes specialists, assume that there is nothing to be done about these conditions.
What causes TMJ disorders?
Caucasians are predisposed to TMJ problems. A contributing factor are the fast, overnight dental treatments, known as "fast-food dentistry." They lack proper planning which can unlock serious problems during treatment.
Separately, dentists often avoid treating the temporomandibular joint, because these problems are quite complex and require hard-to-obtain knowledge and skills.
Does nutrition affect these conditions?
Human teeth and jaws have evolved for eating more stringy, fibre-rich and less processed food. Today, we eat a lot of processed foods that are easy to chew, but can lead to dysfunctional muscles. This is why we have to eat hard, stringy foods several times a week, to train the masticatory muscles.
How are TMJ disorders treated?
Usually, surgeons claim the situation is incurable, or send the patient to physiotherapy, or recommend surgery. My approach is different. I treat the joints conservatively, with jaw splints that centre the lower jaw and position correctly the articular head and disc.
The splints are individually made. I prefer hard splints. They are worn permanently and allow the patient to eat and live their normal life. The treatment's period depends on the severity of the condition – from a few months to a couple of years.
Is full recovery from TMJ disorders possible?
To a great extent – yes. It depends at what stage the disease is caught and whether the patient is serious and wears their splints.
How does temporomandibular joint disease affect patients' daily lives?
Very seriously. Initially the popping and clicking symptoms do not cause such discomfort, although sometimes patients are embarrassed to eat in public. However, when disease progresses, the jaw may lock and serious pain might ensue, preventing patients from sleeping and living normally and causing serious psychological strain. If this problem is not addressed properly, patients can become psychosomatic. The problem can affect children and adults alike. Therefore, patients should know that there is effective treatment, but that the specialists who can apply it are a very small minority.
Do TMJ disorders get worse without treatment?
Yes, in some cases more slowly, in others – much faster.
What causes these problems?
The causes are multifaceted – a misalignment in the body, some trauma to another part of the body that has led to a twist, improper sleeping, a neglected trauma, or a sports injury.
How can we relieve the symptoms at home?
If the patient suffers muscle pains they can use stretching exercises or massage. If the problem comes from a disorder inside the joint, this will not help.
How to choose a good specialist?
The specialist must first confirm that they deal exclusively with this type of patient and to share where they have studied as there are no such schools in Bulgaria. For example, I have trained in Austria, Vienna, Brazil, and the US. They should also show solved cases beyond stating that "the patient was in pain and now he is not in pain". And third – the patient should be able to trust the doctor.
It's very important that patients understand that TMJ problems should not be ignored. In time, they can get worse, and there is a solution. Fast dental treatments can unlock these types of problems, so they have to visit only dentists they trust. A comprehensive approach is also crucial. It can require orthodontics and if whoever planned the case does not understand this field in dentistry, the patient may remain on braces for life.
Sofia, 2 Balgarska Legiya St, phone: +359 896 593 939
office@coldydent.com
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