Open UP: A TMJ Discussion

Finding the right TMJ Dentist (Ep 24)

In this episode, Dr. Mac Lee and Dr. Pam Marzban discuss one of the most challenging aspects of TMD treatment: determining whether symptoms are truly related to TMD or caused by something else. They explore the importance of differential diagnosis and share practical strategies for identifying when symptoms like headaches, vertigo, and tinnitus are linked to jaw dysfunction versus other medical conditions.
Dr. Lee shares insights from his book, "Life-Robbing Pain: TMD," emphasizing the value of simple, common-sense approaches to understanding TMD symptoms. He also discusses his upcoming book, designed to empower patients by guiding them through self-assessment techniques and helping them identify whether TMD might be the root cause of their pain.
They also touch on the importance of patient education, building trust, and finding the right neuromuscular dentist who truly understands TMD treatment. Plus, learn about Dr. Lee’s efforts to bridge the gap between different dental philosophies to create a more unified approach to TMD care.
Book and Podcast Info:📚 Books by Dr. Mac Lee and Dr. Pam Marzban:
Life-Robbing Pain: TMDCraniofacial Development by Dr. Pamela Marzban🎧 Podcast: https://carekp.podbean.com/
#TMD #TMJ #NeuromuscularDentistry #HeadacheRelief #Vertigo #Tinnitus #JawPain #OralHealth #PainManagement #PatientEducation #FindTheRightDentist #DifferentialDiagnosis #Podcast #HealthTips #ChronicPain #DentalHealth #DrMacLee #DrPamMarzban

Vertigo & Tinnitus (Ep 23)

In this episode, we dive deep into the connection between TMD, vertigo, and tinnitus. Dr. Mac Lee and Dr. Pamela Marzban discuss the challenges of diagnosing and treating vertigo when TMD might be the underlying cause. Learn how the complex relationship between jaw position, inner ear structures, and nerve involvement can lead to symptoms like dizziness and ringing in the ears.
Dr. Marzban shares real-life cases, including a remarkable success story of a patient whose debilitating vertigo was resolved through neuromuscular orthotic treatment. They discuss why some TMD treatments fail and why finding a skilled neuromuscular dentist is essential for lasting relief. Plus, learn a quick at-home test to see if your jaw position might be impacting your symptoms.
Whether you're a dentist looking to expand your understanding or a patient seeking solutions, this episode offers invaluable insights into how TMD and inner ear issues intertwine.
Mentioned Resources:
Book: Life-Robbing Pain: TMD by Dr. Mac Lee
Book: Craniofacial Development by Dr. Pamela Marzban
Podcast Website: carekp.podbean.com
Hashtags:#TMD #TMJ #Vertigo #Tinnitus #NeuromuscularDentistry #PainRelief #JawPain #ChronicPain #PatientEducation #DrMacLee #DrPamelaMarzban #DentalPodcast #OralHealth

Bed Wetting and Night Terrors (Ep 22)

Mouth breathing and sleep issues in children can contribute to bedwetting (nocturnal enuresis) and night terrors due to poor oxygenation, nervous system imbalance, and disrupted sleep cycles. Listen to Pam and Mac on how it all connects:
1. Mouth Breathing and Poor Oxygenation
When a child breathes through their mouth instead of their nose, the airway tends to collapse more easily. This can lead to obstructive sleep apnea (OSA) or hypoxia (low oxygen levels) during sleep. When the brain senses oxygen deprivation, it triggers a “fight-or-flight” stress response, activating the sympathetic nervous system. This stress response can:
Increase urine production (causing bedwetting)Interrupt deep sleep, making night terrors more likely2. Nervous System Imbalance and Bedwetting
Bedwetting occurs when the body doesn’t properly control the bladder during sleep. This happens when there’s a dysregulation of the autonomic nervous system due to repeated oxygen drops and sleep disturbances. The brainstem controls both breathing and bladder function, so if breathing is impaired, bladder control can also suffer.
Additionally, when the body is in chronic stress mode from poor sleep, it releases more cortisol and adrenaline, which can interfere with the hormone (vasopressin) that tells the kidneys to slow urine production at night.
3. Night Terrors and Disrupted Sleep Stages
Night terrors occur during deep non-REM sleep, often when a child is overtired or experiencing disrupted sleep. If a child struggles to breathe properly due to mouth breathing or airway blockages, their body may frequently pull them out of deep sleep to restore normal breathing. This incomplete arousal can trigger night terrors.
4. The Role of Nasal Breathing and Nitric Oxide
Breathing through the nose is essential for healthy sleep because it:
Filters, warms, and humidifies the airProduces nitric oxide (NO), a gas that helps open airways, improve oxygen exchange, and regulate blood pressureNitric oxide plays a key role in brain function, blood circulation, and nervous system balance. Without it, children are more prone to:
Poor oxygen delivery to the brainIncreased airway resistanceHigher stress levels in the body5. How to Address the Issue
To reduce the risk of bedwetting and night terrors caused by mouth breathing:
Encourage nasal breathing by addressing allergies, enlarged tonsils, or chronic congestionCheck for sleep-disordered breathing like snoring or apneaUse myofunctional therapy or orthodontic treatment if needed to correct mouth posturePromote good sleep hygiene with a regular bedtime and reduced screen time before bedBy ensuring proper nasal breathing and healthy sleep, children can experience better oxygenation, balanced nervous system function, and improved sleep quality, reducing both bedwetting and night terrors
#bedwetting, #nightterrows, #mouthbreathing, #nitricoxide

Dr. Howard Farran Unfiltered: The Untaught Challenges of TMD Treatment in Dentistry (Ep 21)

In this episode, we sit down with Dr. Howard Farran, founder of Dentaltown, to discuss the pressing issues in dental care for patients with temporomandibular disorders (TMD). Dr. Farran passionately explains how TMD treatment is often overlooked in dental education, leading to inconsistencies among dentists regarding effective care strategies. He delves into the pitfalls of insurance-driven dental practices, highlighting the shortcomings of the current dental insurance system. Moreover, Dr. Farran emphasizes the critical need for improved collaboration between doctors and dentists to enhance patient outcomes.
We also explore how artificial intelligence is revolutionizing patient care and dentist-patient connections. AI-powered tools can help pain patients locate qualified dentists near them by analyzing their symptoms and using their location to provide tailored recommendations. Additionally, AI is reshaping how search engines rank and present businesses, offering critical insights that benefit both dentists and patients. Understanding these advancements is essential for dentists aiming to attract patients and for individuals seeking specialized care.
Hashtags:#TMDTreatment #DentalEducation #HowardFarran #DentalInsurance #HealthcareCollaboration #PatientCare #AIinDentistry #TechForHealthcare

Why Are Our Jaws Shrinking? (Ep 20)

Navigating Missing Teeth and TMJ (Ep 19)

If missing teeth don’t seem to cause trouble with eating, why spend the time, money, and emotional energy to replace them? In this episode, we explain how missing teeth can contribute to TMJ/TMD pain and why replacing them is crucial for your overall oral health.
We’ll discuss different tooth replacement options, from implants to partial dentures, and break down the hidden risks of leaving gaps in your smile. Think of your teeth like books in a bookcase—remove a few, and everything starts to shift and lean. Unstable teeth can cause bigger problems over time.
We’ll also talk about the surprising value of a healthy mouth (hint: it’s well over $100,000).
This honest, no-nonsense conversation will help you see the true importance of your teeth. Stick around until the end to understand how much your smile is really worth.
#missingteeth #TMD #TMJ #implants #partialdentures

The Nose, Airway and TMJ Connection with Special Guest: Dr. Manan Shah (Ep 18)

Mouth breathing, often caused by allergies and nasal congestion, can significantly impact a growing child’s health, sleep, facial development, and overall well-being. Dr. Manan Shah, ENT, joins us to explain why environmental allergies are the leading cause of nasal blockages and why addressing them is essential.
Key Highlights:
80 million Americans suffer from allergies.
Nasal sprays aren’t the solution.
Allergies affect sleep, quality of life, and overall health.
Only 4,000 allergists are available to help millions of sufferers.
Dr. Shah discusses how to retrain the immune system with a no-shot form of immunotherapy, providing relief from allergies like ragweed, cedar, cat dander, and more. As the founder of Wyndly, Dr. Shah has developed a convenient at-home solution for allergy testing, diagnosis, and treatment.
Don’t miss this episode to learn how to breathe easier and live allergy-free!
#MouthBreathing #ENT #AirwayHealth #Allergies #Immunotherapy #TMJ #TMD

The Bicuspid Controversy in Orthodontics (Ep 17)

Bicuspid extractions for orthodontics remain a hot topic worldwide. Pam and Mac tackle this issue head-on and share the good and the bad.
Mac brings fifty years of experience working with various orthodontists—some great, some less so. Pam, who performs much of her own orthodontic work, responded emphatically to Mac’s initial question on bicuspid extractions with, “Do not do it!”
Removing bicuspids creates a large gap on both sides of the mouth, which can simplify tooth movement during orthodontic treatment. However, this can also lead to long-term issues, such as TMD (temporomandibular disorder) pain and airway complications like obstructive sleep apnea. While there’s debate over whether this technique directly causes such problems—since not every patient with extractions develops these issues—many clinicians treating adult TMD patients report a significant number have undergone bicuspid extractions.
"Four-bicuspid" extraction cases may initially appear successful but can restrict and compromise jaw closure and contribute to a deficient maxilla, as discussed in our Trifecta Podcasts. Although some orthodontic studies deny this correlation, practitioners dealing with TMD pain often see a different reality.
Bicuspid extractions can also alter facial structure, often resulting in a flattened profile. James Nestor, author of the bestseller Breath, has publicly shared his own experience with bicuspid extractions and recovery on the Joe Rogan Podcast, further highlighting its relevance in the dental industry.
Pam also discusses the optimal age for children to be screened for orthodontic intervention and shares her differing views on craniofacial development compared to many orthodontists. Compressed airways in children can lead to chronic oxygen deprivation, causing them to "live in a fog."
In this episode, Pam and Mac challenge certain established dental practices, offering a unique perspective. Once patients complete orthodontic treatment, orthodontists typically don’t see them again—general dentists do. Unfortunately, many dentists are not equipped to treat TMD, leading to referrals to specialists like Pam and Mac. Having seen retraction orthodontics cause TMD countless times, they emphasize its impact.
If you’ve undergone orthodontics or have children in need of it, this podcast is essential listening. It’s a controversial discussion, as intended.
Hashtags: #Orthodontics #BicuspidExtraction #TMD #AirwayHealth #DentalPodcast #CraniofacialDevelopment #OrthoControversy #DentalHealth #ParentingTips #OrthodonticScreening

Finding the Right TMJ Dentist (Ep 16)

Finding a dentist who really understands TMD can feel like a puzzle. In Podcast 16: Finding the Right TMJ Dentist, Pam and Mac dig into the reasons behind this challenge—and provide practical tips for finding the best dentist for your jaw pain.
They explore why TMD diagnosis and treatment can seem so confusing and inconsistent. One dentist may offer one approach, while another suggests something entirely different. This disconnect often comes down to post-dental school training, where each dentist may follow a different philosophy, from neuromuscular to functional or cosmetic approaches. Since TMD education is almost nonexistent in dental school, only a few dedicated dentists pursue specialized training after graduation.
For patients, this podcast emphasizes the importance of interviewing potential dentists to learn about their post-graduate education in TMD. Pam and Mac explain the core "camps" in advanced dental training—like the Pankey Institute, Dawson Academy, and LVI—and share why they chose to focus on Neuromuscular Dentistry. Neuromuscular dentists are unique in that they focus on aligning the jaw position, which can often be the key to TMD relief.
Pam and Mac also stress that successful TMD dentists have super-trained teams who are just as dedicated to understanding and listening to patients' needs. From the first call to the website quality, a knowledgeable team and a state-of-the-art clinic environment make all the difference. If your first visit doesn’t feel right, that’s a sign to keep looking.
In short, this podcast gives TMD patients valuable insights to find the right dentist who will listen, diagnose confidently, and commit to a personalized treatment plan.
#TMJRelief #FindYourDentist #TMDJourney #NeuromuscularDentistry #PainFreeLiving #TMD #ICCMO #DentalEducation

Fascia: The New Frontier in Pain Management with Special Guest: Dana Sterling (Ep 15)

Guest: Dana Sterling, Founder of Sterling Structural Therapy (SST) Introduction:o Dana Sterling, an expert on fascia, joins the Open Up podcast as the first-everguest.o Fascia is emerging as a new frontier in pain management, revolutionizingtreatment approaches.o Dana recently spoke at the ICCMO conference in Denver, where both Pam andMac felt her insights were essential to share with the world. About Dana Sterling & Sterling Structural Therapy (SST):o Dana pioneered Sterling Structural Therapy (SST), a groundbreaking non-invasive method for treating chronic pain and orthopedic conditions.o SST is the only fascia-based therapy delivering effective results virtually,eliminating the need for hands-on treatment.o With SST, Dana is able to help people worldwide through virtual consultations.o Dana offers a free 45-minute assessment and consultation for those interestedin SST.
 Key Discussion Points:o Transition from Hands-on to Virtual Fascia Therapy: Dana explains how she adapted hands-on fascia treatment into a virtualmodel, making her therapy accessible globally.
o Understanding Fascia and its Role: Fascia is referred to as the "organ of form"—a connective tissue systemthat holds our muscles, organs, and bones in place. Removing fascia would leave the body as a "formless goo,"demonstrating its structural importance.
o Anatomy Trains: The concept of "Anatomy Trains" is introduced, highlighting theconnections from the feet to the teeth.
o TMD and the Jaw: The jaw is a floating structure, and conditions like TMD can wreakhavoc on it, affecting the entire body’s fascia.
o Muscle Pain vs. Fascia Pain:
 Dana differentiates between muscle pain and fascia pain and explainshow chronic pain differs from acute pain.
o Noninvasive First: Dana emphasizes starting with noninvasive techniques for painmanagement. Additional Insights:o "My boss is your body": Dana stresses that the body directs the therapy, not the therapist.o Muscle Memory & Myofascial Connection: The discussion touches on how muscle memory and myofascialconnections work together, with fascia being the hardware and the brainthe software.o Exercise and Fascia: The importance of regular exercise for maintaining muscle, fascia, andbone health is highlighted.o Phonetics & Jaw Alignment: Phonetic exercises can help in finding the correct upper and lower jawrelationships, aiding in pain relief.
o Tongue Exercises: Tongue exercises are explored as a method to relieve fascia tension inthe body.
o Efficiency of the Human Body: Dana explains how the human body is designed for efficiency, and howfascia plays a role in that.o Forward Head Posture: The impact of forward head posture on fascia and the body as we ageis discussed.
Link: https://docs.google.com/presentation/d/1RouUMpYquI3A-GS7TMrUGVaxmrrG-h8o/pub?start=false&loop=false&delayms=3000&slide=id.p4
* Slide number 5 & 6 specifically show the images we were discussing during the podcast.
Hashtags:#Fascia #PainManagement #SterlingStructuralTherapy #NonInvasiveTreatment#ChronicPainRelief #TMD #VirtualTherapy #Myofascial #AnatomyTrains #ForwardHeadPosture#JawAlignment #ConnectiveTissue #BodyEfficiency #TongueExercises #PostureAndPain#tmj