Open UP: A TMJ Discussion

Q&A (Ep 14)

In this episode, we dive deep into the importance of listening skills when answering multiple patient questions, particularly for those dealing with pain. The main focus is on a patient's inquiry about displaced discs, the need for an MRI, and whether orthodontic elastics can contribute to displacing a disc. The patient, with limited jaw opening (30mm, 20mm too little) and a slight joint noise, seeks clarity on these issues.
We break down the question into simple, understandable parts. The key takeaway? The bite directly affects joint position. When the bite changes, so does the joint position. While this shift is generally tolerated during orthodontic treatment, everything needs to be in harmony once the treatment is complete. If bite and joint position aren’t aligned, serious problems can arise, leading to long-term pain and damage.
We emphasize the importance of dentists having a clear understanding of the proper jaw-to-jaw relationship before starting any orthodontic treatment. Pam always begins with a neuromuscular orthotic to create a "blueprint" for the correct joint and bite alignment, ensuring that treatment is geared toward optimal results.
If you've ever had, are currently wearing, or are considering braces, this podcast is a must-listen. Braces done without considering the critical relationship between the bite and joint can lead to a lifetime of pain and destruction. We also offer valuable advice on how to find the right dentist for your orthodontic treatment.
In a second question, we discuss other orthodontic issues, like why teeth shift so quickly, the importance of addressing the root causes, and how lip and tongue posture affect treatment outcomes. We even cover why some people develop a gummy smile and the strange connection between orthodontic issues and ear pressure changes, like those felt when driving through mountains.
Join us as we explore these vital topics and more in a way that’s easy to understand and directly helpful to anyone navigating orthodontic treatment.
Hashtags/SEO Topics:#ListeningSkills #OrthodonticTreatment #JawPain #DisplacedDiscs #BiteAlignment #NeuromuscularOrthotic #DentalHealth #BracesProblems #JawJoint #TMJPain #TeethShifting #GummySmile #TonguePosture #LipPosture #EarPressure #DentalCareTips

Tongue Ties and Craniofacial Development (Ep 13)

The detrimental effects of the New York Times article on Tongue Tie is discussed in an Open Up fashion.
 
The author had no idea about the importance of tongue ties and wrote a one-sided report without knowing the true devastating effects of a true tongue tie.
 
Pam had a negative personal experience with her own son dealing with her son’s pediatrician who was unaware of the importance of tongue tie during childhood development.
 
Tongue ties and its negative effects are not taught in medical or dental school the same as TMD is not taught. The unawareness of tongue tie and mouth breathing is also ubiquitous worldwide.
 
Why tongues can damage one’s life from birth to adulthood if it is not allowed to do its job.
 
The tongue’s job for craniofacial growth is explained.
 
The ultimate time for cutting tongue tie is discussed along with Myofunctional therapy, along with the importance of breastfeeding.

MRIs, Are they needed for TMJ? (Ep 12)

Discusses the pros and cons of MRI, Cone Beam (CBCT), and Panorama fordiagnosing of TMJ.
Addresses common misconceptions seen on social media—“I’m waiting for my MRI!”Explains how joint anatomy is critical, but it’s only part of the overall TMD diagnosis.
Breakdown of imaging types:
Pantograph: 2D, cheapest, least useful for joint issues.Cone Beam (CBCT): 3D images of hard tissue, spine, and more.MRI: Useful for disc imaging, but not always needed for TMD.
Insights on overhead costs of CBCT and its impact on TMD treatment pricing.Condylar remodeling and arthritis explained, plus tips for successfulorthotic treatment.
Dr. Mac Lee's Book: "The Life Robbing Pain of TMD; Why Me?" (Can be found on Amazon)Dr. Marzban's Book: "Craniofacial Development from Infancy to Adult" (Can be found on Amazon)
#TMJ #TMD #MRI #ConeBeam #CBCT #JointAnatomy #OrthoticTreatment #DentistTips #Imaging

ADHD and Airway Health (Ep 11)

In this episode of the "Open Up - A TMJ Discussion" podcast:
The importance of early diagnosis in childhood is highlighted, focusing onthe connection between ADHD, airway health, and maxillarydeficiencies. The discussion delves into how conditions like mouthbreathing and genetic factors contribute to a constricted airway,which can lead to sleep apnea and other health issues.
Pam shares an emotional story about a child who was terrified to sleepdue to severe nasal obstructions, which multiple doctors, includingENTs and neurologists, failed to diagnose. This case underscores thecritical need for awareness of nasal breathing issues and their impacton overall health.
The podcast also explores the benefits of nose breathing, such as theproduction of nitric oxide, and the often-overlooked dangers of mouthbreathing, which can affect a child’s mental acuity, behavior, andoverall well-being. Misdiagnosis of ADHD is discussed as a commonissue, with many children struggling due to underlying airwayproblems.
Pam explains the difference between traditional orthodontics, whichfocuses on straightening teeth, and orthopedic orthodontics, whichprioritizes facial structure and, by extension, airway health. Macemphasizes the need for parents to be vigilant and proactive inidentifying potential airway issues in their children, such as mouthbreathing and snoring, and to seek appropriate medical advice.
The episode also highlights the remarkable improvements seen inchildren who receive treatment for airway issues. Parents of childrendiagnosed with ADHD are encouraged to watch the "Finding Connor Deegan– AAPMD" video and to explore the potential benefits of addressingairway health in their child's overall treatment plan.
Join Pam and Mac as they discuss the significant, yet oftenoverlooked, link between airway health and behavioral issues, and theimportance of proper diagnosis and treatment.
#TMJ #ADHD #AirwayHealth #ChildrensHealth #SleepApnea#Orthodontics #MouthBreathing #NoseBreathing #Parenting#MaxillaryDeficiency #PediatricCare

Why is TMJ/D Diagnosis and Treatment so Expensive? (Ep 10)

Listen to Our Podcast:
Why is TMJ/D Diagnosis and Treatment so Expensive?
Welcome to The Open Up Podcast, where we tackle every subject with honesty and transparency. Today, we're diving into the often surprising cost of TMD (Temporomandibular Joint Disorder) treatment.
Sticker Shock in TMD Treatment
Many dentists who specialize in TMD are familiar with patients' initial "sticker shock" at the cost of treatment. It's crucial to discuss both the treatment and the financial aspects with the same level of openness.
Pam's Perspective on Costs and Time
Dr. Pam shares insights into her fee range, treatment durations, and patient satisfaction. The primary reason for the high cost is the time required, which is expensive in today's medical environment. Unlike many medical treatments, TMD care demands significant time between the doctor and patient.
Insurance Realities
One major issue is that medical insurance typically covers procedures, including surgeries, but often excludes dental treatments. This podcast dives into the harsh realities of dental insurance and why it fails to cover necessary TMD treatments.
Financial Struggles
We also explore the tough reality that some patients simply cannot afford the treatment they need. This financial barrier can be a significant obstacle in getting proper care.
The Flawed Medical Model
The modern medical model prioritizes quick appointments and rapid patient turnover, which is incompatible with effective TMD treatment. Successful TMD diagnosis and care require ample time, making the medical model unsuitable for this type of dental issue.
The Hidden Costs of Pain
Beyond financial costs, there's a deep discussion on the broader impacts of untreated TMD pain, including effects on personal well-being, family life, social interactions, and professional life.
What If There's No Money?
Finally, we discuss the hard reality of what happens when patients lack the financial resources for TMD treatment and explore potential solutions and alternatives.
Tune in to hear the full, open discussion and gain a better understanding of why TMD treatment is priced as it is.
Watch more on Dr. Pamela Marzban's YouTube channel: Dr. Pamela Marzban DDS Burke.
#TMDCost #TMDTreatment #DentalCare #OpenUpPodcast #DentalInsurance #HealthcareCosts #TMDPain #MedicalModel #PatientCare #Dentistry #DrPamelaMarzban

Treating TMD Belongs to the Dental Profession (Ep 9)

In this Episode:
Important Links:
 
Podcast Video on Youtube: https://youtu.be/brhhTTjLTVk?si=MQiWp1Jz4v37q4Ca
 
Website TMD Link: https://marzbandds.com/tmj/    
 
Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0    
 
Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1

Different Dental Appliances (Ep 8)

In this Episode:
- Once again, Pam and Mac shared stories of how inadequate their dental school training was when it came to TMD and its appliances. 
- Pam was told about the “nightguard” but that’s all.  She never made one with an instructor to guide her.  It wasn’t until in private practice that she made them for those with badly worn teeth. 
- Mac’s history was zero information in dental school but heard about “nightguards” in dental trade magazines and dental labs.  It was the blind leading the blind. 
- Both Open Up and discuss the ridiculous “POP” which stands for Piece of Plastic that was almost worthless for most people. 
- A properly made Neuromuscular Orthotic is lightyears above a night guard and Mac explains how by using prescription glasses as an analogy. 
- Mac discusses his history of using different appliances over several decades including a Midpoint (Lucia Jig, NTI, Kois Deprogrammer) and the Tanner appliance, what worked, why they worked on some bite issues but not on others. 
- What separates TMD dentists like he and Pam from the other dental camps like Pankey, Dawson, Kois, Spear, AAOP, etc. was discussed. 
- Both believe all dental camps need to come together to find their likeness and share success’s to the benefit of the pain patient. 
- Pam shares experiences of interacting with a person in the medical profession that once again reinforced the fact that dentistry has failed the public due to TMD unawareness. 
- Mac discusses how sleep dentistry is changing the mindsets of the different TMD camps, yet the other camps and other medical professions cannot see and recognize the destruction the deficient maxilla can cause. 
- We discussed OTC appliances both good and bad. 
- Phase I and Phase II treatments plus the different types of surgery, including MMA, was discussed. 
- The importance of finding the right jaw position prior to any permanent change was stressed. 
- Changes in TMD unawareness is coming from the NIH, TMJ Association, and the American Academy of Orofacial Pain (AAOP) all working together for you the pain patient.
Important Links:
Podcast Video on Youtube: https://youtu.be/gflNwS4e2eo?si=4skS60qJ_WCPlE_6
 
Website TMD Link: https://marzbandds.com/tmj/    
 
Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0    
 
Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1

Trigeminal Neuralgia (Ep 7)

In this Episode:
 
• Pam shares story about a patient with Trigeminal Neuralgia which is an extremely painful condition, one that TMD can make worse and vice versa.
• If you have had problems with Trigeminal Neuralgia, this is an interesting Podcast!
• Pam discusses different treatments patient encountered over the years; the ones that did work and didn’t work.
• On top of medical issues, the patient had braces with four bicuspid extractions which in our experience can create a deficient maxilla which can compress the condyle, airway, and the Trigeminal Nerve.
• Pam treated her with a neuromuscular orthotic with a year of success meaning little to no pain.
• The patient, in her late 30’s, was tired of the orthotic and wanted options.
• Both the patient and Pam decided on orthodontics after careful consideration since both Pam and the patient knew where the upper and lower jaw/teeth relationship needed to be.  The orthotic would direct and drive the case.
• The case is now over seven years old.  Patient infrequently needs a minor adjustment on teeth, neck or hips, but no more pain to speak of.  Summary is a very appreciative patient and a very satisfied treating doctor.
• The topic turns to having a correct differential diagnosis, no matter who is doing the treatment.  If a medical doctor does not know how to diagnose TMD, they diagnose the wrong treatment.
• Trigeminal Neuralgia, migraines, cluster headaches, and some tumors, mimic TMD pain.  It is critically important that all health care professionals who treat these conditions know how to do a differential diagnosis.
• The big question in this podcast was, if no medical doctors, and few dentists have been trained in the proper diagnosis of TMD, how can there ever be a differential diagnosis.  Yes, we are Opening Up the real concerns facing the pain patient.
• The bite can irritate and put pressure on the Trigeminal Nerve which creates pain in the face.
• Biopsychosocial is discussed and how important it is in a differential diagnosis.
• TN surgery is discussed with the problem of returning pain.
• Both Pam and Mac are calling for everyone in the medical community to know/learn about the mouth and TMD.  The conversation gets quite emotional because of the frustration of the medical and dental community not working together.
• Another example is MD’s diagnosing a joint image as arthritis when in fact the bone defect is due to bone compression.  Mac fires Pam up on how frustrating it is for all.
• Joint anatomy is discussed in a very easy to understand examples.  Pam is even more fired up!!!!!
• Clicking joints discussed again because a clicking joint is a compressed joint.
• Mac surprises Pam with an analogy of why joints click.
• There are more variables in TMD and facial pain as stars in the sky.
• Neuromuscular dentists look at the whole body because everything is connected.
• There is no overall training of TMD in dental school.
Important Links: 
 
Podcast Video on Youtube: https://youtu.be/SsmMecaaSPw?si=dKIE--9zntzuwWSp
 
Website TMD Link: https://marzbandds.com/tmj/    
 
Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0    
 
Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1

Posterior Interferences (Ep 6)

In this Episode:
 
· Review of trifecta, with this podcast concentrating on posterior interferences
· What are posterior interferences? DIY diagnosis, sliding jaw forward and then sideways.
· Discuss patient difficulties in finding interferences.
· Discuss red and blue occlusal paper and how each of us use them
· T Scan and its abilities and uses on both teeth, dentures, fillings, crowns, FMR, and orthotics.
· The miraculous PDL, our built-in tire pressure sensor
· “My tooth was OK until you worked on it
· Abfractions
· The power of the Trigeminal Nerve
 
Important Links: 
 
Podcast Video on Youtube: https://youtu.be/lgqR3LgfyyM?si=Ytjihs38AvKmv4sP   
 
Website TMD Link: https://marzbandds.com/tmj/    
 
Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0    
 
Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1

The Torqued Mandible (Ep 5)

In this Episode:
• Review of the Trifecta which includes deficient upper jaw, interferences with posterior teeth, and today’s topic, the torqued mandible.
• A torqued hip is when one side is lower or at a different angle than the other.  A torqued mandible is when one side hits before the other.
• A torqued mandible is like a porch swing with one chain being longer than the other.  That’s not a comfortable swing to sit in.
• It’s also like having one leg shorter than the other, at some point in life, there will be pain or destruction of spine, hips, etc.
Important Links: 
 
Podcast Video on Youtube: https://youtu.be/lgqR3LgfyyM?si=Ytjihs38AvKmv4sP   
 
Website TMD Link: https://marzbandds.com/tmj/    
 
Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0    
 
Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1