Open UP: A TMJ Discussion

Open UP: A TMJ Discussion

By Dr. Pamela Marzban and Dr. Mac LeeMedicineHealth & Fitness
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Open UP: A TMJ Discussion episodes

  • 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.

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

    Discusses the pros and cons of MRI, Cone Beam (CBCT), and Panorama for

    diagnosing 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 successful

    orthotic 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

    27 min
  • 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 on
    the connection between ADHD, airway health, and maxillary
    deficiencies. The discussion delves into how conditions like mouth
    breathing 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 sleep
    due to severe nasal obstructions, which multiple doctors, including
    ENTs and neurologists, failed to diagnose. This case underscores the
    critical need for awareness of nasal breathing issues and their impact
    on overall health.
    The podcast also explores the benefits of nose breathing, such as the
    production of nitric oxide, and the often-overlooked dangers of mouth
    breathing, which can affect a child’s mental acuity, behavior, and
    overall well-being. Misdiagnosis of ADHD is discussed as a common
    issue, with many children struggling due to underlying airway
    problems.
    Pam explains the difference between traditional orthodontics, which
    focuses on straightening teeth, and orthopedic orthodontics, which
    prioritizes facial structure and, by extension, airway health. Mac
    emphasizes the need for parents to be vigilant and proactive in
    identifying potential airway issues in their children, such as mouth
    breathing and snoring, and to seek appropriate medical advice.
    The episode also highlights the remarkable improvements seen in
    children who receive treatment for airway issues. Parents of children
    diagnosed with ADHD are encouraged to watch the "Finding Connor Deegan
    – AAPMD" video and to explore the potential benefits of addressing
    airway health in their child's overall treatment plan.
    Join Pam and Mac as they discuss the significant, yet often
    overlooked, link between airway health and behavioral issues, and the
    importance of proper diagnosis and treatment.
    #TMJ #ADHD #AirwayHealth #ChildrensHealth #SleepApnea
    #Orthodontics #MouthBreathing #NoseBreathing #Parenting
    #MaxillaryDeficiency #PediatricCare
    24 min
  • Treating TMD Belongs to the Dental Profession (Ep 9)
    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
    20 min
  • 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
    33 min
  • 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:
     
    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
    26 min
  • 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
    22 min
  • 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
    19 min
  • The Trifecta of TMJ/TMD pain (Ep 4)
    In this Episode:
    . People can have “bad” bites but no pain. Others can have basically the same bite with tremendous pain. No one knows why.
    · In today’s and the next two episodes, we explain what the different “bad bites” look like.
    · With an in-the-mouth exam on pain patients, both Pam and Mac look for three occlusal (the way the teeth hit) schemes that occur in almost all pain patients.
    · These different schemes are called posterior interferences, torqued mandible, and a deficient maxilla, each will be explained beginning with the deficient maxilla.
    · Mac explains how his enlightenment on the deficient maxilla changed his knowledge of helping the TMD pain patients.
    · Pam reiterates how deficient maxilla occurs during development.
    · The tongue is the sculpture of the jaws and it must do its job. When allowed to do its job, the mouth is shaped like a U. When it can't, the mouth is shaped like a V.
    · There must be a balance of pressures between the tongue and the cheeks.
    · With V shaped palates, the lower teeth have a hard time knowing where to fit.
    · Deficient maxilla usually have crooked teeth, V shaped, and worn front teeth.
    · The importance of watching your children and how they breathe.
    · The role deficient maxilla has in joint noise, joint pain, and deviated opening and closing of the jaw.
    · Pam discusses the needed equipment in diagnosing and treating TMJ pain.
    · Mac discusses how jaw tracking equipment can track the backwards movement of the jaw on closing which compresses the TMJ and causes joint issues.
    · Orthotics, and how they work in treating TMD, is briefly discussed.
    · The difference between an orthotics and a mouth guard, Invisalign, etc.
    Important Links:
    Podcast Video on Youtube: https://youtu.be/_Wma1v82DNg?si=BbQFjm48LCgEHXjS
    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
    24 min

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