Marla Albright (Photo by: Carper Creative Photography)

Imagine being in so much pain that you can’t open your mouth very wide, you have difficulty swallowing, and sometimes it feels like your muscles are on fire. Eating isn’t a pleasure, but misery. It is difficult to turn your neck, there are frequent headaches and ringing in the ears. As the disease progresses, you experience fibromyalgia, vertigo, eye pain, blood vessels bursting in the eye, blurred vision and difficulty in breathing and speaking.           

Those and more are symptoms of temporomandibular joint disorder (TMJ) that Marla Albright, RN, has experienced over the past 35 years.

“The pain is so extreme it feels like you are constantly on fire,” Albright said.

“Aspirin and Advil dulled it, but if you take too much over a long period of time, it loses its effectiveness. What helped more than painkillers were muscle relaxers. But I’ve had it so long, it got to the point any kind of medication didn’t help.”

She found it difficult over the years to find the right combination of healthcare treatments for TMJ, and wants to share her story about how she found the right combinations of care that have freed her from constant pain.

“It is so hard to find a TMJ doctor that early symptoms are often misdiagnosed,” Albright said. “This leads to having these later symptoms. That is why I want to alert those with the early symptoms to a course of treatment so they will not see the problems progress.”

Albright said three things have brought her relief after years of pain:

• Neuromuscular dentistry, which involves the correct positioning of the jaw to locate a balanced bite. Albright said a number of people who develop TMJ have, like herself, had braces as a youth. Sometimes teeth removal and braces can lead to an imbalance. Neuromuscular dentistry involves restoring the balance. But this is not a mainstream treatment, and sometimes it is not covered by health insurance.
• Chiropractic orthospinology.
• Cranialsacral physical therapy and manual treatment techniques to treat the contracting and spasms in the muscles, which are so prevalent in TMJ.

Albright has had good results getting treatment from E. Kyle Dalton, DDS, Dalton Designer Smiles, Conway. Dalton said neuromuscular dentistry involves balancing the mandible to the maxilla. Ideal oral posture is achieved with the muscles of the face being in balance creating a neutral physiological position.

“When myocentric or ideal physiologic occlusion is achieved, the entire stomatognathic system, including supporting structures, function at their most efficient capacity,” Dalton said. “This almost always eliminates pain.”

While neuromuscular dentistry was a big help, Albright said she was able to “get over the hump” to complete wellness when she added orthospinology. According to Albright, to get optimal results, the jaw, neck and back all need to be aligned.

“A lot of people don’t know to check out their necks,” she said. “That is the breakthrough information a lot of people need to learn about. To have ultimate success the neck has to be balanced.”

Her chiropractor, Craig York, DC, York Spinal Care, Morrilton, describes orthospinology as an upper cervical adjusting method which he says is designed to realign the top two vertebrae of the neck, C1 and C2.

“To facilitate a specific correction of this misalignment, three x-rays are taken on a laser aligned x-ray machine from an x, y, and z axis,” York said. “This gives us a three dimensional idea of how that individual’s upper cervical spine has misaligned, which is measured in degrees determining the head placement and vector used to facilitate the correction. Though the adjustment can be delivered by hand, I use a hand held or table mounted instrument. The adjustment is painless and care plans are generally ten visits over six weeks, though some patients require more or less care.”

Success is dependent on the patient “holding” the correction of the spine, which is why they schedule patients in a serial fashion to realign the spine as soon as it gets out of alignment or establish a record of holding in order to reduce the frequency of care. A post x-ray is taken after the first correction to validate the established vector.

“Usually, this is the only time a patient is x-rayed as the misalignment will go back ‘out’ in the same pattern,” York said. “When the upper cervical spine is realigned, traction forces, via the dentate ligaments that affect the outside tracts of the spinal cord, which control muscle tone, are reduced creating equal tone bilaterally and improved mechanical function of the joints bilaterally, including the temporal mandibular joints. The equalization of muscle tone improves posture, and the most important postural relationship in TMJ dentistry is the loss of forward curve of the neck, which has been shown in dental research to directly influence the position of the jaw. Indeed, the “T” of the disorder is the temporal bone which is essentially the posture of the head.”

York said the goal with all patients is the same, but some patients have TMJ pain and dysfunction while others may have lower back pain. Both are out of balance and need the upper cervical spine adjusted, but the work is not diagnostically specific to one or the other. Patients who have TMJ pain tend to have a loss of the normal cervical lordosis, so in their cases, York gives extra effort to restoring the forward cervical curve.

York said most dentists who work with the TMJ are familiar with the relationship between the TMJ and the loss of cervical lordosis and forward head carry via research published in dental journals.

“I have had numerous cases over the years with chronic TMD that resolved with only the adjustment of the UC spine,” York said. “Some got better in a matter of days. Others I could not help. Too often, I think, irreversible dental procedures are initiated before underlying postural causes are addressed.”

The third thing Albright found to be very helpful is the cranialsacral therapy she gets from Anne Miskin, a physical therapist at the Little Rock Athletic Club. Cranialsacral therapy involves manipulating the spine and the skull and its cranial sutures, diaphragms, and fascia.

When Miskin first started practicing 30 years ago, few health professionals were treating TMJ. There was even some thought that patients with TMJ had mental problems because they came in with such a wide host of problems.

“TMJ is such an all-encompassing disorder,” Miskin said. “I look at the body as a whole and focus on the body being balanced through its different members. When I treat, I also understand you are more than just your bones and skin. To feel and be whole, you have to address the emotional and spiritual aspects. Not being heard is a common complaint of TMJ patients.”

Miskin urges listening to patients and try understand that they are all different.

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