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Author: admin | 26.11.2015 | Category: Ginkgo Biloba Tinnitus

Our understanding of TMJ dysfunctions begins with the stomatognathic system that is composed of the teeth, the temporomandibular joints (TMJs) and the mastication muscles. When the upper teeth and the lower teeth don’t fit properly (malocclusion), the other two components of the stomatognathic system, muscles and TM joints must accommodate the discrepancies to guarantee the primary functions but this will lead to a structural disorganization of the cranio-cervical-mandibular biomechanical unit (“upper pole”). Any tooth gearing abnormality causes the neuromuscular system to program reflex movements for the mandible to avoid any damage to the teeth and to the temporomandibular joint when closing the mouth. When the patient slowly opens and closes the mouth, the midline incisal path of the mandible deviates: it wobbles back and forth. The stomatognatic system is part of the cranio-cervico-mandibular biomechanical unit (“upper pole”). The neck must be aligned with the centers of the shoulder, diaphragm and pelvic rings on a vertical line (“the line”). The deep neck muscles are the core muscles mainly supporting the cervical vertebrae so that the head movement (“yes” and “no” movements) are possible in an efficient way.
Traumatic events like car accidents (whiplash), a blow in the head or face and loss of teeth can trigger a change in the occlusion and then cause TMJ disorders (see the article “trauma: a structural approach”). In conclusion TMJ syndrome must be evaluated and treated as part of the whole-body structural organization. Chiropractic neurological treatments include: exercise rehabilitation (on premise), stretching, nutritional counseling, massage, physical therapy and spinal decompression. The Chiropractic educational community recognized the need for expanding its specialized training and in 1979 initiated a three-year post-doctoral course in Clinical Neurology.
Benign positional vertigo (BPV) is a relatively common condition which is characterized by episodes of severe spinning (vertigo) associated with turning the head. The treatment for this type of dizziness is a physical maneuver which can easily be done in the office.
The balance system in the ear is called the vestibular system and it consists of the semicircular canals which have the nerve endings of the nerve of balance. Meniere's Disease (MD) is characterized by hearing loss, ringing in the ear, and episodes of severe dizziness often with nausea and vomiting. Treatment of MD is directed primarily at controlling the episodes of dizziness which can be debilitating. Treatment includes antibiotics to treat the infection and in some cases allergy treatment to reduce Eustachian Tube swelling and help with drainage. In some cases the bacteria can be eliminated but the fluid remains causing a persistent hearing loss. In some situations the acute infection may resolve, but continue to recur despite medical therapy.
In some cases these infections are recurrent or chronic and require other treatments and medications.
The medical diagnosis of 'SUDDEN HEARING LOSS' is a hearing loss due to inflammation of the nerve of hearing (viral infection is the most accepted theory).
We view the teeth as a set of gears which must mesh perfectly in order to provide the primary physiologic functions of the mastication and swallowing. Each one is a synovial joint formed where the condyle of the mandible articulates with the articular tubercle of the temporal bone. Three pairs of muscles are mainly responsible for elevating the mandible when we close the mouth. A poor organization will develop myofascial pain conditions as we have already explained in previous articles (see “chronic myofascial pain and dysfunction: break the pain cycle!”). This creates a situation in which the jaw is “limping” much as we limp with an injured ankle. The most marked deviation from the mid-line during movement is usually away from the side of the more affected laterally pterygoid muscle.
Any deviation from this easy structural relationship means that the whole myofascial network of the upper pole is out of balance. The sterno-cleido-mastoid muscles (SCM) are the main muscles responsible for this pattern because when they are tight short, they flex the neck on the thoracic spine and they extend the head on the top of the neck.
These muscles are surrounded by the deep prevertebral fascia (see picture showing a section of the neck).


Balancing the head on the neck at the atlas-occipital joint involves working all the myofascial tissues inside the mouth.
Grinding the teeth (bruxism) overuse the masticatory muscles and this will lead to myofascial pain in this area.
Sports activities like weight lifting and scuba diving involving clenching the teeth, can also contribute to TMJ disorders. In our Chronic Pain Management program at the Pakua Integrative Health Clinic we use the therapeutic bodywork modalities structural bodywork and neuromuscular therapy to address the TMJ soft tissues dysfunctions. Bookmark this page to see his latest cartoon each week, and peruse the Cartoon Archives of over 400 "Politically Correct" cartoons.
Saracino was one of the first five Board Certified Chiropractic Neurologists in Pennsylvania, the first in the Valley Forge Area and is currently certified Diplomat of the American Chiropractic Neurology Board (ACNB). The focus on muscles, ligaments and tendons to rebalance the nervous system allows for fewer spinal manipulations than those used by regular doctors of chiropractic.
Board Certified Chiropractic Neurologists are Doctors of Chiropractic who have completed post-doctoral training in clinical neurology whose program is approved by the Continuing Education Committee of the Commission for the Accreditation of Graduate Education in Neurology. Calcium crystals floating in the inner ear fluid stimulate the nerve of balance and stimulate dizziness. In some cases the pattern of symptoms suggests a specific cause and this provides a starting point for the evaluation. MD is a chronic condition which is managed like other chronic conditions such as asthma or arthritis. People can have one episode every few years or frequent episodes several times a week or month. Bacterial or viral infection sometimes in association with allergy leads to an accumulation of fluid in the middle ear space behind the ear drum (see ear diagram). In these cases the fluid is drained by placing a ventilation tube (or pressure equalization tube, PE tube) through the ear drum with a brief surgical procedure. This is an emergency requiring immediate treatment in order to maximize the chance of regaining hearing. The dizziness can be controlled with medications until the virus has passed through the system. You can feel them work by placing your fingers just in front of your ears and opening and closing your mouth. This will close off the Eustachian tube that connects the throat to the middle ear and keeps the air pressure in the middle air the same as the outside atmosphere. The head must be kept in balance on the top of the neck so that the jaw can track straight up and down. A dysfunctional position of the head can lead to occlusal problem and viceversa a tooth gearing problem can affect the balance of the head on the neck. That means that the inframandibular muscles (suprahyoid muscles) that are flexors of the head at the atlanto-occipital joint, are overstretched (tight long) in their effort to counteract the action of SCM to keep the eyes horizontal.
Only after releasing the tensions in the jaw, the internal extension of the neck up to the crown of the head will be possible! The diplomat program requires a minimum of 300 credit hours and competency in written and practical examinations administered by the ACNB. This triggers both the nerve of hearing and the nerve of balance leading to the typical symptoms. There are medications or treatments taken on a regular maintenance basis and there are other medications or treatments for acute flare ups. Normally this fluid would drain through the Eustachian Tube into the nose but with an infection the drainage tube may be blocked.
Placement of a ventilation tube creates an alternative pathway and helps control the infections.
If that hole is plugged by water or shifting wax, the patient experiences a 'sudden hearing loss'.
The noises range from infrequent and inconsequential to continuous and disruptive during the day and night.
Interposed between the two surfaces of the joint there is a disc composed of fibrocartilage.


This changes the movement patterns of the jaw and that means that some muscles of the mastication must work too much and they go to spasm. The closing of the Eustachian tube will produce symptoms of earaches, ringing and dizziness. Clicking occurs when the articular disc has become displaced anteriorly due to a spasm of the lateral pterygoid muscle. Evaluating the structural organization of the upper pole is crucial to understand any TMJ disorder. This will lead to the elevation of the hyoid bone and to a change of the mandibular position (posterior-superior into the retrodiscal tissue).
Mouth breathing is characterized by a dysfunctional position of the tongue: it is between the lower and upper teeth.
They are symptoms dizziness blackout cold sweat ringing in earspolitical and, indeed, correct. Currently certified Chiropractic Neurologists must obtain 30 approved chiropractic neurologic credits per year. The sense of balance is also affected by vision, special sensory nerves in the muscles and joints, blood pressure and circulation, and some hormones in the blood. In some instances the heart, blood vessels, and brain may also need evaluation by the appropriate specialists. If pressure builds up in the middle ear because of Eustachian tube dysfunction or infected fluid that can also cause a 'sudden hearing loss'. The vestibular system is based on symmetry; the input from each nerve of balance has to be coordinated with the other.
When opening the jaw, the forward moving condyle bumps over the edge of the displaced disc causing a clicking sound. The tongue should rest behind the front upper teeth and during the swallowing action the tip of the tongue touches the anterior palate just above the upper teeth (roof of the mouth). The ACNB is the only specialty-certification agency for the Chiropractic profession that is fully accredited by the National Commission for Certification Agency, the accreditation body of the National Organization for Competency Assurance, the leader in setting quality standards for credentialing organizations. When one nerve has a viral inflammation it begins to send signals to the brain out of sync with the other ear.
The other muscles involved in opening the mouth are the suprahyoid muscles that depress the mandible once the hyoid bone is stabilized by the infrahyoid muscles. Occlusal problems overwork especially the lateral pterygoid muscle in its effort to center the teeth against the forceful occlusion produced by the mandibular elevator muscles. The muscles elevating the mandible (masseter, temporalis and medial pterygoid) overwork to close the mouth in the mastication process because their antagonists the inframandibular muscles are too tight long.
A dysfunctional tongue position in the childhood can affect the development of the teeth and the facial bones leading to occlusal problems. These signals tell the brain you are moving when you are not actually moving, resulting in the sensation of spinning known as vertigo. The disc is anteriorly attached to the superior lateral pterygoid muscle and posteriorly to the retrodiscal material that is a thick ligament that prevents the disc sliding too forward. Myofascial trigger points (MTrPs) in this muscle are the chief source of referred pain felt in the TMJ area. The assessment of the jaw gait gives us more information about which myofascial tissues are involved in the dysfunctional movement pattern. All this dysfunctional organization of the upper pole will develop myofascial trigger points in the head, face and neck. After the initial rotation, the condyle and the disc glide together along the articular tubercle.



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