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The temporomandibular joint (TMJ) is the joint between your skull and the mandible (lower jaw).
Our goal is to diagnose and offer appropriate treatment that will help combat your head, neck, and facial pain or joint dysfunction. Because the TMJ is so complex, many factors can contribute to TMJ disorders including stress, lack of sleep and bruxing (jaw clenching and grinding). When head pain dictates lives, and sufferers visit doctor after doctor, without results - a trained, experienced dentist can be the answer! Patients may also benefit from medications, physical therapy, stress management, nutritional counseling and self-help information. At Audiology-Hearing Aid Associates of SE Texas, we provide full-service care for our patients' hearing. Have you ever rolled over in bed to kiss your spouse goodnight, turn off the alarm clock, or to toss "Fluffy" the cat, out of bed and then suddenly felt as though the world was spinning out of control?
The calcium carbonate needs to be in sufficient quantities where it becomes heavy enough to be able to push or move the nerve endings.
The good news about BPPV is that for many people, the experience will not last more than a few days and it will seem to disappear as quickly as it came. In 1988, at the Paris Ear Institute, a French physiatrist, Alain Semont, along with a group of French ear, nose and throat physicians wrote a paper and presented a simple treatment, a five-minute physical therapy maneuver, which moved the debris to circulate through the long arm of the posterior canal and drop back into the utricle. Since Semont's article, dozens of studies and methods of varying techniques from balance specialists around the world have been published.
It is possible that other canals, predominantly the side canals (referred to as the horizontal canals) may also contain some trapped debris. It has been customary to ask the patient not to lie flat for at least one or two nights following treatment, and to perhaps avoid lying on the side of the affected ear for several nights. A word of caution: Although some web or information sites may show you the treatment diagrams, I am not in favor of having patients self-perfonn them. The purpose of these comments if not to unnecessarily frighten anyone, but to further confirm that although BPPV is not a serious, condition and can be treated quite readily with no discomfort or special equipment, there can be a number of other medical conditions, which are far more serious, which may need to be completely differentiate by a trained professional. This notice applies to the information and records we have about your health, health status, and the health care servies you receive at this office. Meniere’s disease is a symptom complex that includes fluctuating hearing loss, tinnitus (ringing or buzzing in the ear), fullness in the ear, and dizziness. This causes a displacement of the usual margins of the inner ear producing disturbances such as changes in hearing and balance. Other options exist including the injection of gentamicin into the middle ear through the eardrum. Further up on the treatment ladder for Meniere’s disease are the surgical procedures to cut the balance nerve to the inner ear and the surgical procedure to completely remove the inner ear where hearing is no longer present. The two TMJ's are located in front of your ears and each joint has a small disc of cartilage that allows smooth movement. Treatment focuses on alleviating TMJ-associated pain, improving jaw function and stabilizing the joint. Other factors such as medications, poor nutrition, poor posture, past head and neck trauma, orthopedic problems, genetics, and poor dental health may also lead to problems.
Van der Werff will help you understand your condition and work with you to help you choose an appropriate treatment plan. Van der Werff provides TMJ Care, and Dental Sleep Appliances providing services in the greater Northern California region north of the San Francisco Bay Area.
We maintain qualified doctors on staff specializing in diagnosis and treatment of virtually any hearing-related difficulty, from audiological testing to hearing-aid fitting and more.


Well, you may have experienced the most common fonn of vertigo, known as Benign Paroxysmal Positional Vertigo. By age seventy, fifty percent of all individuals will experience this frightening sense of falling, tumbling, or spinning at least once in their lives, In younger individuals, it may occur following medical conditions such as Meniere's disease, vestibular neuronitis, labyrinthitis, migraine, or after even a mild head trauma. It can be strong-feeling like you're being pushed off a bridge, or being pulled down by a giant magnet. Any nonnal degeneration of these calcium carbonate crystals, also called otoconia, fall into the back semicircular canal, aptly named the posterior canal. Once the debris entered the utricle, ifthe patient did not return to the problem position for a day or two, the symptoms would resolve. The treatments may be referred to a Semont Liberatory Maneuver, Epley Repositioning Maneuver, Gans Repositioning Maneuver, or simply Canalith Repositioning Maneuver.
These canals require other fonns of treatment, which also have been written about for many years, and may include treatments known as Appiani, Casani, or Bar-b-que. Sometimes patients have been provided with a soft cervical collar as a friendly reminder to help them to keep their head from tipping or moving.
The reason being, it is very important that a proper diagnosis be made before treatment starts! The typical episodes of dizziness that the affected individual experiences is where the environment or the individual themselves feel as though they are moving when they are not. It is felt that Meniere’s disease is a disorder that arises secondary to the presence of excessive fluid within the inner ear.
The inner ear on the right is swollen with excessive amount of fluid as seen In Meniere’s disease. The attacks can be triggered by a variety of occurrences such as exposure to things one is allergic to, stress, atmospheric pressure changes, etc.
As Meniere’s disease is thought to occur as a result of a fluid overload within the inner ear, a diet that has reduced salt content is beneficial. Depending on the circumstance of the individual that has failed medical therapy, additional treatment options are available, primarily surgical. This places gentamicin, a substance that preferentially neutralizes the balance center in that particular inner ear, near a point where it can diffuse into the inner ear. We appreciate the recommendation and are honored by your kind words about our medical practice.
Even some fibromyalgia, tinnitus and migraine patients may be helped with our conservative, non-invasive treatment.
In fact, any malfunction that prevents the complex system of muscles, bones and ligaments from working together may lead to TMJ disorder. Many times, patients benefit from a custom-fitted oral device - a splint (or orthotic) made of clear acrylic. The semicircular canals (the three balance canals), are designed to be velocity sensors and not gravity sensors. The biochemistry of the human body is such that our bodies should normally absorb this calcium within hours, or certainly days, and it never gets to a point where it is heavy enough to cause dizziness symptoms. The theory was that the biochemistry of the utricle, because it is a larger space, is different from that of the posterior canal~ and this allows the calcium carbonate to readily dissolve in the larger space, while it could not do so when in the smaller area of the posterior canal.
These treatments, all basically achieve the same thing, but require the patient to be moved into slightly different head or body positions.
Recent studies suggest, however, that some of these restrictions may not be necessary, but the jury is still out on this, In the meantime, it is likely that if you find you have BPPV and seek treatment, your clinician will ask you to restrict some of your daily activities or your head positions. There is a number of other rather serious medical conditions that share some of the same symptoms and may mimic BPPV.


It will tell you about the ways in which we may use and disclose health information about you and describes your rights and our obligations regarding the use and disclosure of that information.
Our typical treatment ladder for the individual in whom medical therapy was not successful would lead to the consideration of surgery to decompress and shunt the fluid containing portion of the inner ear (endolymphatic shunt surgery). The Meniett device also exists where, after a pressure equilization tube is placed through the eardrum introduces positive pressure air through the ear drum and to the inner ear “milking” the inner ear fluid away from the areas involved in balance and hearing.
When specific muscles contract, they move the mandible (lower jaw) to allow chewing and talking. If needed, special diagnostic procedures such as joint vibration analysis, cone beam imaging, MRI, or computerized joint tracking can be used to determine the condition of the TMJ and associated muscles. Splints can be constructed in over 100 different designs and choosing the appropriate design will optimize treatment results. Only 2-3% of all TMJ disorder patients require surgery, orthodontics, or extensive restorative dental care.
However, the consequences of being acutely dizzy with such strong sensations of being out of control is what can really get you in trouble.
So, when the additional weight of the otoconia enters into these canals, it converts this velocity sensor into a gravity sensor.
There are now some theories that the reason some individuals become symptomatic with BPPV their body's biochemistry is having difficulty with calcium absorption.
Anti-motion medication such as mec1izine or Antivert may minimize the dizziness or accompanying nausea, but will not treat the problem itself. Research has not shown that one treatment is better than the other, but are decided upon by the individual clinician or therapist based on the nature of the problem, as well as any physical imitations or restrictions such as the range of motion of your neck, and any back or shoulder problems.
There are a number of excellent web sites that provide additional infonnation concerning the diagnosis and treatment of BPPV.
Positional vertigo can be caused by such other disorders as Arnold Chiari malfonnations, vascular loop, subdural hematoma, or posterior fossa cyst. Often, individuals are also prescribed a diuretic ( a water pill) to facilitate the removal of water not just from the inner ear but from the body itself.
In addition to jaw joint pain and dysfunction, difficulty with swallowing and snoring can be related to TMJ disorders. The undennost portion, referred to as the otolith system, is actually a gravity sensor, which tells our brain about the pull of gravity. While our head is erect, seated, or standing, it may not cause difficulty when we look up however, or when we lie flat with our head completely back or rolled to one side, the debris, which is now in the back balance canal (the posterior canal), causes the nerve endings to be misdirected.
This, of course, only a theory and is not intended to discourage the use of calcium, a critically important element in all organ functions, as well as necessary for our nervous system. The treatment is very simple, and may range anywhere from three to ten minutes to perform, depending upon the variation. Likewise, if a patient has cervico-spinal problems where there is compression of blood flow through the vertebral artery, it is possible that if they are not properly screened and were to hyper-extend and rotate their neck improperly, a stroke could result. This is made up of both the utricle and the saccule, an within these two structures are calcium carbonate crystals whose weight responds to the pull of gravity by resting on nerve endings that sends a signal to the brain about the force or pull of gravity.
During this instance, if our eyes are open, our vision may seem blurred or the world around us may appear to be in a spin.



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21.01.2016 admin



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