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Author: admin, 03.11.2014
The temporomandibular joint (TMJ) is the area right in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. The temporomandibular joints are very complex and are made up of muscles, tendons, a disc and bones.You have a temperomandibular joint on each side of your jaw (right and left side). Micro trauma is considered internal, such as grinding the teeth (bruxism) and clenching (jaw tightening). TMJ pain can usually occur because of unbalanced activity, spasm, or overuse of the jaw muscles. Most patients are quite successful with conventional conservative therapy (such as resting the jaw or night guard). We are a full service dental practice that specializes in relaxation and cosmetic dentistry services, dental implants, TMJ disorder treatment, periodontal disease treatment, teeth whitening, porcelain crowns and porcelain veneers, and other restorative dental care. The following is an abbreviated list taken from Ototoxic Medications:  Drugs that can cause Hearing Loss and Tinnitus, as published by the League for the Hard of Hearing. While there is no 100% cure for tinnitus, it is possible to alleviate annoying tinnitus symptoms by making modifications in your diet and lifestyle. When listening to music, keep the volume down to a safe decibel, in order to avoid noise-induced tinnitus. Ask your doctor if you can take natural supplements for tinnitus, containing Ginkgo biloba, Black Cohosh, zinc, and B vitamins.
Headache along the side of the head with a feeling of sensitivity in the upper teeth.  There are 3 or 4 patterns that come off the trigger points in the temporalis.
Enter your email address to subscribe to this blog and receive notifications of new posts by email. While an estimated 43% of adults over the age of 65 have hearing loss, roughly only 25% wear hearing aids. Complete hearing tests for children from age four to adults of any age provided by licensed clinical audiologists who hold the Doctor of Audiology degree.
The practice of audiology requires that ear canals be unobstructed from occluding debris, including cerumen, or earwax. Because speech understanding in noise cannot be reliably predicted from the audiogram, this test may be administered to help understand the unique difficulties some patients encounter when trying to understand speech imbedded in noise. The Acceptable Noise Level Test is used to predict whether a person will be a successful hearing aid user by finding out how well they tolerate noise and speech when presented together. A common condition among millions of Americans who perceive a sound within the ear or head in the absence of a corresponding sound in the environment. A wide variety of hearing instruments featuring the latest technology is offered at Audiology of Nassau.
We are sensitive to your concerns and financial constraints and we emphasize the limitations and explore your expectations prior to recommending any particular device. Amplification decisions also include an analysis of your daily activities and communication requirements. Additional services include a minimum of four follow-up visits within the first forty five day trial period to ensure a reasonable and acceptable adjustment to the fit and sound of the devices.
Soundfield testing of the devices provide objective measures to ensure audibility and acceptable, individual speech clarity in quiet. These are test procedures also used to validate acceptable hearing performance measured at the level of the eardrum using Real Ear protocol. Verification using speech mapping is a procedure that uses a probe microphone and live speech to see and understand the benefits of a recommended device. At Audiology of Nassau we take pride in offering counseling and aural rehabilitation that maximizes our patients’adjustment and appreciation of hearing enhancement. We recommend routine cleaning and maintenance after your hearing aid is dispensed to ensure you receive optimum performance and benefit from your hearing aids. In some cases, hearing aids are not the single answer to address all communication difficulties. Today’s modern hearing aids use wireless technology to connect your  new devices to the television,  mobile phone, computer,  Ipads or Ipods. All patients can be reassured that they will be referred for appropriate medical followup in the event that their audiometric results call for otology intervention, or for the removal of impacted cerumen, for removal of a foreign body, when fluid is detected in the ear, for complaints of tinnitus and dizziness. Muscles attached to and surrounding the jaw joint control the position and movement of the jaw. Patients may complain that it is difficult to find a  comfortable bite or that the way their teeth fit together has changed.  Chewing on only one side of the jaw can lead to or be a result of TMJ  problems. This continuous pounding on the temporomandibular joint can change the alignment of the teeth. This trauma can fracture the jawbone, cause dislocation of the TMJ, or cause damage to the cartilage disc of the joint. It is very common for people under stress to release this nervous energy by either consciously or unconsciously grinding  and clenching their teeth. About 80% of patients with a TMJ disorder complain of headache and about 40% report facial pain, and ear pain.
About one half of patients with a TMJ disorder notice ear pain and do not have any signs of ear infection.


Grinding, crunching, clicking, or popping sounds (medical term = crepitus) are common for patients with a TMJ disorder. If your symptoms persist, your doctor may recommend medications or a night guard to help keep you from grinding your teeth at night.
Dentist or doctor will recommend over the counter medications (like Aleve or Motrin), or prescription medications such as Dolobid are a first option to relieve pain.
Antidepressants prescribed to be taken at bedtime have been successful in relieving TMJ pain in some patients. These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders.
Injecting botulinum toxin (example Botox) into the jaw muscles may give relief to pain associated with TMJ disorders.
For patients who grind their teeth patients may gain from wearing a  firm custom made appliance.
For patients whose main symptom is from stress or anxiety they may benefit from a visit to a psychotherapist. The success of treatment depends on how severe the symptoms are and how well you comply with treatment. Marielaina Perrone's advanced training and years of experience translate into greater confidence and convenience for your entire family.
Each one has a band of pain that extends upward and associated sensitivity in the upper teeth. Most of the time, this pattern occurs a feeling of infection and sensitivity in the lower molars and bicuspids.
It is intended to help one to understand how tooth pain is generated by trigger points and how to relieve tooth pain by releasing trigger points.
Many are in denial about their hearing loss, often because it is a gradual process and are truly unaware that there is a problem. Anyone getting into a car and turning on the ignition has a tremendous responsibility; the life of the driver, passengers, pedestrians and other motorists is in many senses in a heighten state of vulnerability.
But drivers with hearing loss needn’t necessarily hang up their keys, instead they should seek help. Hearing impairments affects older people’s ability to drive in the presence of distracters. Evaluations include measurements of hearing sensitivity for air and bone conducted sounds, measurements of word recognition ability, and assessment of the middle ear functions. It can help distinguish between the sensory and neural components of “nerve loss” hearing because of its sensitivity to cochlear function. The test is used to compare each individuals speech in noise abilities compared to normal listeners. An area of the cochlea with complete loss of function of inner hair cells is known as a 'dead region'. Our best choice for amplification is only as effective as the quality and consistency of the follow-up and counseling sessions that we provide as an included service with your newly dispensed device. There are many other devices available to help you in your most difficult listening environments. Remote microphones offered by some manufacturers can help reduce the difficulty of hearing speech in noise. When the muscles are relaxed and in balance and both jaw joints open and close comfortably, we are able to talk, chew, or yawn without discomfort or pain. A problem with either one can lead to stiffness, headaches, ear pain, bite problems ( also called a malocclusion), clicking sounds, or locked jaws. Teeth grinding as a habit can result in muscle spasm and inflammatory reactions, thus causing the initial pain. Pain in the TMJ can also occur following dental treatment whereby the joint is stretched open for extended periods of time. 50% of those patients will have resolution of their tinnitus after successful treatment of their TMJ disorder. Your dentist will conduct a careful patient history, dental examination, and take necessary x-rays to determine the cause of your symptoms. This night guard prevents your teeth from coming together in contact, and repositions teeth to decompress the jaw joint. This would allow the patient to become self aware of stress triggers as well learning relaxation techniques to relieve stress.
As always, it is best to maintain regular appointments to see your dentist and let them know if there any TMJ issues developing. You’ll find complete dental expertise, utilizing the latest advancements in dentistry, all here under one roof. Like the bands of pain, the trigger points in the front create sensitivity in the front teeth and the trigger points in the back create sensitivity in the back teeth. People complain about their headache as they trace their eyebrow with their fingers. They consistently complain about the tension in the jaw when the trigger point is pressed but seldom report the achy jaw unless asked. Others are concerned that admitting to a hearing loss or assisting it with amplification will make them look “old.” Although, untreated hearing loss has been known to lead to social isolation and depression and recent studies have correlated a decrease in auditory stimulation to dementia, untreated hearing loss poses safety issues as well, especially for drivers.


Careful driving requires engagement of visual and auditory senses to make informed often, very quick decisions to navigate safely. If you suspect you or a loved one has a hearing loss, see an audiologist for an audiologic evaluation.  If you have a diagnosed hearing loss, see your audiologist annually to monitor for changes.
It useful for differential diagnosis, monitoring of progressive loss due to ototoxicity and consistent exposure to loud music or noise, and for testing uncooperative patients or individuals with developmental disabilities  or very small children. Dead regions can be identified by measuring detection thresholds for pure tones in quiet and in threshold-equalizing noise (TEN). These devices include television listening systems, special doorbells, alarm clocks, fire alarms, captel telephone systems. The temporomandibular joint functions to move the jaw, especially in biting and chewing, talking, and yawning.
We can also feel the joint motion if we put a little finger against the inside front part of the ear canal. Changes in the normal stimuli or height of the teeth, misalignment of the teeth, and changes in the chewing muscles may cause temporomandibular joint changes. Teeth grinding and clenching are habits that may be diagnosed in people who complain of pain in the temporomandibular joint or have facial pain that includes the muscles involved in chewing. Massage and heat application following your dental appointment can help relive the discomfort. These symptoms are usually caused by Eustachian-tube dysfunction (structure responsible for the regulation of pressure in the middle ear). Conventional treatment consists of a diet of soft foods along with warm compresses to settle down the tension of the muscles. People complain of a headache as they trace their hands up and down the side of their head. Temporalis is always working to support the jaw while we are awake, so this headache is often constant and really bothersome. This referral, like its counter part in the upper belly of the masseter, creates that yucky toothache feeling that  where it feels like it is infected into the root of the tooth. Even when the pain is generated by trigger points, the chemical irritants in the referral pattern impact the tooth and gums adversely and your teeth should be checked by a dentist.
They usually associate it with a tooth problem and something that dentist should address instead of the massage therapist. If a patient is experiencing TMJ difficulty the simple act of opening and closing your mouth can cause considerable pain. Opening your mouth allows the rounded ends of the lower jaw (condyles) to glide along the joint socket of the temporal bone. These can include arthritis, trauma to the jaw, or muscle fatigue from clenching or grinding your teeth. Ear specialists are routinely called on to make the definitive diagnosis of a TMJ disorder. It is believed that patients with TMJ syndromes have hyperactivity (muscle spasms) of the muscles responsible for regulating the opening and closing of the Eustachian tube. The trigger points are in the superficial masseter in middle of the muscle belly making the whole area sore.
People usually complain about an earache and some jaw tension. Sometimes they complain about a roaring in the ear or some other form of tinnitus. We practice infection control and ensure proper cleaning and disinfection or sterilization of patient-care equipment and environmental surfaces and we wear protective gloves.
TMJ disorders most commonly occur in women between the ages of 30 and 50, but can occur in teens after braces, and in both men and women at any age.
I have a particularly big head and would get these when trying on motorcycle helmets when I was younger. People come in complaining of a tooth ache and infection in their lower molars teeth that seems to extend up into the roots. At times, when the trigger point is most severe, there is sharp pain deep in the ear with a sickly ache in the jaw. This pattern occurs as mostly a feeling of infection and sensitivity in the upper premolars and first molar. The darker areas are darker because of how often they are a part of the pattern not because of the intensity of the referral. Usually clients don’t complain to their massage therapist about this kind of earache and jaw pain.
This is why the therapist may ask about other sensations that you have, even though the pain is less bothersome in those areas. Like many of the trigger points in the TMJ musculature, this one is activated by uneven chewing or chewing on things like toothpicks and popcorn kernels. Unless they know that trigger points cause earaches and that their massage therapist can help with that, they only complain about this as an incidental comment.




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