Archive | TMD and Chronic Pain

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COMT (Catechol-O-methyl transferase) role in TMD New research has shown one of the genes that increases the likelihood of development of chronic pain.  COMT (Catechol-O-methyl transferase) enzyme degrades catecholamines such as dopamine, epinephrine, and norepinephrine in our brain and there are multiple variants of this enzyme.  COMT is associated with pain responsiveness and contains some […]

Placebo effect and regression fallacy

Image of a wheaton dentist

Placebo effect and regression fallacy impacts on dental care Chemical reason some are more prone to placebo Scientists don’t know all the details but we do know that placebo treatments work for some issues (especially those that involve brain chemicals like dopamine and endorphins).  Examples of health problems that are altered by those chemicals include […]

Temporomandibular disorder TMD

Classification of TMD

Temporomandibular disorder TMD Temporomandibular disorders (TMDs) are characterized by pain in the muscles of mastication, the temporomandibular joint (TMJ), and/or the muscles associated with mastication in the head and neck.  Patients typically experience pain, limited opening, and/or clicking/popping of the TMJ joint.  This condition is much more common in females.  The severity of TMD ranges […]

NTI Information


NTI appliance NTI stands for Nociceptive Trigeminal Inhibition Tension Suppression System, which explains exactly what it does. How does the NTI work? The NTI is an FDA approved occlusal splint (nightguard) designed to reduce muscle tension headaches and migraines.  All the information one would ever be interested in can be found on their website here.  […]

Orofacial pain


Orofacial pain experts Orofacial pain experts are a newer sub-specialty that treat chronic pain patients without the dental blinders. I have great respect for those that have training through a University program as they are almost always more in line with how the medical field treats chronic pain. Orofacial pain professional organization The American Academy […]

Occlusal device night guard


Night Guard Types – Different classes of Night Guards Night guard or occlusal appliance classifications. Some are to treat or manage TMD some are simply to protect teeth wear. 1. Anterior midline stop device or anterior midline point stop (AMPS) This appliance is a small one that only contacts in the anterior.  Care needs to be […]

Jay Shah and MTrPs


MYOFASCIAL PAIN: INTEGRATING OBJECTIVE PHYSICAL FINDINGS WITH TREATMENT STRATEGIES Jay P. Shah, MD 8:00 AM–4:00 PM (Break: 10:30–10:45 AM, Lunch: 12:00–1:30 PM, Break: 2:45–3:00 PM) Chronic pain states are characterized by profound changes in neuronal excitability and architecture in the pain matrix. This workshop integrates emerging knowledge the pain sciences in a clinically accessible way. […]

Dogma in dentistry


Dental dogma There is a shift to treating TMD in terms of psychological factors and pain physiology. Occlusal role Long believed to be dominant cause now gradually being completely debunked. Information, reassurance, analgesics for pain relief, and jaw exercises will help majority of TMD patients. Placebo splint covering only hard palate is largely as effective […]