Patient safety must be an essential component of high quality oral 

It is important to look for “Red flags”. The more red flags you notice, the higher the likelihood that the provider in question isn’t really the best you could hope to find.

• Ask about the dentist’s sterilization procedures to ensure they are up to state, Osha, and ADA codes. http://www.ada.org/sections/professionalResources/pdfs/cdc_sterilization.pdf
• Does the practice have a written infection-control program to prevent or reduce the risk of disease transmission?
• Check with the Better Business Bureau (BBB) to ensure the dentist follows sound business practices and has positive references, even if he or she does not have BBB accreditation.
• Check Credentials and History- You’ll want to investigate the dentist’s credentials, such as their degree and licenses. You’ll also want to check and see if the dentist you’re looking at has ever been sued. If they have, what was it for and what is the current situation of the case? What was the verdict? You certainly don’t want someone who has been sued multiple times and especially if they were found guilty.

                         1. Look up the state medical board website for the state in which the

                             doctor practices. Enter the name and city to search for his/her license.

                          2. Check to see if there are any disciplinary or legal actions against

                               him/her. If there are, click the link to view the public documents.

                               If the documents aren’t available online, click an information link

                               to inquire about how they can be viewed.

• Ask local pharmacists or family physicians for recommendations. Dentists are in constant contact with these professions, and most can at the very least, let you which dentists to avoid.

Be wary of

• Any sign that the facility is not kept clean and sanitary. The dentist must make sure that his sterilization equipment is in good working order and that proper disinfecting sprays and/or wipes are available to clean hard surfaces after each patient. In other words, grocery store purchased Lysol spray and Clorox wipes are not allowed!
• Dentists who delegate almost everything to their assistants. There are some dentists that let assistants do more than what they are licensed to. 

Dental Assistant and Dental Hygienist 

There is a big difference between the duties of a dental assistant and a dental hygienist and job descriptions can vary from state to state, practice-to-practice, based on a dentist’s individual preferences. It is important to know the limitations of each position. In addition to the job descriptions listed there are other certifications that may obtained. You can check your specific state to see exact job functions. There are some dentists that let assistants do more than what they are licensed to. 

Dental Assistant

The term “certified dental assistant” refers to someone who has met the requirements to become board certified by the Dental Assisting National Board (DANB). This title has nationwide breadth and is recognized or required by 29 states for practicing dental assistants. Registered dental assistants are registered through state agencies, and their registration is only viable in that state. Know the limitations of dental assistants. You can check your specific state to see exact job functions. 

• Works closely with patients before, during and after procedures
• Assists the dentist during a variety of treatment procedures
• Takes and develops x-rays
• Prepares and sterilizes instruments and equipment
• Takes impressions of patients’ teeth for study casts (models of teeth)
• Teaches patients appropriate oral hygiene strategies
• Performs office management

Dental Hygienist

Dental hygienists are licensed by each state to provide dental hygiene care and patient education. Almost all states require that dental hygienists be graduates of commission-accredited dental hygiene education programs to be eligible for state licensure. And, almost all states require candidates for licensure to obtain a passing score on the National Board Dental Hygiene Examination (a comprehensive written examination) in addition to passing the state-authorized licensure examination. The state or regional examination tests candidates’ clinical dental hygiene skills as well as their knowledge of dental hygiene and related subjects. Since each state has its own specific regulations regarding their responsibilities, the range of services performed by hygienists varies from state to state. Upon receipt of their license, dental hygienists may use “R.D.H.” after their names to signify recognition by the state that they are a Registered Dental Hygienist. 

In addition to some of the same duties as dental assistants, a dental hygienist often performs the following types of tasks:

• Collecting information about the patient’s oral and medical health history
• Removing calculus, stains and plaque (hard and soft deposits) from all surfaces of the teeth
• Making molds of patients’ teeth used for evaluating treatment
• Charting patients’ dental conditions for the dentist
• Applying fluorides and decay preventatives
• Administering local anesthetics
• Removing sutures and dressings

By Lisa Foster, Reiki Master

Reiki is a Japanese stress reduction & relaxation technique that uses your own bodies energy to help to heal itself.  Reiki is a subtle, yet powerful modality that can help alleviate Stress, Pain and Balance the bodies energy.

Reiki is a simple, non-invasive technique and the energy goes to the Root Cause of the discomfort, illness and disease. The Reiki practitioner acts as a conduit for the healing energy which passes through his/her hands.  It is the patients Higher Self that draws the energy in through the practitioner and their Higher Self knows where the higher vibrational healing energy is needed.

How Reiki Healing Can Help You Release Emotional and Physical Pain
During a Reiki treatment we partake in discovering healing and balance by directly connecting with our source. This source is not some separate location or place of origin, far removed in time and space. It is that which we are in every moment, yet fail to notice because we cling to so many limited concepts about ourselves, most often not even feeling our own presence.

Sometimes defeating concepts and beliefs prevent us from appreciating our true nature. Because of their constant agitation we experience mental and physical imbalances, which inevitably manifest as degeneration and disease.

Through the use of Reiki healing, we can prevent ourselves from straying further from the source. We heal ourselves through the direct application of the source’s very own energy in the body. In this way, Reiki heals us from the depth of our own being: kindly, gently, and without undue imposition. If we permit ourselves to surrender and feel the flow of universal life force energy as it recharges our own life force, a Reiki healing treatment turns into a very comforting, nourishing, and pleasing experience. Afterwards we feel more at one with ourselves, more vibrant, and more alive.

Because the mind is contained in the entire body, illness in any one spot is an indication of a specific energetic block. For example, the experience of grief can create arthritis in the joints, and so forth. When you target concentrations of negative emotional or mental energy with universal life force energy you can help eradicate disease in the body.

To treat a mind with Reiki healing is to liberate the mind from the shackles of long-buried memories, traumatic experiences, and painful emotions. When exposed to the love and transforming power of universal life force energy, these remnants of old traumas and misunderstandings are released. We also cease clinging to them, because Reiki permeates both the clinging and the one who clings. By treating the mind in this way, we express our desire for freedom in practical terms by fully accepting things as they are. When we accept things as they are, we disregard the impulse to try and destroy the ego.

Reiki energy helps to alleviate pains and discomforts on all levels of physical, mental/emotional and spiritual levels.  Having your Chakras balanced – creates a whole body balance, when one chakra is out of balance, there is a reaction such as a “ripple effect” throughout the other chakras.  As each one are connected on all the levels.

The Throat Chakra
This chakra is our will center. The healthfulness of the fifth chakra is in relation to how honestly one expresses himself/herself. Lying violates the body and spirit . We speak our choices with our voices (throats). All choices we make in our lives have consequences on an energetic level.

Even choosing not to make a choice such as in repressing our anger (not speaking out) may manifest into laryngitis. We have all experienced that “lump in our throats” when we are at a crossroad of not knowing how to speak the right words in any given situation, perhaps even stuffing our own emotions. A challenge of the throat chakra is to express ourselves in the most truthful manner. Also to receive and assimilate information. Seek only the truth.

Chakra Five – Associations

•  Color – light blue
•  Sanskrit Name – vishuddha
•  Physical Location – throat, neck region
•  Purposes – learning to take responsibility for one’s own needs
•  Spiritual Lesson – confession, surrender personal will over to divine will, faith, truthfulness over deceit
•  Physical Dysfunctions- sore throat, mouth ulcers, scoliosis, swollen glands, thyroid dysfunctions, laryngitis, voice problems, gum or tooth problems, TMJ
•  Mental and Emotional Issues – personal expression, creativity, addiction, criticism, faith, decision making (choices), will, lack of authority
•  Information Stored Inside Throat Chakra – self-knowledge, truth, attitudes, hearing, taste, smell
•  Area of Body Governed – throat, thyroid, trachea, neck vertebrae, mouth, teeth, gums, esophagus, parathyroid, hyper/o-thalemus

Reiki promotes self-healing:

•  letting go of limiting conscious and sub-conscious thoughts and feelings,
•  creates forward movement in your life,
•  improves immunity, and is a holistic approach if you are under the care of a medical provider.
•  Note: Reiki is not a substitute for medical care.
•  stress reduction, stress-related aliments
•  depression, anxiety, living with chronic conditions
•  emotional balancing, self-esteem, mental clarity
•  pain reduction or elimination, releasing tension in the body
•  maintaining general wellness
•  sexual/physical/emotional abuse, trauma, grief
•  pre and post surgery (relaxation before surgery, reduce recovery time, and help with pain management) help 
• to reduce side effects of medications or treatments (including individuals with cancer), mental, emotional, physical, and spiritual healing

Treating TMJ with The Personal REIKI Program
A typical Reiki treatment involves the client lying on a massage table, or sitting comfortably in a chair, fully clothed within the relaxing confines of a treatment room.  On lying down on the treatment table the client may be asked to close their eyes while taking a series of slow deep breaths, focusing on the feeling of relaxation as the breath leaves the body during exhalation.

At the same time the Reiki practitioner will connect and become attuned to the clients energy by closing their own eyes, and gently resting their hands on, or slightly above the clients body.  The practitioner may then perform a series of stationery hand positions, usually starting at the head and working down the body. The hands are placed on, or just above the body, depending on the area being worked on and the comfort of the client.

Beyond Lotus Touch offers the opportunity to experience Reiki, in a very relaxing, unique atmosphere.

It is recommended that you do 4 Reiki sessions within 1 month, followed by bi-weekly to eventually monthly Reiki sessions.

The first session is generally 90 Minutes –  involves a brief consultation to answer any questions and to fill out an information form, which allows the Reiki practitioner to become familiar with what ailments the client may have. The Chakra Balancing Technique, Head to Toe, Front/Back Full body treatment – which helps the  body to become acclimated to the Reiki Energy.

The second, third and fourth session is generally 75 minutes long, again a Full Body treatment is performed along with a Chakra Balancing and the practitioner will focus on the Fifth chakra known as the Throat Chakra.  Hand positions on the locations of Ears, Throat, Jaw, Neck and Shoulders.

It is important to remember when searching for a dentist to treat your TMD that according to the NIH “there are no certifications in dentistry or any other medical field specifically to specialize in TMJ”. What that means is the title of “TMJ Specialist” is a self proclaimed title rather than one that is given because of additional training or certification. Many patients have as much success with a general dentist vs a “TMJ Specialist” This doesn’t mean there are not doctors who primarily focus on TMD, it just makes them a little more difficult to find.

Contact the closest dental school.
http://predds.net/dental-school-list/ A list of all the dental schools in the U.S.
Ask which faculty members at the dental school treat TMJ. Request a list, if possible. Also ask if they can refer you to someone near you who treats TMD

Visit the web site of the American Academy of Orofacial Pain, www.aaop.org to search for dentists that treat TMJ disorders. Find a link to the search site in References.
Select your state in the drop down box.
Review the list of dentists in your state who treat TMJ disorders, as well as their office addresses, telephone numbers, e-mail addresses and web sites. You may want to evaluate the list by focusing on dentists that are closest to you. You may also want to consider asking whether these dentists accept certain kinds of dental insurance, whether they consider alternative therapies for pain management, or if their practice focuses on a particular patient demographic, such as children, teens or adults.

American Academy of Craniofacial Pain member directory http://www.aacfp.org/directory/index.cfm

Dental Organizations
http://www.ada.org/localorganizations.aspx  List of local dental organizations by state.

http://www.ada.org/1403.aspx    List of all national dental organizations

Dentist Search Sites
http://www.healthgrades.com/  Search for dentists and doctors. The site provides information on background (sanctions, licensing, education etc) as well as patient satisfaction surveys.

http://www.leadingdentist.com/neuromuscular-dentist-search-find-tmjtmd-dentist

http://www.angieslist.com/oral-health/tmj.htm       You will need to join, however, the dentists listed are not paying to advertise. The recommendations are made by patients.

http://www.mouthhealthy.org/find-a-dentist.aspx   ADA Member directory

Ask your dentist  Often times your general dentist will be able to refer you to a dentist who treats TMD

Pain Management Specialist Search Site

http://www.practicalpainmanagement.com/locate/specialists

Free and low cost dental care list sites

http://www.freedentalcare.us/

http://www.1dental.com/free-dental/

Tips for making the decision
http://www.tmjhope.org/tmj-treatment/choosing-tmj-dentist/

• Learn all you can about TMJ Disorder,  including treatments and proper terminology. You will gain a better understanding of what I am going through.
• Be a good compassionate listener, never be dismissive or patronizing. Let me vent frustrations, I’m not mad at you, I am mad at TMJ Disorder.
• Be encouraging.  TMJ disorder is pretty greedy, and unpredictable. Sometimes just accomplishing daily tasks is a big deal.
• Be available, whether it be to go along on doctor appointments, or just a nice quiet evening at home.
• Help me learn to ask for help when I need it . Sometimes I feel isolated because I don’t want to bother anyone.
• Provide support, but don’t make me feel helpless.
• Ask questions…..I don’t mind – in fact, it lets me know that you care.
• Sometimes I just need to cry, even if it makes my eyes all puffy. Sometimes the pity pot is a nice place to sit….Don’t let me stay too long.
• I understand that you feel helpless. I do too. We can work on feeling better together.
• I know it’s hard to talk about things that are scary or unpleasant, and that there are no easy or obvious solutions,  but we need to find a way to discuss my challenges and build a team.

Your presence and support are the most meaningful gifts you can give to me.

 TMJ Healing Plan

Drawing on >20 years as a physical therapist, training in head, neck and jaw pain, and work with dental and medical experts, Cynthia Peterson explains a 10-step process that addresses the root causes and contributing factors of TMJ disorders. Her simple practices and exercises allow you to replace hurtful habits with the healthy ones necessary for long-term relief. You learn to

• Lighten the load on your jaw
• Correct your posture as you stand, sit, and sleep
• Breathe and swallow properly
• Soothe head and neck pain
• Reduce stress and exercise with ease
• Save money by avoiding or reducing costly treatment
• More than 50 photos and illustrations 
• Examples
• Information on getting medical care and choosing specialists
• Helpful for everyone with a head, neck and jaw.  
• More reviews and helpful resources tmjhealingplan.com

Trigger point therapy is one of the most intriguing and fastest-growing bodywork styles in the world. Medical doctors, chiropractors, physical therapists, and massage therapists are all beginning to use this technique to relieve formerly undiagnosable muscle and joint pain—conditions that studies have shown to be the cause of nearly 25 percent of all doctor visits. The technique involves applying short, repeated massage strokes to trigger points, tiny contraction knots in muscle tissue where restricted circulation and lack of oxygen cause referred pain. Trigger points create pain throughout the body in predictable patterns characteristic to each muscle, producing discomfort ranging from mild to severe. Trigger point massage increases circulation and oxygenation in the area and often produces instant relief.

Nutritionist Daniella Chace, coauthor of Smoothies for Life, is back with 150 smoothie recipes designed to cure common ailments, increase longevity, and satisfy cravings with fat-burning snacks. Learn how to save money and time by making Starbucks- and Jamba Juice–worthy drinks right in your own kitchen, using the healthiest ingredients on the planet! There’s no easier, more decadent way to provide all the nutrients your body needs. With More Smoothies for Life, you can whip up:• smoothies that enhance weight loss, increase metabolic rate, and control appetite
•heart-healthy smoothies rich in antioxidants from blueberries, walnuts, green tea, avocados,
pomegranates, and more 
•elixirs that heighten mental clarity, improve memory, and support rejuvenating sleep 
•quick-and-easy remedies for hangovers, insomnia, and stress 
•homemade energy drinks that work and taste like Red Bull, minus the sugar and the price tag.

Translating complex food science into easy-to-understand advice, Chace thoroughly explains the scientific basis for each medicinally active ingredient so you know you’re getting the most out of your daily shake. Your blender will never be put to better use!

Sick and Tired of Feeling Sick and Tired

Unlike a leg in a cast, invisible chronic illness (ICI) has no observable symptoms.

Consequently, people who suffer from chronic fatigue, chronic pain, and many other miseries often endure not only the ailment but dismissive and negative reactions from others. Since its first publication, Sick and Tired of Feeling Sick and Tired has offered hope and coping strategies to thousands of people who suffer from ICI. Paul Donoghue and Mary Siegel teach their readers how to rethink how they themselves view their illness and how to communicate with loved ones and doctors in a way that meets their needs. The authors’ understanding makes readers feel they have been heard for the first time. For this edition, the authors include a new introduction drawing on the experiences of the many people who have responded to the book and to their lectures and television appearances. They expand the definition of ICI to include other ailments such as depression, addiction, and obsessive-compulsive disorders. They bring the resource material, including Web sites, up to the present, and they offer fresh insights on four topics that often emerge: guilt, how ICI affects the family, meaningfulness, and defining acceptance.

Understanding Chronic Pain: A Doctor Talks to His Patients

This is a personal narrative, a record of my passage among victims of chronic pain and the discoveries that have come from those encounters. I write for physicians, nurses, therapists, and caregivers, but mostly, I write for you who suffer the disease. I know you very well, perhaps as well as anybody in the world. I have listened to your stories with patience and attention, and I have been greatly rewarded. You have trusted me with the deep recesses of your thoughts and fears, and the memories of the dreadful experiences that are so often the origin of chronic pain. I have treated thousands of you and I believe I have some understanding of your illness. I offer a series of essays about people like you who suffer chronic pain. From their case histories, I derive certain conclusions. Some conclusions are bold and imaginative. Some are disturbing and frightful. Not all of them will apply to you, but some certainly will. My wish is that you gain greater understanding of you.

HEALTHMINDER Personal Wellness Journal

The HEALTHMINDER Personal Wellness Journal has been published for the past 16 years under the title MEMORYMINDER Personal Health Journal. HealthMinder is simply a new, more descriptive title for this excellent, checklist-style health diary. For conditions or concerns of virtually any kind, the HealthMinder is an easy way to keep track of everything including medications, vitamins, vital signs, pain and other symptoms, sleep habits, daily exercise, meals, and much more. Even the weather and pollen counts can be logged. As part of the easy-to-use daily format, two human body outlines make it simple to mark areas of pain, rashes, etc. Each day consists of a 2-page spread and the spiral binding makes it convenient for writing. Records will be more organized and accurate; patterns may be discovered, progress can be observed. The pages are not pre-dated so it can be used every day or whenever needed. Doctors, patients, health enthusiasts, caregivers, students, and others rave about the HealthMinder. This journal can, indeed, be a lifesaver!

 

Do you have any books to add to our list?

TMJ Hope Blog Posts

TMJ Disorder Timeline

http://www.tmjhope.org/tmj-disorder-timeline/ 

The Trigeminal Nerve Explained

http://www.tmjhope.org/the-trigeminal-nerve/

MRI VS CT Scan, a Comparison

http://www.tmjhope.org/mri-vs-ct-scan/

Science and Research

Stem Cells and Bio Engineering
http://news.columbia.edu/record/1729

Gender Bias In Pain Management
http://www.tmjhope.org/gender-bias-pain-management/

OPPERA Study ll
http://www.dentistry.unc.edu/news/2012/2012-09-18_RCND.cfm

Nutrition

30 Days of Smoothies
http://www.tmjhope.org/smoothie-recipes/

75 Healthiest Foods For Women
http://www.tmjhope.org/76-healthiest-foods-for-women/

Why I Choose Juicing For My TMJ Disorder
http://www.tmjhope.org/why-i-chose-juicing-for-my-tmj-disorder/

Dining Out with TMJ Disorder

http://www.tmjhope.org/dining-out-with-tmd/

Members Who Give Us Hope..We Thank You…..

Stacy (our founder)
For being the light at the end of the tunnel
http://www.tmjhope.org/stepping-down-give-you-hope/

Cathy
For taking the time to reach out and personally help another member. We salute you!

Lorelei
For living with the glass half full! For helping to teach us how to advocate for ourselves in order to become successful patients.

Pete
For sharing your great success story with us.
http://www.tmjhope.org/tmj-arthroplasty-success-story/

Blogs That Make A Difference

Rob’s Blog
http://loudstuffs.wordpress.com/

Goalistics
http://goalistics.com/

Happy Rambles
http://happyrambles.com/

For those who support us through our journey may they be husband, wife, mother, father, sister, brother or friend we say this:

Thanks to those who love me,

you make my heart go fonder.

Thanks to those who care,

you make me feel important.

Thanks to those who entered my life,

you make me who I am today.

Thanks to those who left,

you showed me that nothing lasts forever.

Thanks to those who stay,

you show me the true meaning of friendship.

Thanks to those who listen,

you make me feel like I am worth it.

It has been an absolute pleasure getting to know all of you over the past year. Thank you so much for sharing your stories and lives with us. and thank you for your support in 2012… Here’s to a happy, healthy, hopeful 2013!

We’ve put together a list of our favorite TMJ friendly items that we would love to find under the tree on Christmas morning!

Things to help TMD patients on the move:

Stainless 16  ounce  thermos perfect for soup or smoothies on the go.

Stainless Steel smoothie spoon straws  (I have a set of these and LOVE them, I never worry about them breaking and I boil them to make sure they are sterilized)

Blender Bottle  (love the wisk idea)

Tribest Personal Blender  (great for in the office)

Things to help us relax at home

Renu Therapy neck and shoulder heat wrap (I use mine every day)

Microwavable moist heat therapy  (this would be perfect after those long drives over the river and through the woods!)

Backnobber ll (for those hard to reach trigger points)

Face Caddy (heat or cold wrap. Leaves your hands free to wrap all those presents!)

In the kitchen:

Breville Juicer

Champion Juicer

Cuisinart Mini Prep  (great for chopping nuts to add to smoothies or mincing meat up, the size is very small and works for small portions)

Vitamix 1780 Turbo Blend (the mac daddy of blenders!)

This is an overview of treatment options that have helped some of our members.  Please remember that what works for one patient might not work for another. Sometimes it takes trial and error before finding what works best for you.

Chiropractor- Chiropractors usually specialize in treating problems that affect the alignment of the muscles and bones of the body. Many chiropractors take a holistic approach to promoting wellness through exercise, nutrition, and lifestyle changes. Most believe that medicines and surgery should be treatments of last resort for many healthcare conditions. Some chiropractors receive extra training in physical rehabilitation and specific exercise therapy. They can be trained in, and recommend the use of nutritional analysis, herbal therapy, and acupuncture.  Chiropractors must pass an exam to get licensed to practice. Other types of treatment that may be included or recommended in your treatment plan could be using heat or ice, ultrasound, strengthening exercises, biofeedback, or relaxation therapy. Some Chiropractic offices employ massage therapists as part of their holistic approach to helping the entire body. Some also chiropractors use X-rays to diagnose conditions.

Types of Chiropractors:

• Atlas Orthogonist Chiropractor-Uses a light force method to adjust the first cervical vertebrae with a gentle percussion instrument to correct spinal misalignments and therefore remove nerve interference. http://www.atlasorthogonalchiro.com/FAQ.aspx

• NUCCA Chiropractor-A small subgroup of chiropractors certified in National Upper Cervical Chiropractic (NUCCA) techniques. The procedure employs precise measurements to determine a patient’s Atlas vertebra alignment The focus of the NUCCA work is on a small misalignment of the bone structure that connects the head and neck.

Postural Restoration Therapy- Postural Restoration is based on the concept of eliminating unwanted muscle tension as it develops in the body. This muscle tension may be a result of many things, including but not limited to: trauma, habitual movement patterns, respiratory patterns, right or left handed patterns, as a response to pain, and as a result of stress. Some physical therapy offices employ Postural Restoration therapists in their office.  http://posturalrestoration.com/about/

Acupuncture- Acupuncture is the insertion of very thin needles through your skin at key points on your body. Acupuncture is most commonly used to treat pain. It is a key component in traditional Chinese medicine. Acupuncture patients say their chronic pain episodes become less frequent and less intense over time, with regular, long-term sessions.
Here is a recent study that was published about  acupuncture-http://archinte.jamanetwork.com/article.aspx?articleid=1357513
http://healthland.time.com/2012/09/11/acupuncture-may-help-reduce-chronic-pain-after-all/

Myofascial Massage Therapy- A  form of soft tissue therapy focusing on releasing muscles that  are tightened/ shortened and can cause pain and restriction of motion.
Patient symptoms can  include:

• Tightness of the tissues that restricts motion or pulls the body out of alignment, causing   individuals  to favor and overuse one hip or shoulder, for example.
• A sense of excessive pressure on muscles or joints that produces pain
• Pain in any part or parts of the body, including headache or back pain.

A therapy session usually lasts about 30-50mins. A lot of times therapist will also help to teach you how to do some of these stretches/exercises at home.  I personally have done this therapy and it has helped a great deal with my pain.
http://www.myofascialtherapy.org/
http://www.tmjpainsolutions.com/the-myofree-solution/the-myofree-solution-why-it-works/

Trigger Point Therapy-A trigger point is an extremely sensitive spot that is painful, sometimes you don’t know it’s painful until you or a therapist touch it. It is called a trigger point because it “triggers” a painful response.
A  trigger point is more than a tender spot in the muscle. It affects not only the muscle where the trigger point is located, but also causes “referred pain” in the surrounding tissue and even nerves.
Trigger points are hyper-contracted bands of muscles that when touched will have a  referred pain pattern. The trigger point is the most tender point in the band. The therapist will locate and deactivate the muscle using finger pressure
Trigger point therapy is used to treat painful trigger points that cause referred pain. Most treatment will take more than one session because the muscles did not become like this in one day so it will take time to undo this. If associated with a chronic problem you could need maintenance therapy.
We have heard from many patients who have used this book and enjoyed it.  http://www.triggerpointbook.com/

Technology tools that might help as well

• Chronic pain tracker- this tool could really help you track your pain and get your doctors to understand the bigger picture. https://itunes.apple.com/us/app/pain-tracker-plus/id578067399?ls=1&mt=8
• Calming apps     http://www.withandrewjohnson.com/

This is just an overview of the treatments we have heard about from TMD patients. We encourage you to do some research, and talk with your doctors to see if these options might work for you.  
Do you have any Recommendations?

Thank you Pete for allowing us to share your forum post.

It’s now almost 2 years to the day that I had my left arthroplasty with discectomy, debridement of joint surfaces and dermis-fat graft. Before I go on, I wonder what your procedure actually is? You have used the term ‘temporalis fat graft’ which piques my interest. Perhaps I’m a bit of a stickler for accuracy, but generally a temporalis graft is a muscle graft in which a flap of temporalis muscle is cut – if you can imagine cutting three sides of a rectangle and the fourth being the bottom left intact to form a hinge, it is folded downwards and tucked into the TMJ to form a new disc. Some surgeons suture the temporalis flap to the back of the condyle and to the lateral pterygoid muscle to emulate the original structure according to its original design. Fat grafting by contrast typically involves a slug of dermis fat being excised – usually from the lower belly region – and it is then packed into the TMJ space after the discectomy and cleaning up is performed. Normally the fat graft is not attached at all. So, two different approaches, two different procedures, both to treat the same problem. I have not had a temporalis muscle graft so I cannot speak from experience about it. I have had a dermis fat graft. The dermis fat graft involves two surgery sites – one being the TMJ and the other being the fat harvest site. Some surgeons shy away from this a bit as it does increase the risk factors for infection and so forth. Personally, I had no issues whatsoever and a very small amount of discomfort post op. With the temporalis graft, there is one surgery site, but it is invariably larger than the fat graft requires due to requiring access to the temporalis muscle. That is also not without risk. It would pay to discuss these things with your surgeon. For me, two years out I eat normally without discomfort, I can yawn, sneeze and cough occasionally without too much drama. Functionally, I am about 80%. Pain-wise, I still get some and it is variable which is a blessing. My right side is more painful than the left. It took fully 12 months post-op for the joint to really settle down and in that time I experienced the full gamut of symptoms. My doctor told me to expect this. It happened and it went away eventually. The surgery is not an instant fix. It does not restore a damaged joint to 100%. If you have a realistic expectation, chances are you won’t be disappointed. I have my life back to a large extent and am thankful. Please let me know if you have any questions. I will do my best to answer and help where I can.

Kind regards
Pete

We hear a lot from tmd patients who have problems with grinding and clenching.

Bruxism  is a condition in which you grind, gnash or clench your teeth. If you  have bruxism, you may unconsciously clench your teeth together during the day or grind/clench them at night. If you do this at night it’s called sleep bruxism. Right now the medical community doesn’t know what causes grinding and clenching but there are things we can do to help mitigate it or lessen it.

Top tips for daytime clenching/grinding

• Set a timer for every 3 minutes and check to make sure you are not clenching or grinding your teeth together, once you found yourself not doing it you can slowly increase the length of time.
• Wear a guard if you are going to be doing stressful work
• Yoga
• Limit your caffeine intake
• Don’t chew gum!
  
• Consider checking out some great apps to help with your stress level and to try and be conscious of clenching/grinding

                       http://www.tonguechi.com/
                       http://www.withandrewjohnson.com/

Top tips for Grinding/Clenching at night

• Shut off all media 1hr before bedtime, the goal is a calm environment
• Deep breathing exercises or even a simple yoga routine
• Supplements like magnesium, they have a relaxing effect.  If you are taking medications though please check with your doctor. Always check with your doctor before adding supplements or other medications.
  
• Limit your caffeine intake or eliminate it all together
• Biofeedback. There are devices that can be worn during sleep that measure the amount of grinding and clenching that you do, and interrupt it with a sound. Over time you learn not to grind or clench. One such device is SleepGuard. It is a biofeedback headband that also tracks how many times you clench during the night.

Another device is GrindCare. GrindCare works by registering muscle activity and sending a mild electrical impulse that interrupts the teeth grinding. The uncomplicated GrindCare device comes with a lightweight electrode you place on your temple when you go to bed at night. It does its work while you sleep  without you even noticing it. GrindCare measures precisely how much you grind your teeth, and can then reduce the grinding while you sleep.  This system can be rented from a dentist before you buy. 

If conservative methods are not working then consider talking with your doctor about ordering a sleep lab test to check for/rule out other sleep problems.  Sleep apnea may also be related to sleep bruxism, and some doctors suggest that treating sleep apnea can help alleviate sleep bruxism.
If none of  these other options are working then please talk with your doctor about the option of medication, I know it’s not the first choice but sometimes it can be helpful if nothing else has worked. I’ve also heard that sometimes medication can be used to break the night time clenching/grinding cycle and then later you can wean off the meds. Again, discuss this with your doctor.