Mike Wiegenstein: You are watching a special edition of Medical News Network; your trusted source for the latest in Medical News and Information. I am Mike Wiegenstein and thanks for joining us.
On this show we take a very special look at TMJ or TMD, the dysfunction of jaw joint and sleeping disorders, including sleep apnea that adversely affect the quality of life for millions of people with one of the leading providers of cutting-edge treatment available. So if you have headaches, neck, or shoulder pain, jaw pain, snore, toss and turn in night, are fatigued, maybe know someone who is, then stick around you are about to hear some your life-changing information. We'll be right back.
Female Speaker: Welcome to an educational and comprehensive discussion with today's top medical experts. Your trusted source for the latest medical news and information. You are watching Medical News Network.
Mike Wiegenstein: Welcome back. We are very pleased to have in studio Dr. Roy Jolley. Dr. Jolley is a fellow of the American Academy of Craniofacial Pain, a small and selected group of dental professionals specializing in the treatment of TMJ and sleep disorders, and is considered by most to be one of the most premier comprehensive care providers available today. Dr. Jolley's general dentistry practice in Little Rock is recognized by patients and peers alike as a cutting-edge treatment and care facility for the cure of TMJ and sleep disorder problems. Dr. Jolley, welcome to the show.
Dr. Roy Jolley: Thank you Mike. It's a privilege to be here. Thank you for having me on the show.
Mike Wiegenstein: I came out now. I did a little background as I do with everybody I came out to your practice before having you on, and I can't help but notice that your practice is more of a spa like setting. It's almost like being in a tree house. We are going to go through some picture, but tell me a little bit about the development of your practice.
Dr. Roy Jolley: Well, Mike the number one reason people don't come to a dental office is fear. So we have tried to create in our office a fearless type of environment and as you say it a spa type environment, that's exactly what we've tried to create. Now you'll see this is a picture of my office, it's in the woods, sits back in a natural setting. There is a inside, this is our reception area, it's clean, crisp, when you walk in it doesn't smell like a dental office, it's smells aroma therapy, smells like more of a massage spa than it does dental.
Mike Wiegenstein: Well, your waiting room had the plants. Again, the big windows those were open. This is just down the hall way.
Dr. Roy Jolley: A shot down the hall.
Mike Wiegenstein: Again, much more of spa like feeling. I took this picture. This is what I call behind the office. When you go into the back office, normally you see the charts and the clutter and like. It's very clean, but if we look in the operatory you kind of see a little bit of foliage through the window there. I took this next picture because every operatory you have has a window just like this. The whole wall is glass and looking out in the beautiful greenery, all of them. Normal dentist office you have the wall and you have normally some venetian blinds lines with a little dust on.
Dr. Roy Jolley: Well, this is no accident. Our office was designed to create a warm environment again addressing the fear issue trying to create a really unique experience when you come to my dental office.
Mike Wiegenstein: Speaking of unique, who are these Catholic characters?
Dr. Roy Jolley: This is my staff who I might say is the best staff in the world. I could not practice the type of dentistry I practiced without this professional staff. Every one of them is just topnotch excellent clinician.
Mike Wiegenstein: Okay. Let's get into what is TMJ or TMD? How do you treat it and how does your treatment differ? First of all, give me a little explanation using the photos about what is it actually.
Dr. Roy Jolley: Well, the TMJ joint is the jaw joint. This is mandibles and these are the condyles. Are you with me? This is the condyle. Here is a picture of a condyle with the disc on top, a blue disc, that's a normal relationship. Behind the disc you see these normal tight ligaments that control the disc as the jaw opens and closes as the red muscle pulls the jaw forward and the disc forward, ligaments pull the disc back.
Now if you'll go to the next slide, you will see here is an example of a patient who is either grinding their teeth, a whiplash injury possible bicuspid extraction where the condyle now is up and back. So the disc is pushed forward. Notice that the disc is now red indicating inflammation. Those normal ligaments are now stretched. Go back to the first picture, Mike.
Mike Wiegenstein: Okay.
Dr. Roy Jolley: Now as you feel notice a normal tight look -- at the difference in these ligaments and go over the second slide and see how these are stretched. Now when the jaw opens, it pops on to the disc and then when it closes it pops off the disc and presses on these ligaments which also is the same area where there is nerves and blood vessels.
Mike Wiegenstein: Then overtime does that just continue to get worse?
Dr. Roy Jolley: Yes, if you don't hear any thing else outside. In fact, we are about to see a movie about this, Temporomandibular disease is always progressive. If you have a clicking joint, that joint in time given enough time will break down. So if you can --
Mike Wiegenstein: Let's go to look that thing. I want to talk to you though -- you made a comment to me about TMD or TMJ being the great impostor.
Dr. Roy Jolley: Right, impostor.
Mike Wiegenstein: Meaning most people would think you would feel the pain here in your jaw joint, but the pain is felt throughout the body.
Dr. Roy Jolley: The most common symptom of temporomandibular disease is headache. Now you would think if I have a jaw joint problem the primary point of pain would be in the joint, but that's not true in the TMJ. Headache is the number one symptom, chronic neck pain, and shoulder pain is a second most common symptom. The third most common symptom is popping, clicking, or pain in the joint and then you get a ringing in the ears, a stiffness, and loss of hearing, a dizziness, kind of vertigo feeling.
Mike Wiegenstein: All from a jaw joint?
Dr. Roy Jolley: All because the condyle is sitting right in front of ear canal so you have ear symptom, but it's important to know that if you are -- are we looking at this picture?
Mike Wiegenstein: Yes we are going to this --
Dr. Roy Jolley: Behind this yellow area that you see, it looks like a fat pad, but what actually is, they are nerves and blood vessels, some of the major arteries and veins of the body; the Jugular vein, the carotid artery, the trigeminal nerve, the auriculotemporal.
Mike Wiegenstein: All run through there?
Dr. Roy Jolley: They all run right through this. So when this condyle backs up, it presses on those nerves and that produces the symptoms throughout the body. For example, if you hurt your neck and your fingers get numb, a good example you pinch the nerve here, but the pain is in the finger. Same pain in TMJ joint; if you press these nerves, you can have symptoms almost anywhere in the body. And that's the reason it's called the great impostor.
Mike Wiegenstein: So you can feel it anywhere.
Dr. Roy Jolley: Exactly right.
Mike Wiegenstein: This is -- now we are going to go get into that, because I interviewed a lot of your patients and most of them had seen a multitude of other doctors before getting to you. So this is what a properly set joint would look like?
Dr. Roy Jolley: Right, the orange is the disc the yellow all the nerves and the blood vessels. This first line is the condyle and the second line is the fossa. Now if you show normal opening, as the condyle slides forward, it rides on the orange disc that's perfectly normal. Then you start grinding your teeth or have some trauma. The disc moves forward still within normal limits and then this gets a little bit worse, the disc continues to move forward. Now you've notice we have created a pop. There is a pop in the joint as you open and a pop when you close. And if you continue, it gets a little bit worse. Can you make that go forward?
Mike Wiegenstein: Yeah, right here. I almost burred here. Oops! Sorry about that doc.
Dr. Roy Jolley: Well, you are all the way forward now. Now when the patient tries to open, they have a restricted opening and many patients out there watching this will say my mouth doesn't open fully anymore, and they are and stage three of temporomandibular disease.
Mike Wiegenstein: What happens after stage three?
Dr. Roy Jolley: Well, what we don't want to happen is for this condyle to perforate the disc and now we are bone on bone which is osteoarthritis.
Mike Wiegenstein: And in most cases as you said the bone has a tendency to rest on the backbone compressing all those veins and nerves, which is why we feel it throughout our body.
Dr. Roy Jolley: Right.
Mike Wiegenstein: When I came to your office, and we are running out time, we have to take a break, but I have an interview I want you to look at. They ask you about age of the patients and you had a patient there I think she is 86 or 87, let's take a look her interview.
Kay VauTrain: I visited him for the wisdom tooth and here I am 86 year old, a year last October and it started popping, my bones popped on my right side. He decided finally -- I had headaches, earaches, backaches, and he finally decided to put another tooth back in that hole, and he left the tooth that was an next to it and pulled the one tooth on the other side to put a permanent bridge in. And when that all got in and my popping got worse, my headache has got worse, my neck hurt, had the earache and this is just bad a friend of mine --
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