Open UP: A TMJ Discussion Dr. Pamela Marzban and Dr. Mac Lee

Important Links:

Podcast Video on Youtube: https://youtu.be/brhhTTjLTVk?si=MQiWp1Jz4v37q4Ca
 
Website TMD Link: https://marzbandds.com/tmj/   
 
Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0   
 
Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1

In this Episode:

- Once again, Pam and Mac shared stories of how inadequate their dental school training was when it came to TMD and its appliances. 
- Pam was told about the “nightguard” but that’s all.  She never made one with an instructor to guide her.  It wasn’t until in private practice that she made them for those with badly worn teeth. 
- Mac’s history was zero information in dental school but heard about “nightguards” in dental trade magazines and dental labs.  It was the blind leading the blind. 
- Both Open Up and discuss the ridiculous “POP” which stands for Piece of Plastic that was almost worthless for most people. 
- A properly made Neuromuscular Orthotic is lightyears above a night guard and Mac explains how by using prescription glasses as an analogy. 
- Mac discusses his history of using different appliances over several decades including a Midpoint (Lucia Jig, NTI, Kois Deprogrammer) and the Tanner appliance, what worked, why they worked on some bite issues but not on others. 
- What separates TMD dentists like he and Pam from the other dental camps like Pankey, Dawson, Kois, Spear, AAOP, etc. was discussed. 
- Both believe all dental camps need to come together to find their likeness and share success’s to the benefit of the pain patient. 
- Pam shares experiences of interacting with a person in the medical profession that once again reinforced the fact that dentistry has failed the public due to TMD unawareness. 
- Mac discusses how sleep dentistry is changing the mindsets of the different TMD camps, yet the other camps and other medical professions cannot see and recognize the destruction the deficient maxilla can cause. 
- We discussed OTC appliances both good and bad. 
- Phase I and Phase II treatments plus the different types of surgery, including MMA, was discussed. 
- The importance of finding the right jaw position prior to any permanent change was stressed. 
- Changes in TMD unawareness is coming from the NIH, TMJ Association, and the American Academy of Orofacial Pain (AAOP) all working together for you the pain patient.

Important Links:

Podcast Video on Youtube:
 
Website TMD Link: https://marzbandds.com/tmj/   
 
Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0   
 
Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1

In this Episode:

• Pam shares story about a patient with Trigeminal Neuralgia which is an extremely painful condition, one that TMD can make worse and vice versa.
• If you have had problems with Trigeminal Neuralgia, this is an interesting Podcast!
• Pam discusses different treatments patient encountered over the years; the ones that did work and didn’t work.
• On top of medical issues, the patient had braces with four bicuspid extractions which in our experience can create a deficient maxilla which can compress the condyle, airway, and the Trigeminal Nerve.
• Pam treated her with a neuromuscular orthotic with a year of success meaning little to no pain.
• The patient, in her late 30’s, was tired of the orthotic and wanted options.
• Both the patient and Pam decided on orthodontics after careful consideration since both Pam and the patient knew where the upper and lower jaw/teeth relationship needed to be.  The orthotic would direct and drive the case.
• The case is now over seven years old.  Patient infrequently needs a minor adjustment on teeth, neck or hips, but no more pain to speak of.  Summary is a very appreciative patient and a very satisfied treating doctor.
• The topic turns to having a correct differential diagnosis, no matter who is doing the treatment.  If a medical doctor does not know how to diagnose TMD, they diagnose the wrong treatment.
• Trigeminal Neuralgia, migraines, cluster headaches, and some tumors, mimic TMD pain.  It is critically important that all health care professionals who treat these conditions know how to do a differential diagnosis.
• The big question in this podcast was, if no medical doctors, and few dentists have been trained in the proper diagnosis of TMD, how can there ever be a differential diagnosis.  Yes, we are Opening Up the real concerns facing the pain patient.
• The bite can irritate and put pressure on the Trigeminal Nerve which creates pain in the face.
• Biopsychosocial is discussed and how important it is in a differential diagnosis.
• TN surgery is discussed with the problem of returning pain.
• Both Pam and Mac are calling for everyone in the medical community to know/learn about the mouth and TMD.  The conversation gets quite emotional because of the frustration of the medical and dental community not working together.
• Another example is MD’s diagnosing a joint image as arthritis when in fact the bone defect is due to bone compression.  Mac fires Pam up on how frustrating it is for all.
• Joint anatomy is discussed in a very easy to understand examples.  Pam is even more fired up!!!!!
• Clicking joints discussed again because a clicking joint is a compressed joint.
• Mac surprises Pam with an analogy of why joints click.
• There are more variables in TMD and facial pain as stars in the sky.
• Neuromuscular dentists look at the whole body because everything is connected.
• There is no overall training of TMD in dental school.
Important Links:
 
Podcast Video on Youtube:
 
Website TMD Link: https://marzbandds.com/tmj/   
 
Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0   
 
Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1

In this Episode:

· Review of trifecta, with this podcast concentrating on posterior interferences
· What are posterior interferences? DIY diagnosis, sliding jaw forward and then sideways.
· Discuss patient difficulties in finding interferences.
· Discuss red and blue occlusal paper and how each of us use them
· T Scan and its abilities and uses on both teeth, dentures, fillings, crowns, FMR, and orthotics.
· The miraculous PDL, our built-in tire pressure sensor
· “My tooth was OK until you worked on it
· Abfractions
· The power of the Trigeminal Nerve

Important Links:
 
Podcast Video on Youtube: https://youtu.be/lgqR3LgfyyM?si=Ytjihs38AvKmv4sP   
 
Website TMD Link: https://marzbandds.com/tmj/   
 
Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0   
 
Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1

• Review of the Trifecta which includes deficient upper jaw, interferences with posterior teeth, and today’s topic, the torqued mandible.
• A torqued hip is when one side is lower or at a different angle than the other.  A torqued mandible is when one side hits before the other.
• A torqued mandible is like a porch swing with one chain being longer than the other.  That’s not a comfortable swing to sit in.
• It’s also like having one leg shorter than the other, at some point in life, there will be pain or destruction of spine, hips, etc.
Important Links:

Podcast Video on Youtube:

Website TMD Link: https://marzbandds.com/tmj/   

Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0   

Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1

In this Episode:

· People can have “bad” bites but no pain. Others can have basically the same bite with tremendous pain. No one knows why.
· In today’s and the next two episodes, we explain what the different “bad bites” look like.
· With an in-the-mouth exam on pain patients, both Pam and Mac look for three occlusal (the way the teeth hit) schemes that occur in almost all pain patients.
· These different schemes are called posterior interferences, torqued mandible, and a deficient maxilla, each will be explained beginning with the deficient maxilla.
· Mac explains how his enlightenment on the deficient maxilla changed his knowledge of helping the TMD pain patients.
· Pam reiterates how deficient maxilla occurs during development.
· The tongue is the sculpture of the jaws and it must do its job. When allowed to do its job, the mouth is shaped like a U. When it can't, the mouth is shaped like a V.
· There must be a balance of pressures between the tongue and the cheeks.
· With V shaped palates, the lower teeth have a hard time knowing where to fit.
· Deficient maxilla usually have crooked teeth, V shaped, and worn front teeth.
· The importance of watching your children and how they breathe.
· The role deficient maxilla has in joint noise, joint pain, and deviated opening and closing of the jaw.
· Pam discusses the needed equipment in diagnosing and treating TMJ pain.
· Mac discusses how jaw tracking equipment can track the backwards movement of the jaw on closing which compresses the TMJ and causes joint issues.
· Orthotics, and how they work in treating TMD, is briefly discussed.
· The difference between an orthotics and a mouth guard, Invisalign, etc.
Important Links:

Podcast Video on Youtube: https://youtu.be/lgqR3LgfyyM?si=Ytjihs38AvKmv4sP  

Website TMD Link: https://marzbandds.com/tmj/   

Dr. Pamela Marzban's book on Craniofacial Development:  https://www.amazon.com/Craniofacial-Development-Dr-Pamela-Marzban/dp/B098G94QQL/ref=sr_1_fkmr0_1?crid=1FEJSPFK1IDR7&dib=eyJ2IjoiMSJ9.ZrAmETl7xcks706SmJjttD7qk4dE1BBV1FnbS4MiPO_GjHj071QN20LucGBJIEps.uWl1dVxUzIsvz3JrnqFjWMvgaqVRwGOR82_vDZEmc5g&dib_tag=se&keywords=Dr+Pam+Marzban&qid=1710086758&s=books&sprefix=dr+pam+marzban%2Cstripbooks%2C111&sr=1-1-fkmr0   

Treatment of adult TMJ starts with a highly trained Neuromuscular dentist as described in Dr. Mac Lee's book: https://www.amazon.com/Life-Robbing-Pain-TMD-Why/dp/B08W7DPVKX/ref=sr_1_1?crid=9BYUZOCDLGT1&dib=eyJ2IjoiMSJ9.hLjNnJAem_aOOpsG6ZA0tUleW6q4adj9kEi2Ud_SXUygvISc5ttL_-W5x0RdU8b6H9Dk_teml8Ymzcjqn7r6aA.rK8BhnrI3S_maQ8wK5KchkwPEVQPa_CBq9CSCgd_0ws&dib_tag=se&keywords=dr+mac+lee&qid=1710086951&s=books&sprefix=Dr+Mac+%2Cstripbooks%2C111&sr=1-1